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Evaluating the application of Pareto navigation guided automated radiotherapy treatment planning to prostate cancer

Wheeler, Philip Anthony, Chu, Michael K., Holmes, Rosemary A., Woodley, Owain W., Jones, Ceri S., Maggs, Rhydian, Staffurth, John ORCID:, Palaniappan, Nachi, Spezi, Emiliano ORCID:, Lewis, David G., Campbell, Sue, Fitzgibbon, Jim and Millin, Anthony E 2019. Evaluating the application of Pareto navigation guided automated radiotherapy treatment planning to prostate cancer. Radiotherapy and Oncology 141 , pp. 220-226. 10.1016/j.radonc.2019.08.001

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Background and purpose Current automated planning methods do not allow for the intuitive exploration of clinical trade-offs during calibration. Recently a novel automated planning solution, which is calibrated using Pareto navigation principles, has been developed to address this issue. The purpose of this work was to clinically validate the solution for prostate cancer patients with and without elective nodal irradiation. Materials and methods For 40 randomly selected patients (20 prostate and seminal vesicles (PSV) and 20 prostate and pelvic nodes (PPN)) automatically generated volumetric modulated arc therapy plans (VMATAuto) were compared against plans created by expert dosimetrists under clinical conditions (VMATClinical) and no time pressures (VMATIdeal). Plans were compared through quantitative comparison of dosimetric parameters and blind review by an oncologist. Results Upon blind review 39/40 and 33/40 VMATAuto plans were considered preferable or equal to VMATClinical and VMATIdeal respectively, with all deemed clinically acceptable. Dosimetrically, VMATAuto, VMATClinical and VMATIdeal were similar, with observed differences generally of low clinical significance. Compared to VMATClinical, VMATAuto reduced hands-on planning time by 94% and 79% for PSV and PPN respectively. Total planning time was significantly reduced from 22.2 mins to 14.0 mins for PSV, with no significant reduction observed for PPN. Conclusions A novel automated planning solution has been evaluated, whose Pareto navigation based calibration enabled clinical decision-making on trade-off balancing to be intuitively incorporated into automated protocols. It was successfully applied to two sites of differing complexity and robustly generated high quality plans in an efficient manner.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0167-8140
Date of First Compliant Deposit: 10 September 2019
Date of Acceptance: 12 August 2019
Last Modified: 02 Dec 2023 18:24

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