1. Knowledge-based plan optimization for prostate SBRT delivered with CyberKnife according to RTOG0938 protocol.
- Author
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Monticelli, Davide, Castriconi, Roberta, Tudda, Alessia, Fodor, Andrei, Deantoni, Chiara, Gisella Di Muzio, Nadia, Mangili, Paola, del Vecchio, Antonella, Fiorino, Claudio, and Broggi, Sara
- Abstract
• KB planning was applied to SBRT prostate cancer with CyberKnife. • The KB model generated DVH prediction for the bladder, the rectum and femoral heads. • A KB-based template was efficiently tuned for both sequential and VOLO algorithms. • The KB-model was able to generate high-quality automatic plans for both modalities. To extend the knowledge-based (KB) automatic planning approach to CyberKnife in the case of Stereotactic Body Radiation Therapy (SBRT) for prostate cancer. Seventy-two clinical plans of patients treated according to the RTOG0938 protocol (36.25 Gy/5fr) with CyberKnife were exported from the CyberKnife system to Eclipse to train a KB-model using the Rapid Plan tool. The KB approach provided dose-volume objectives for specific OARs only and not PTV. Bladder, rectum and femoral heads were considered in the model. The KB-model was successfully trained on 51 plans and then validated on 20 new patients. A KB-based template was tuned in the Precision system for both sequential optimization (SO) and VOLO optimization algorithms. Plans of the validation group were re-optimized (KB-TP) using both algorithms without any operator intervention and compared against the original plans (TP) in terms of OARs/PTV dose-volume parameters. Paired Wilcoxon signed-rank tests were performed to assess statistically significant differences (p < 0.05). Regarding SO, automatic KB-TP plans were generally better than or equivalent to TP plans. PTVs V95% was slightly worse while OARs sparing for KB-TP was significantly improved. Regarding VOLO optimization, the PTVs coverage was significantly better for KB-TP while there was a limited worsening in the rectum. A significant improvement was observed in the bladder in the range of low-intermediate doses. An extension of the KB optimization approach to the CyberKnife system has been successfully developed and validated in the case of SBRT prostate cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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