Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance

Jim P. Tol, Max Dahele, Vincent Gregoire, Jens Overgaard, Ben J. Slotman, Wilko F. A. R. Verbakel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. Materials and methods: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (Ptrial). RapidPlan plans (Prapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between Prapidplan mean predicted/achieved OAR doses, and Ptrial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). Results: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in Prapidplan. Using predicted Prapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. Discussion: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes.
Original languageEnglish
Pages (from-to)75-81
Number of pages7
JournalRadiotherapy and Oncology
Volume130
Early online date2018
DOIs
Publication statusPublished - 1 Jan 2019

Cite this

@article{8f6a105598454c83905ddc425189eb62,
title = "Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance",
abstract = "Introduction: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. Materials and methods: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (Ptrial). RapidPlan plans (Prapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between Prapidplan mean predicted/achieved OAR doses, and Ptrial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). Results: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in Prapidplan. Using predicted Prapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. Discussion: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes.",
author = "Tol, {Jim P.} and Max Dahele and Vincent Gregoire and Jens Overgaard and Slotman, {Ben J.} and Verbakel, {Wilko F. A. R.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.radonc.2018.10.005",
language = "English",
volume = "130",
pages = "75--81",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance

AU - Tol, Jim P.

AU - Dahele, Max

AU - Gregoire, Vincent

AU - Overgaard, Jens

AU - Slotman, Ben J.

AU - Verbakel, Wilko F. A. R.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. Materials and methods: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (Ptrial). RapidPlan plans (Prapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between Prapidplan mean predicted/achieved OAR doses, and Ptrial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). Results: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in Prapidplan. Using predicted Prapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. Discussion: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes.

AB - Introduction: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. Materials and methods: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (Ptrial). RapidPlan plans (Prapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between Prapidplan mean predicted/achieved OAR doses, and Ptrial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). Results: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in Prapidplan. Using predicted Prapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. Discussion: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85055050620&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30348462

U2 - 10.1016/j.radonc.2018.10.005

DO - 10.1016/j.radonc.2018.10.005

M3 - Article

VL - 130

SP - 75

EP - 81

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

ER -