The purpose of this feasibility study is to develop a fully automated procedure capable of generating treatment plans with multiple fractionation schemes to improve speed, robustness, and standardization of plan quality. A fully automated script was implemented for spinal stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT) plan generation using Eclipse v15.6 API. The script interface allows multiple dose/fractionation plan requests, planning target volume (PTV) expansions, as well as information regarding distance/overlap between spinal cord and targets to drive decision‐making. For each requested plan, the script creates the course, plans, field arrangements, and automatically optimizes and calculates dose. The script was retrospectively applied to ten computed tomography (CT) scans of previous cervical, thoracic, and lumbar spine SBRT patients. Three plans were generated for each patient — simultaneous integrated boost (SIB) 1800/1600 cGy to gross tumor volume (GTV)/PTV in one fraction; SIB 2700/2100 cGy to GTV/PTV in three fractions; and 3000 cGy to PTV in five fractions. Plan complexity and deliverability patient‐specific quality assurance (QA) was performed using ArcCHECK with an Exradin A16 chamber inserted. Dose objectives were met for all organs at risk (OARs) for each treatment plan. Median target coverage was GTV V100% = 87.3%, clinical target volume (CTV) V100% = 95.7% and PTV V100% = 88.0% for single fraction plans; GTV V100% = 95.6, CTV V100% = 99.6% and PTV V100% = 97.2% for three fraction plans; and GTV V100% = 99.6%, CTV V100% = 99.1% and PTV V100% = 97.2% for five fraction plans. All plans (n = 30) passed patient‐specific QA (>90%) at 2%/2 mm global gamma. A16 chamber dose measured at isocenter agreed with planned dose within 3% for all cases. Automatic planning for spine SRS/SBRT through scripting increases efficiency, standardizes plan quality and approach, and provides a tool for target coverage comparison of different fractionation schemes without the need for additional resources.

中文翻译：

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使用Varian Eclipse脚本实现脊柱立体定向放射外科手术和立体定向身体放射疗法治疗计划的完全自动化。

这项可行性研究的目的是开发一种全自动程序，该程序能够生成具有多个分级方案的治疗计划，以提高速度，健壮性和计划质量的标准化。使用Eclipse v15.6 API生成了全自动脚本，用于脊柱立体定向放射外科/立体定向放射治疗（SRS / SBRT）计划生成。脚本界面允许多个剂量/分级计划请求，计划目标体积（PTV）扩展以及有关脊髓与目标之间距离/重叠的信息，以推动决策。对于每个请求的计划，脚本都会创建课程，计划，现场布置，并自动优化和计算剂量。该脚本被追溯应用于以前的颈椎，胸椎，和腰椎SBRT患者。为每位患者生成了三个计划-将总集成肿瘤体积（GTV）/ PTV的同时集成增强（SIB）1800/1600 cGy降低为一小部分；SIB 2700/2100 cGy转换为GTV / PTV的三个部分；和3000 cGy分为五个部分传送到PTV。计划的复杂性和可交付性使用ArcCHECK并插入Exradin A16腔室进行患者特定的质量保证（QA）。每个治疗计划的所有处于危险中的器官（OAR）的剂量目标均已达到。单份计划的中位目标覆盖率是GTV V100％= 87.3％，临床目标量（CTV）V100％= 95.7％和PTV V100％= 88.0％；三个分段计划的GTV V100％= 95.6，CTV V100％= 99.6％和PTV V100％= 97.2％；和GTV V100％= 99.6％，CTV V100％= 99.1％和PTV V100％= 97.2％。所有计划（n = 30）通过了患者特定的质量检查（> 90％）在2％/ 2毫米的整体伽玛值下。在所有情况下，在等角点处测量的A16腔室剂量与计划剂量相吻合在3％以内。通过脚本自动规划脊柱SRS / SBRT，可以提高效率，标准化计划质量和方法，并提供了一种工具，可以比较不同分级方案的目标覆盖率，而无需额外的资源。