Purpose

Radiation treatment planning for head and neck cancer is a complex process with much variability; automated treatment planning is a promising option to improve plan quality and efficiency. This study compared radiation plans generated from a fully automated radiation treatment planning system to plans generated manually that had been clinically approved and delivered.

Methods and Materials

The study cohort consisted of 50 patients treated by a specialized head and neck cancer team at a tertiary care center. An automated radiation treatment planning system, the Radiation Planning Assistant, was used to create autoplans for all patients using their original, approved contours. Common dose-volume histogram (DVH) criteria were used to compare the quality of autoplans to the clinical plans. Fourteen radiation oncologists, each from a different institution, then reviewed and compared the autoplans and clinical plans in a blinded fashion.

Results

Autoplans and clinical plans were very similar with regard to DVH metrics for coverage and critical structure constraints. Physician reviewers found both the clinical plans and autoplans acceptable for use; overall, 78% of the clinical plans and 88% of the autoplans were found to be usable as is (without any edits). When asked to choose which plan would be preferred for approval, 27% of physician reviewers selected the clinical plan, 47% selected the autoplan, 25% said both were equivalent, and 0% said neither. Hence, overall, 72% of physician reviewers believed the autoplan or either the clinical or autoplan was preferable.

Conclusions

Automated radiation treatment planning creates consistent, clinically acceptable treatment plans that meet DVH criteria and are found to be appropriate on physician review.

中文翻译：

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使用放射计划助手对头颈癌进行自动放射治疗计划的临床可接受性

目的

头颈癌的放射治疗计划是一个复杂的过程，具有很大的可变性。自动化治疗计划是提高计划质量和效率的一种有前途的选择。本研究将全自动放射治疗计划系统生成的放射计划与手动生成的已获得临床批准和交付的计划进行了比较。

方法和材料

该研究队列由 50 名在三级护理中心接受专门头颈癌团队治疗的患者组成。一个自动化的放射治疗计划系统，即放射计划助手，被用来为所有使用其原始、批准的轮廓的患者创建自动计划。常用剂量体积直方图 (DVH) 标准用于比较自动计划与临床计划的质量。十四名放射肿瘤学家，每人来自不同的机构，然后以盲目的方式审查和比较自动计划和临床计划。

结果

Autoplans 和临床计划在覆盖范围和关键结构约束的 DVH 指标方面非常相似。医师审阅者发现临床计划和自动计划都可以使用；总体而言，发现 78% 的临床计划和 88% 的自动计划可按原样使用（未经任何编辑）。当被要求选择哪个计划更适合批准时，27% 的医师审阅者选择了临床计划，47% 选择了自动计划，25% 的人表示两者都相同，0% 的人表示两者都没有。因此，总体而言，72% 的医师审阅者认为自动计划或临床或自动计划更可取。

结论

自动放射治疗计划创建符合 DVH 标准的一致的、临床上可接受的治疗计划，并且在医生审查中被认为是合适的。