Functional-guided radiotherapy using knowledge-based planning

Publication date: Available online 5 April 2018
Source:Radiotherapy and Oncology
Author(s): Austin M. Faught, Lindsey Olsen, Leah Schubert, Chad Rusthoven, Edward Castillo, Richard Castillo, Jingjing Zhang, Thomas Guerrero, Moyed Miften, Yevgeniy Vinogradskiy
Background and purposeThere are two significant challenges when implementing functional-guided radiotherapy using 4DCT-ventilation imaging: (1) lack of knowledge of realistic patient specific dosimetric goals for functional lung and (2) ensuring consistent plan quality across multiple planners. Knowledge-based planning (KBP) is positioned to address both concerns.Material and methodsA KBP model was created from 30 previously planned functional-guided lung patients. Standard organs at risk (OAR) in lung radiotherapy and a ventilation contour delineating areas of high ventilation were included. Model validation compared dose-metrics to standard OARs and functional dose-metrics from 20 independent cases that were planned with and without KBP.ResultsA significant improvement was observed for KBP optimized plans in V20Gy and mean dose to functional lung (p = 0.005 and 0.001, respectively), V20Gy and mean dose to total lung minus GTV (p = 0.002 and 0.01, respectively), and mean doses to esophagus (p = 0.005).ConclusionThe current work developed a KBP model for functional-guided radiotherapy. Modest, but statistically significant, improvements were observed in functional lung and total lung doses.



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