Two non-parametric methods for derivation of constraints from radiotherapy dose-histogram data

Phys Med Biol. 2014 Jul 7;59(13):N101-11. doi: 10.1088/0031-9155/59/13/N101. Epub 2014 Jun 12.

Abstract

Dose constraints based on histograms provide a convenient and widely-used method for informing and guiding radiotherapy treatment planning. Methods of derivation of such constraints are often poorly described. Two non-parametric methods for derivation of constraints are described and investigated in the context of determination of dose-specific cut-points-values of the free parameter (e.g., percentage volume of the irradiated organ) which best reflect resulting changes in complication incidence. A method based on receiver operating characteristic (ROC) analysis and one based on a maximally-selected standardized rank sum are described and compared using rectal toxicity data from a prostate radiotherapy trial. Multiple test corrections are applied using a free step-down resampling algorithm, which accounts for the large number of tests undertaken to search for optimal cut-points and the inherent correlation between dose-histogram points. Both methods provide consistent significant cut-point values, with the rank sum method displaying some sensitivity to the underlying data. The ROC method is simple to implement and can utilize a complication atlas, though an advantage of the rank sum method is the ability to incorporate all complication grades without the need for grade dichotomization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Follow-Up Studies
  • Humans
  • ROC Curve
  • Radiation Dosage*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Statistics, Nonparametric
  • Treatment Outcome