Planning evaluation of a novel volume-based algorithm for personalized optimization of lung dose in VMAT for esophageal cancer

Chen-Xiong Hsu; Kuan-Heng Lin; Shan-Ying Wang; Wei-Ta Tsai; Chiu-Han Chang; Hui-Ju Tien; Pei-Wei Shueng; Tung-Hsin Wu; Greta S P Mok

doi:10.1038/s41598-021-04571-3

Planning evaluation of a novel volume-based algorithm for personalized optimization of lung dose in VMAT for esophageal cancer

Sci Rep. 2022 Feb 15;12(1):2513. doi: 10.1038/s41598-021-04571-3.

Authors

Chen-Xiong Hsu^#^{1

2}, Kuan-Heng Lin^#^{1

2

3}, Shan-Ying Wang^{1

4}, Wei-Ta Tsai¹, Chiu-Han Chang², Hui-Ju Tien^{1

2}, Pei-Wei Shueng^{5

6}, Tung-Hsin Wu⁷, Greta S P Mok⁸

Affiliations

¹ Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
³ Industrial Ph.D. Program of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁵ Division of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan. shuengsir@gmail.com.
⁶ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. shuengsir@gmail.com.
⁷ Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. tung@ym.edu.tw.
⁸ Biomedical Imaging Laboratory, Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau, SAR, China.

^# Contributed equally.

Abstract

Radiotherapy treatment planning (RTP) is time-consuming and labor-intensive since medical physicists must devise treatment plans carefully to reduce damage to tissues and organs for patients. Previously, we proposed the volume-based algorithm (VBA) method, providing optimal partial arcs (OPA) angle to achieve the low-dose volume of lungs in dynamic arc radiotherapy. This study aimed to implement the VBA for esophageal cancer (EC) patients and compare the lung dose and delivery time between full arcs (FA) without using VBA and OPA angle using VBA in volumetric modulated arc therapy (VMAT) plans. We retrospectively included 30 patients diagnosed with EC. RTP of each patient was replanned to 4 VMAT plans, including FA plans without (FA-C) and with (FA + C) dose constraints of OARs and OPA plans without (OPA-C) and with (OPA + C) dose constraints of OARs. The prescribed dose was 45 Gy. The OARs included the lungs, heart, and spinal cord. The dose distribution, dose-volume histogram, monitor units (MUs), delivery time, and gamma passing rates were analyzed. The results showed that the lung V₅ and V₁₀ in OPA + C plans were significantly lower than in FA + C plans (p < 0.05). No significant differences were noted in planning target volume (PTV) coverage, lung V₁₅, lung V₂₀, mean lung dose, heart V₃₀, heart V₄₀, mean heart dose, and maximal spinal cord dose between FA + C and OPA + C plans. The delivery time was significantly longer in FA + C plans than in OPA + C plans (237 vs. 192 s, p < 0.05). There were no significant differences between FA + C and OPA + C plans in gamma passing rates. We successfully applied the OPA angle based on the VBA to clinical EC patients and simplified the arc angle selection in RTP. The VBA could provide a personalized OPA angle for each patient and effectively reduce lung V₅, V_10, and delivery time in VMAT.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Algorithms*
Esophageal Neoplasms / radiotherapy*
Female
Humans
Lung / radiation effects*
Male
Middle Aged
Organs at Risk / radiation effects*
Precision Medicine / methods*
Radiation Oncology / methods
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted / methods*
Radiotherapy, Intensity-Modulated / methods*
Retrospective Studies
Treatment Outcome