Radiotherapy Plan Quality Assurance in NRG Oncology Trials for Brain and Head/Neck Cancers: An AI-Enhanced Knowledge-Based Approach

Author:

Wang Du1ORCID,Geng Huaizhi1,Gondi Vinai2,Lee Nancy Y.3,Tsien Christina I.4,Xia Ping5,Chenevert Thomas L.6ORCID,Michalski Jeff M.7,Gilbert Mark R.8,Le Quynh-Thu9ORCID,Omuro Antonio M.9,Men Kuo1,Aldape Kenneth D.8,Cao Yue6,Srinivasan Ashok6,Barani Igor J.10,Sachdev Sean2,Huang Jiayi7,Choi Serah11,Shi Wenyin12,Battiste James D.13,Wardak Zabi14,Chan Michael D.15,Mehta Minesh P.16,Xiao Ying1ORCID

Affiliation:

1. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA

2. Northwestern Medicine Cancer Center Warrenville, Warrenville, IL 60555, USA

3. Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA

4. McGill University Health Centre, Montreal, QC H4A 3J1, Canada

5. Cleveland Clinic Foundation, Cleveland, OH 44195, USA

6. Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA

7. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA

8. National Cancer Institute, Bethesda, MD 20892, USA

9. Stanford Cancer Institute, Stanford, CA 94305, USA

10. Saint Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA

11. UPMC-Shadyside Hospital, Case Western Reserve University, Pittsburgh, PA 15232, USA

12. Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA

13. Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA

14. UT Southwestern, Simmons Cancer Center, Dallas, TX 75235, USA

15. Baptist Comprehensive Cancer Center, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA

16. Miami Cancer Institute, Miami, FL 33176, USA

Abstract

The quality of radiation therapy (RT) treatment plans directly affects the outcomes of clinical trials. KBP solutions have been utilized in RT plan quality assurance (QA). In this study, we evaluated the quality of RT plans for brain and head/neck cancers enrolled in multi-institutional clinical trials utilizing a KBP approach. The evaluation was conducted on 203 glioblastoma (GBM) patients enrolled in NRG-BN001 and 70 nasopharyngeal carcinoma (NPC) patients enrolled in NRG-HN001. For each trial, fifty high-quality photon plans were utilized to build a KBP photon model. A KBP proton model was generated using intensity-modulated proton therapy (IMPT) plans generated on 50 patients originally treated with photon RT. These models were then applied to generate KBP plans for the remaining patients, which were compared against the submitted plans for quality evaluation, including in terms of protocol compliance, target coverage, and organ-at-risk (OAR) doses. RT plans generated by the KBP models were demonstrated to have superior quality compared to the submitted plans. KBP IMPT plans can decrease the variation of proton plan quality and could possibly be used as a tool for developing improved plans in the future. Additionally, the KBP tool proved to be an effective instrument for RT plan QA in multi-center clinical trials.

Funder

NRG Oncology Network Group Operations Center

Radiation Oncology Core (IROC) Group

Publisher

MDPI AG

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