Development and validation of an automated Tomotherapy planning method for cervical cancer-Reference-Cited by-同舟云学术

Development and validation of an automated Tomotherapy planning method for cervical cancer

Published:2024-07-08 Issue:1 Volume:19 Page:
ISSN:1748-717X
Container-title:Radiation Oncology
language:en
Short-container-title:Radiat Oncol

Author:

Han Feiru,Xue Yi,Huang Sheng,Lu Tong,Yang Yining,Cao Yuanjie,Chen Jie,Hou Hailing,Sun Yao,Wang Wei,Yuan Zhiyong,Tao Zhen,Jiang Shengpeng

Abstract

Abstract Purpose This study aimed to develop an automated Tomotherapy (TOMO) planning method for cervical cancer treatment, and to validate its feasibility and effectiveness. Materials and methods The study enrolled 30 cervical cancer patients treated with TOMO at our center. Utilizing scripting and Python environment within the RayStation (RaySearch Labs, Sweden) treatment planning system (TPS), we developed automated planning methods for TOMO and volumetric modulated arc therapy (VMAT) techniques. The clinical manual TOMO (M-TOMO) plans for the 30 patients were re-optimized using automated planning scripts for both TOMO and VMAT, creating automated TOMO (A-TOMO) and automated VMAT (A-VMAT) plans. We compared A-TOMO with M-TOMO and A-VMAT plans. The primary evaluated relevant dosimetric parameters and treatment plan efficiency were assessed using the two-sided Wilcoxon signed-rank test for statistical analysis, with a P-value < 0.05 indicating statistical significance. Results A-TOMO plans maintained similar target dose uniformity compared to M-TOMO plans, with improvements in target conformity and faster dose drop-off outside the target, and demonstrated significant statistical differences (P+ < 0.01). A-TOMO plans also significantly outperformed M-TOMO plans in reducing V50Gy, V40Gy and Dmean for the bladder and rectum, as well as Dmean for the bowel bag, femoral heads, and kidneys (all P+ < 0.05). Additionally, A-TOMO plans demonstrated better consistency in plan quality. Furthermore, the quality of A-TOMO plans was comparable to or superior than A-VMAT plans. In terms of efficiency, A-TOMO significantly reduced the time required for treatment planning to approximately 20 min. Conclusion We have successfully developed an A-TOMO planning method for cervical cancer. Compared to M-TOMO plans, A-TOMO plans improved target conformity and reduced radiation dose to OARs. Additionally, the quality of A-TOMO plans was on par with or surpasses that of A-VMAT plans. The A-TOMO planning method significantly improved the efficiency of treatment planning.

Publisher

Springer Science and Business Media LLC

Link

https://link.springer.com/content/pdf/10.1186/s13014-024-02482-x.pdf

Reference38 articles.

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.

2. Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, Clarke-Pearson DL, Insalaco S. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144–53. https://doi.org/10.1056/nejm199904153401502.

3. Hänsgen G, Kuhnt T, Pigorsch S, Strauss H, Dunst J. Adjuvant simultaneous radiochemotherapy after operated uterine cervix carcinoma in high risk situation. Results of a pilot study. Strahlenther Onkol. 2002;178(2):71–7. https://doi.org/10.1007/s00066-002-0914-y.

4. Ryu HS, Chun M, Chang KH, Chang HJ, Lee JP. Postoperative adjuvant concurrent chemoradiotherapy improves survival rates for high-risk, early stage cervical cancer patients. Gynecol Oncol. 2005;96(2):490–5. https://doi.org/10.1016/j.ygyno.2004.10.038.

5. Rubinsak LA, Kang L, Fields EC, Carter JS, McGuire WP, Temkin SM. Treatment-related radiation toxicity among cervical cancer patients. Int J Gynecol Cancer. 2018;28(7):1387–93. https://doi.org/10.1097/igc.0000000000001309.