Feasibility of Automatic Treatment Planning in Intensity-modulated Radiotherapy of Nasopharyngeal Carcinoma_Journal of Biomedical Engineering

Authors：

HEYinbo ¹ , ZHANGLongbin ² ,  XIAOJianghong ¹ , DUANBaofeng ¹

1. Center for Radiation Physics and Technology Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Chongqing Three Gorges Central Hospital, Chongqing 404100, China;

Corresponding author：

XIAOJianghong, Email: huaxixiao@126.com

Keywords：

nasopharyngeal carcinoma; intensity-modulated radiotherapy; automatic treatment planning

DOI：

10.7507/1001-5515.20150229

Video：

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Intensity-modulated radiotherapy planning for nasopharyngeal carcinoma is very complex. The quality of plan is often closely linked to the experience of the treatment planner. In this study, 10 nasopharyngeal carcinoma patients at different stages were enrolled. Based on the scripting of Pinnacle³ 9.2 treatment planning system, the computer program was used to set the basic parameters and objective parameters of the plans. At last, the nasopharyngeal carcinoma intensity-modulated radiotherapy plans were completed automatically. Then, the automatical and manual intensity-modulated radiotherapy plans were statistically compared and clinically evaluated. The results showed that there were no significant differences between those two kinds of plans with respect to the dosimetry parameters of most targets and organs at risk. The automatical nasopharyngeal carcinoma intensity-modulated radiotherapy plans can meet the requirements of clinical radiotherapy, significantly reduce planning time, and avoid the influence of human factors such as lack of experience to the quality of plan.

Citation： HEYinbo, ZHANGLongbin, XIAOJianghong, DUANBaofeng. Feasibility of Automatic Treatment Planning in Intensity-modulated Radiotherapy of Nasopharyngeal Carcinoma. Journal of Biomedical Engineering, 2015, 32(6): 1288-1293. doi: 10.7507/1001-5515.20150229 Copy

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2.	LEE N, HARRIS J, GARDEN A S, et al. Intensity-modulated radiationtherapy with or without chemotherapy for nasopharyngealcarcinoma:Radiation therapy oncology group PhaseⅡtrial0225[J]. J Clin Oncol, 2009, 27:3684-3690.
3.	NUTTING C, DEARNALEY D P, WEBB S. Intensitymodulated radiation therapy:A clinical review[J]. Br J Radiol, 2000, 73:459-469.
4.	ZENG L, TIAN Y-m, SUN X-m, et al. Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma:patient and treatment-related risk factors[J]. Br J Cancer, 2014, 110(1):49-54.
5.	POW E H, KWONG D L, MCMILLAN A S, et al. Xerostomia and quality of Life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma:initial report on a randomized controlled clinical trial[J]. Int J Radiat Oncol Biol Phys, 2006, 66(4):981-991.
6.	LEE N, XIA P, QUIVEY J M, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:An update of the UCSF experience[J]. Int J Radiat Oncol Biol Phys, 2002, 53(1):12-22.
7.	KAM M K, LEUNG S F, ZEE B, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients[J]. J Clin Oncol, 2007, 25(31):4873-4879.
8.	LEE A W, NG W T, HUNG W M, et al. Major late toxicities after conformal radiotherapy for nasopharyngeal carcinoma-patient-and treatment-related risk factors[J]. Int J Radiat Oncol Biol Phys, 2009, 73(4):1121-1128.
9.	BOHSUNG J, GILLIS S, ARRANS R, et al. IMRT treatment planning:-a comparative inter-system and inter-centre planning exercise of the ESTRO Quasimodo group[J]. Radiother Oncol, 2005, 76(3):354-361.
10.	CHUNG H T, LEE B, PARK E, et al. Can all centers plan intensity-modulated radiotherapy (IMRT) effectively? An external audit of dosimetric comparisons between three-dimensional conformal radiotherapy and IMRT for adjuvant chemoradiation for gastric Cancer[J]. Int J Radiat Oncol Biol Phys, 2008, 71(4):1167-1174.
11.	YAN D, VICINI F, WONG J, et al. Adaptive radiation therapy[J]. Phys Med Biol, 1997, 42(1):123-132.
12.	BREEDVELD S, STORCHI P R, KEIJZER M A, et al. A novel approach to multi-criteria inverse planning for IMRT[J]. Phys Med Biol, 2007, 52(20):6339-6353.
13.	VOET P W, DIRKX M L, BREEDVELD S, et al. Toward fully automated multicriterial plan Generation:a prospective clinical study[J]. Int J Radiat Oncol Biol Phys, 2013, 85(3):866-872.
14.	ZHANG Xiaodong, LI Xiaoqiang, QUAN E M, et al. A methodology for automatic intensity-modulated radiation treatment planning for lung Cancer[J]. Phys Med Biol, 2011, 56(13):3873-3893.
15.	WU B, RICCHETTI F, SANGUINETI G, et al. Data-driven approach to generating achievable dose-volume histogram objectives in intensity-modulated radiotherapy planning[J]. Int J Radiat Oncol Biol Phys, 2011, 79(4):1241-1247.
16.	ZAREPISHEH M, LONG T, LI Nan, et al. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning[J]. Med Phys, 2014, 41(6):061711.
17.	中国鼻咽癌临床分期工作委员会.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志, 2011, 20(4):267-269.
18.	柏朋刚.基于数据驱动的鼻咽癌调强计划自动化设计[J].医疗装备, 2013, 26(2):6-9.
19.	FREDRIKSSON A. Automated improvement of radiation therapy treatment plans by optimization under reference dose constraints[J]. Phys Med Biol, 2012, 57(23):7799-7811.
20.	LI Nan, ZAREPISHEH M, URIBE-SANCHEZ A, et al. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs[J]. Phys Med Biol, 2013, 58(24):8725-8738.

1. MCDERMOTT A L, DUTT S N, WATKINSON J C. The aetiology of nasopharyngeal carcinoma[J]. Clin Otolaryngol Allied Sci, 2001, 26(2):82-92.
2. LEE N, HARRIS J, GARDEN A S, et al. Intensity-modulated radiationtherapy with or without chemotherapy for nasopharyngealcarcinoma:Radiation therapy oncology group PhaseⅡtrial0225[J]. J Clin Oncol, 2009, 27:3684-3690.
3. NUTTING C, DEARNALEY D P, WEBB S. Intensitymodulated radiation therapy:A clinical review[J]. Br J Radiol, 2000, 73:459-469.
4. ZENG L, TIAN Y-m, SUN X-m, et al. Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma:patient and treatment-related risk factors[J]. Br J Cancer, 2014, 110(1):49-54.
5. POW E H, KWONG D L, MCMILLAN A S, et al. Xerostomia and quality of Life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma:initial report on a randomized controlled clinical trial[J]. Int J Radiat Oncol Biol Phys, 2006, 66(4):981-991.
6. LEE N, XIA P, QUIVEY J M, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:An update of the UCSF experience[J]. Int J Radiat Oncol Biol Phys, 2002, 53(1):12-22.
7. KAM M K, LEUNG S F, ZEE B, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients[J]. J Clin Oncol, 2007, 25(31):4873-4879.
8. LEE A W, NG W T, HUNG W M, et al. Major late toxicities after conformal radiotherapy for nasopharyngeal carcinoma-patient-and treatment-related risk factors[J]. Int J Radiat Oncol Biol Phys, 2009, 73(4):1121-1128.
9. BOHSUNG J, GILLIS S, ARRANS R, et al. IMRT treatment planning:-a comparative inter-system and inter-centre planning exercise of the ESTRO Quasimodo group[J]. Radiother Oncol, 2005, 76(3):354-361.
10. CHUNG H T, LEE B, PARK E, et al. Can all centers plan intensity-modulated radiotherapy (IMRT) effectively? An external audit of dosimetric comparisons between three-dimensional conformal radiotherapy and IMRT for adjuvant chemoradiation for gastric Cancer[J]. Int J Radiat Oncol Biol Phys, 2008, 71(4):1167-1174.
11. YAN D, VICINI F, WONG J, et al. Adaptive radiation therapy[J]. Phys Med Biol, 1997, 42(1):123-132.
12. BREEDVELD S, STORCHI P R, KEIJZER M A, et al. A novel approach to multi-criteria inverse planning for IMRT[J]. Phys Med Biol, 2007, 52(20):6339-6353.
13. VOET P W, DIRKX M L, BREEDVELD S, et al. Toward fully automated multicriterial plan Generation:a prospective clinical study[J]. Int J Radiat Oncol Biol Phys, 2013, 85(3):866-872.
14. ZHANG Xiaodong, LI Xiaoqiang, QUAN E M, et al. A methodology for automatic intensity-modulated radiation treatment planning for lung Cancer[J]. Phys Med Biol, 2011, 56(13):3873-3893.
15. WU B, RICCHETTI F, SANGUINETI G, et al. Data-driven approach to generating achievable dose-volume histogram objectives in intensity-modulated radiotherapy planning[J]. Int J Radiat Oncol Biol Phys, 2011, 79(4):1241-1247.
16. ZAREPISHEH M, LONG T, LI Nan, et al. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning[J]. Med Phys, 2014, 41(6):061711.
17. 中国鼻咽癌临床分期工作委员会.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志, 2011, 20(4):267-269.
18. 柏朋刚.基于数据驱动的鼻咽癌调强计划自动化设计[J].医疗装备, 2013, 26(2):6-9.
19. FREDRIKSSON A. Automated improvement of radiation therapy treatment plans by optimization under reference dose constraints[J]. Phys Med Biol, 2012, 57(23):7799-7811.
20. LI Nan, ZAREPISHEH M, URIBE-SANCHEZ A, et al. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs[J]. Phys Med Biol, 2013, 58(24):8725-8738.

Journal of Biomedical Engineering

Feasibility of Automatic Treatment Planning in Intensity-modulated Radiotherapy of Nasopharyngeal Carcinoma

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