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Dose Auto-Planning Intensity Modulated Radiotherapy Treatment Planning for Central Lung Cancer Improve Plan Quality?

H Chen*, H Wang , Y Shao , H Gu , J Wang , Z Xu , shanghai chest hospital, shanghai jiaotong university, Shanghai, shanghai


(Sunday, 7/29/2018) 3:00 PM - 6:00 PM

Room: Exhibit Hall

Purpose: To investigate the performance of Auto-Planning intensity modulated radiation therapy(IMRT) plan for patients with central lung cancer, and whether Auto-Planning improve the quality of IMRT plans.

Methods: Thirty patients treated with IMRT for central lung cancer were re-planned with Pinnacle³ Auto-Planning module. The target dose distribution, organs at risk(OAR) sparing, the dose distribution of normal tissues in the ring within 3cm distance outside of the target and the low-dose region outside of this ring, monitor units(MU) and the efficiency of MU were evaluated. Wilcoxon signed rank test was used to check for significant differences (p<0.05) between datasets.

Results: The target homogeneity in Auto-Planning was significantly better than the manual plan, but manual plans significantly improved conformability. Auto-Planning had lower lung of V₅, V�₀, V�₃, V₂₀, V₃₀, V₄₀, MLD(p<0.01); Spinal cord of maximum dose(p<0.01); and heart of V₃₀(p<0.01); no significantly different in heart of V₄₀ as compared with manual plans(p=0.088). The mean dose and D₂ of the ring 5mm away from target were reduced with Auto-Planning, however the mean dose, D₂ and D₅ in the rings between 1cm and 3cm outside the target were significantly increased. In 11 plans, 6000cGy hot spots appeared in the low-dose region for Auto-Planning, although Auto-Planning reduce 4000cGy dose volume in this region, the hot spots 5400cGy dose volume was significantly increased as compared with manual plans. MUs were added by 5.3% in Auto-Planning, the MU delivery efficiency of the Auto-Planning (39.3 cm²/MU) was lower than that of the manual plans (46.1 cm²/MU).

Conclusion: Auto-planning achieved highly quality consistent and OAR spring, but for some plans, the dose in the rings between 1cm and 3cm outside the target increased in Auto-planning, and hot spots appeared in the low-dose region. It was recommended to be combined with further manual processing, especially hot spot processing.

Funding Support, Disclosures, and Conflict of Interest: Funding Support: This work was supported by Shanghai Hospital Development Center "Three-year plan of action for promoting clinical skills and clinical innovation in municipal hospitals" (No.16CR3056A).


Lung, Radiation Therapy, Treatment Planning


TH- External beam- photons: treatment planning/virtual clinical studies

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