PMID- 37914563
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 49
IP  - 1
DP  - 2024 Spring
TI  - Advancing knowledge-based intensity modulated proton planning for adaptive 
      treatment of high-risk prostate cancer.
PG  - 19-24
LID - S0958-3947(23)00094-8 [pii]
LID - 10.1016/j.meddos.2023.10.001 [doi]
AB  - To assess the performance of a knowledge-based planning (KBP) model for 
      generating intensity-modulated proton therapy (IMPT) treatment plans as part of 
      an adaptive radiotherapy (ART) strategy for patients with high-risk prostate 
      cancer. A knowledge-based planning (KBP) model for proton adaptive treatment plan 
      generation was developed based on thirty patient treatment plans utilizing 
      RapidPlan(TM) PT (Varian Medical Systems, Palo Alto, CA). The model was 
      subsequently validated using an additional eleven patient cases. All patients in 
      the study were administered a prescribed dose of 70.2 Gy to the prostate and 
      seminal vesicle (CTV70.2), along with 46.8 Gy to the pelvic lymph nodes (CTV46.8) 
      through simultaneous integrated boost (SIB) technique. To assess the quality of 
      the validation knowledge-based proton plans (KBPPs), target coverage and 
      organ-at-risk (OAR) dose-volume constraints were compared against those of 
      clinically used expert plans using paired t-tests. The KBP model training 
      statistics (R(2)) (mean +/- SD, 0.763 +/- 0.167, range, 0.406 to 0.907) and chi(2) values 
      (1.162 +/- 0.0867, 1.039-1.253) indicate acceptable model training quality. 
      Moreover, the average total treatment planning optimization and calculation time 
      for adaptive plan generation is approximately 10 minutes. The CTV70.2 D(98%) for 
      the KBPPs (mean +/- SD, 69.1 +/- 0.08 Gy) and expert plans (69.9 +/- 0.04 Gy) shows a 
      significant difference (p < 0.05) but are both within 1.1 Gy of the prescribed 
      dose which is clinically acceptable. While the maximum dose for some 
      organs-at-risk (OARs) such as the bladder and rectum is generally higher in the 
      KBPPs, the doses still fall within clinical constraints. Among all the OARs, most 
      of them received comparable results to the expert plan, except the cauda equina 
      D(max), which shows statistical significance and was lower in the KBPPs than in 
      expert plans (48.5 +/- 0.06 Gy vs 49.3 +/- 0.05 Gy). The generated KBPPs were 
      clinically comparable to manually crafted plans by expert treatment planners. The 
      adaptive plan generation process was completed within an acceptable timeframe, 
      offering a quick same-day adaptive treatment option. Our study supports the 
      integration of KBP as a crucial component of an ART strategy, including 
      maintaining plan consistency, improving quality, and enhancing efficiency. This 
      advancement in speed and adaptability promises more precise treatment in proton 
      ART.
CI  - Published by Elsevier Inc.
FAU - Johnson, Casey L
AU  - Johnson CL
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Hasan, Shaakir
AU  - Hasan S
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Huang, Sheng
AU  - Huang S
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Lin, Haibo
AU  - Lin H
AD  - New York Proton Center, New York, NY 10035, USA; Memorial Sloan Kettering Cancer 
      Center, New York, NY, 10065, USA.
FAU - Gorovets, Daniel
AU  - Gorovets D
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
FAU - Shim, Andy
AU  - Shim A
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Apgar, Thomas
AU  - Apgar T
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Yu, Francis
AU  - Yu F
AD  - New York Proton Center, New York, NY 10035, USA.
FAU - Tsai, Pingfang
AU  - Tsai P
AD  - New York Proton Center, New York, NY 10035, USA. Electronic address: 
      ptsai@nyproton.com.
LA  - eng
PT  - Journal Article
DEP - 20231030
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
RN  - 0 (Protons)
SB  - IM
MH  - Male
MH  - Humans
MH  - Protons
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Organs at Risk
MH  - *Proton Therapy/methods
MH  - *Radiotherapy, Intensity-Modulated/methods
MH  - *Prostatic Neoplasms/radiotherapy
OTO - NOTNLM
OT  - Adaptive planning
OT  - High-risk prostate cancer
OT  - Intensity-modulated proton therapy
OT  - Proton
EDAT- 2023/11/02 00:42
MHDA- 2024/02/11 07:43
CRDT- 2023/11/01 22:58
PHST- 2023/08/07 00:00 [received]
PHST- 2023/10/02 00:00 [revised]
PHST- 2023/10/03 00:00 [accepted]
PHST- 2024/02/11 07:43 [medline]
PHST- 2023/11/02 00:42 [pubmed]
PHST- 2023/11/01 22:58 [entrez]
AID - S0958-3947(23)00094-8 [pii]
AID - 10.1016/j.meddos.2023.10.001 [doi]
PST - ppublish
SO  - Med Dosim. 2024 Spring;49(1):19-24. doi: 10.1016/j.meddos.2023.10.001. Epub 2023 
      Oct 30.