open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2019-11-06
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Impact of different optimization strategies on the compatibility between planned and delivered doses during radiation therapy of cervical cancer

Agata Jodda, Tomasz Piotrowski, Marta Kruszyna-Mochalska, Julian Malicki
DOI: 10.1016/j.rpor.2020.03.027
·
Rep Pract Oncol Radiother 2020;25(3):412-421.

open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2019-11-06

Abstract

Purpose

To analyse the impact of different optimization strategies on the compatibility between planned and delivered doses during radiotherapy of cervical cancer.

Material/methods

Four treatment plans differing in optimisation strategies were prepared for ten cervical cancer cases. These were: volumetric modulated arc therapy with (_OPT) and without optimization of the doses in the bone marrow and for two sets of margins applied to the clinical target volume that arose from image guidance based on the bones (IG(B)) and soft tissues (IG(ST)). The plans were subjected to dosimetric verification by using the ArcCHECK system and 3DVH software. The planned dose distributions were compared with the corresponding measured dose distributions in the light of complexity of the plans and its deliverability.

Results

The clinically significant impact of the plans complexity on their deliverability is visible only for the gamma passing rates analysis performed in a local mode and directly in the organs. While more general analyses show statistically significant differences, the clinical relevance of them has not been confirmed. The analysis showed that IG(ST)_OPT and IG(B)_OPT significantly differ from IG(ST) and IG(B). The clinical acceptance of IG(ST)_OPT obtained for hard combinations of gamma acceptance criteria (2%/2 mm) confirm its satisfactory deliverability. In turn, for IG(B)_OPT in the case of the rectum, the combination of 2%/2 mm did not meet the criteria of acceptance.

Conclusion

Despite the complexity of the IG(ST)_OPT, the results of analysis confirm the acceptance of its deliverability when 2%/2 mm gamma acceptance criteria are used during the analysis.

Abstract

Purpose

To analyse the impact of different optimization strategies on the compatibility between planned and delivered doses during radiotherapy of cervical cancer.

Material/methods

Four treatment plans differing in optimisation strategies were prepared for ten cervical cancer cases. These were: volumetric modulated arc therapy with (_OPT) and without optimization of the doses in the bone marrow and for two sets of margins applied to the clinical target volume that arose from image guidance based on the bones (IG(B)) and soft tissues (IG(ST)). The plans were subjected to dosimetric verification by using the ArcCHECK system and 3DVH software. The planned dose distributions were compared with the corresponding measured dose distributions in the light of complexity of the plans and its deliverability.

Results

The clinically significant impact of the plans complexity on their deliverability is visible only for the gamma passing rates analysis performed in a local mode and directly in the organs. While more general analyses show statistically significant differences, the clinical relevance of them has not been confirmed. The analysis showed that IG(ST)_OPT and IG(B)_OPT significantly differ from IG(ST) and IG(B). The clinical acceptance of IG(ST)_OPT obtained for hard combinations of gamma acceptance criteria (2%/2 mm) confirm its satisfactory deliverability. In turn, for IG(B)_OPT in the case of the rectum, the combination of 2%/2 mm did not meet the criteria of acceptance.

Conclusion

Despite the complexity of the IG(ST)_OPT, the results of analysis confirm the acceptance of its deliverability when 2%/2 mm gamma acceptance criteria are used during the analysis.

Get Citation

Keywords

Cervical cancer; VMAT; gamma analysis; Treatment plan complexity; 3DVH software.

About this article
Title

Impact of different optimization strategies on the compatibility between planned and delivered doses during radiation therapy of cervical cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 3 (2020)

Pages

412-421

Published online

2020-05-01

DOI

10.1016/j.rpor.2020.03.027

Bibliographic record

Rep Pract Oncol Radiother 2020;25(3):412-421.

Keywords

Cervical cancer
VMAT
gamma analysis
Treatment plan complexity
3DVH software.

Authors

Agata Jodda
Tomasz Piotrowski
Marta Kruszyna-Mochalska
Julian Malicki

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