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Clinical acceptability of fully automated external beam radiotherapy for cervical cancer with three different beam delivery techniques.

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Clinical acceptability of fully automated external beam radiotherapy for cervical cancer with three different beam delivery techniques. Medical physics Rhee, D. J., Jhingran, A., Huang, K., Netherton, T. J., Fakie, N., White, I., Sherriff, A., Cardenas, C. E., Zhang, L., Prajapati, S., Kry, S. F., Beadle, B. M., Shaw, W., O'Reilly, F., Parkes, J., Burger, H., Trauernicht, C., Simonds, H., Court, L. E. 2022

Abstract

PURPOSE: To fully automate CT-based cervical cancer radiotherapy by automating contouring and planning for 3 different treatment techniques.METHODS: We automated 3 different radiotherapy planning techniques for locally advanced cervical cancer: 2D 4-field-box (4-field-box), 3D conformal radiotherapy (3D-CRT), and volumetric modulated arc therapy (VMAT). These auto-planning algorithms were combined with a previously developed auto-contouring system. To improve the quality of the 4-field-box and 3D-CRT plans, we used an in-house, field-in-field automation program. Thirty-five plans were generated for each technique on CT scans from multiple institutions and evaluated by 5 experienced radiation oncologists from 3 different countries. Every plan was reviewed by 2 of the 5 radiation oncologists and scored using a 5-point Likert scale.RESULTS: Overall, 87%, 99%, and 94% of the automatically generated plans were found to be clinically acceptable without modification for the 4-field-box, 3D-CRT, and VMAT plans, respectively. Some customizations of the field-in-field configuration was necessary on the basis of radiation oncologist preference. Additionally, in some cases, it was necessary to renormalize the plan after it was generated to satisfy radiation oncologist preference.CONCLUSION: Approximately, 90% of the automatically generated plans were clinically acceptable for all 3 planning techniques. This fully automated planning system has been implemented into the radiation planning assistant (RPA) for further testing in resource-constrained radiotherapy departments in low- and middle-income countries. This article is protected by copyright. All rights reserved.

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