Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer

We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate canc...

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Bibliographic Details
Published in:PloS one 2021-09, Vol.16 (9), p.e0257216-e0257216
Main Authors: Park, Jongmoo, Park, Jaehyeon, Oh, Sean, Yea, Ji Woon, Lee, Jeong Eun, Park, Jae Won
Format: Article
Language:English
Subjects:
Algorithms
Biology and Life Sciences
Bladder
Cancer
Cancer therapies
Care and treatment
Dosimetry
Drug dosages
Evaluation
Femur
Homogeneity
Lee, Jae Won
Magnetic resonance imaging
Mathematical analysis
Medical schools
Medicine
Medicine and Health Sciences
Multiple criterion
Oncology
Optimization
Organs
Parameters
Patients
People and Places
Physicians
Planning
Prostate cancer
Radiation
Radiation therapy
Rectum
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Summary:We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate cancer who were previously treated on the basis of a VMAT plan. All plans were imported into the Eclipse Treatment Planning System version 15.6, and re-calculation and re-optimization were performed. The MCO plan was then generated. The dosimetric quality of the plans was evaluated using dosimetric parameters and dose indices that account for target coverage and sparing of the organs at risk (OARs). We defined the rectum, bladder, and bilateral femoral heads. The VMAT-MCO plan offers an improvement of gross treatment volume coverage with increased minimal dose and reduced maximal dose. In the planning treatment volume, the D.sub.mean and better gradient, homogeneity, and conformity indexes improved despite the increasing hot and cold spots. When implemented through the MCO plan, a steeper fall off the adjacent OARs in the overlap area was achieved to obtain lower dose parameters. MCO generated better sparing of the rectum and bladder through a tradeoff of the increasing dose to the bilateral femoral heads within the tolerable dose constraints. Compared with re-optimization and re-calculation, respectively, significant dose reductions were observed in the bladder (241 cGy and 254 cGy; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0257216