Comparison of biological-based and dose volume-based intensity-modulated radiotherapy plans generated using the same treatment planning system

• Published in: Journal of cancer research and therapeutics 2019-03, Vol.15 (8), p.33-38
• Main Authors: Senthilkumar, K, Maria Das, K
• Format: Article
• Language: English
• Subjects: Algorithms; Cancer; Cancer patients; Care and treatment; Comparative analysis; Dose-Response Relationship, Radiation; Economic models; Humans; Intensity-modulated radiotherapy; Male; Models, Biological; NMR; Nuclear magnetic resonance; Optimization algorithms; Organs at Risk - radiation effects; Planning; Pricing policies; Prostate; Prostate cancer; Prostatic Neoplasms - radiotherapy; Quality; Radiation (Physics); Radiotherapy; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted - methods; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Retrospective Studies; Studies
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/jcrt.JCRT_956_16

Purpose: Nowadays, most of the radiotherapy (RT) treatment planning systems (TPSs) uses dose or dose-volume (DV)-based cost functions for Intensity modulated radiation therapy (IMRT) fluence optimization. Recently, some of the TPSs incorporated biological-based cost function for IMRT optimization. Most of the previous studies compared IMRT plans optimized using biological-based and DV-based cost functions in two different TPSs. Hence, the purpose of the study is to compare equivalent uniform dose (EUD)-based and DV-based IMRT plans generated using the same TPS. Materials and Methods: Twenty patients with prostate cancer were retrospectively selected for this study. For each patient, two IMRT plans were generated using EUD-based cost function (EUD_TP) and DV-based cost (DV_Treatment Plan (TP)), respectively. The generated IMRT plans were evaluated using both physical and biological dose evaluation indices. Results: Biological-based plans ended up with a highly inhomogeneous target dose when compared to DV-based plans. For serial organs, Dnear-max or D2%(Gy) of EUD-based plans showed significant difference with DV-based plans (P = 0.003). For both rectum and bladder, there was a significant difference in mean dose and D30%(Gy) dose between EUD-based plans and DV-based plans. Conclusion: In this study, we decoupled the influence of optimization parameters from the potential use of EUD-based cost functions on plan quality by generating both plans in the same TPS.