Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit
Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short...
Ausführliche Beschreibung
Autor*in: |
de Jong, R. [verfasserIn] Crama, K. F. [verfasserIn] Visser, J. [verfasserIn] van Wieringen, N. [verfasserIn] Wiersma, J. [verfasserIn] Geijsen, E. D. [verfasserIn] Bel, A. [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
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2020 |
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Übergeordnetes Werk: |
Enthalten in: Radiation oncology - London : BioMed Central, 2006, 15(2020), 1 vom: 09. Juli |
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Übergeordnetes Werk: |
volume:15 ; year:2020 ; number:1 ; day:09 ; month:07 |
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DOI / URN: |
10.1186/s13014-020-01597-1 |
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Katalog-ID: |
SPR040277224 |
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245 | 1 | 0 | |a Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit |
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520 | |a Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). | ||
650 | 4 | |a Adaptive radiotherapy |7 (dpeaa)DE-He213 | |
650 | 4 | |a Adaptive treatment |7 (dpeaa)DE-He213 | |
650 | 4 | |a Rectal cancer |7 (dpeaa)DE-He213 | |
650 | 4 | |a Plan selection |7 (dpeaa)DE-He213 | |
650 | 4 | |a Library of plans |7 (dpeaa)DE-He213 | |
650 | 4 | |a Plan of the day |7 (dpeaa)DE-He213 | |
650 | 4 | |a Normal tissue sparing |7 (dpeaa)DE-He213 | |
700 | 1 | |a Crama, K. F. |e verfasserin |4 aut | |
700 | 1 | |a Visser, J. |e verfasserin |4 aut | |
700 | 1 | |a van Wieringen, N. |e verfasserin |4 aut | |
700 | 1 | |a Wiersma, J. |e verfasserin |4 aut | |
700 | 1 | |a Geijsen, E. D. |e verfasserin |4 aut | |
700 | 1 | |a Bel, A. |e verfasserin |4 aut | |
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10.1186/s13014-020-01597-1 doi (DE-627)SPR040277224 (SPR)s13014-020-01597-1-e DE-627 ger DE-627 rakwb eng 610 ASE de Jong, R. verfasserin aut Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). Adaptive radiotherapy (dpeaa)DE-He213 Adaptive treatment (dpeaa)DE-He213 Rectal cancer (dpeaa)DE-He213 Plan selection (dpeaa)DE-He213 Library of plans (dpeaa)DE-He213 Plan of the day (dpeaa)DE-He213 Normal tissue sparing (dpeaa)DE-He213 Crama, K. F. verfasserin aut Visser, J. verfasserin aut van Wieringen, N. verfasserin aut Wiersma, J. verfasserin aut Geijsen, E. D. verfasserin aut Bel, A. verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 09. Juli (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:09 month:07 https://dx.doi.org/10.1186/s13014-020-01597-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 09 07 |
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10.1186/s13014-020-01597-1 doi (DE-627)SPR040277224 (SPR)s13014-020-01597-1-e DE-627 ger DE-627 rakwb eng 610 ASE de Jong, R. verfasserin aut Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). Adaptive radiotherapy (dpeaa)DE-He213 Adaptive treatment (dpeaa)DE-He213 Rectal cancer (dpeaa)DE-He213 Plan selection (dpeaa)DE-He213 Library of plans (dpeaa)DE-He213 Plan of the day (dpeaa)DE-He213 Normal tissue sparing (dpeaa)DE-He213 Crama, K. F. verfasserin aut Visser, J. verfasserin aut van Wieringen, N. verfasserin aut Wiersma, J. verfasserin aut Geijsen, E. D. verfasserin aut Bel, A. verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 09. Juli (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:09 month:07 https://dx.doi.org/10.1186/s13014-020-01597-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 09 07 |
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10.1186/s13014-020-01597-1 doi (DE-627)SPR040277224 (SPR)s13014-020-01597-1-e DE-627 ger DE-627 rakwb eng 610 ASE de Jong, R. verfasserin aut Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). Adaptive radiotherapy (dpeaa)DE-He213 Adaptive treatment (dpeaa)DE-He213 Rectal cancer (dpeaa)DE-He213 Plan selection (dpeaa)DE-He213 Library of plans (dpeaa)DE-He213 Plan of the day (dpeaa)DE-He213 Normal tissue sparing (dpeaa)DE-He213 Crama, K. F. verfasserin aut Visser, J. verfasserin aut van Wieringen, N. verfasserin aut Wiersma, J. verfasserin aut Geijsen, E. D. verfasserin aut Bel, A. verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 09. Juli (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:09 month:07 https://dx.doi.org/10.1186/s13014-020-01597-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 09 07 |
allfieldsGer |
10.1186/s13014-020-01597-1 doi (DE-627)SPR040277224 (SPR)s13014-020-01597-1-e DE-627 ger DE-627 rakwb eng 610 ASE de Jong, R. verfasserin aut Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). Adaptive radiotherapy (dpeaa)DE-He213 Adaptive treatment (dpeaa)DE-He213 Rectal cancer (dpeaa)DE-He213 Plan selection (dpeaa)DE-He213 Library of plans (dpeaa)DE-He213 Plan of the day (dpeaa)DE-He213 Normal tissue sparing (dpeaa)DE-He213 Crama, K. F. verfasserin aut Visser, J. verfasserin aut van Wieringen, N. verfasserin aut Wiersma, J. verfasserin aut Geijsen, E. D. verfasserin aut Bel, A. verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 09. Juli (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:09 month:07 https://dx.doi.org/10.1186/s13014-020-01597-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 09 07 |
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10.1186/s13014-020-01597-1 doi (DE-627)SPR040277224 (SPR)s13014-020-01597-1-e DE-627 ger DE-627 rakwb eng 610 ASE de Jong, R. verfasserin aut Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). Adaptive radiotherapy (dpeaa)DE-He213 Adaptive treatment (dpeaa)DE-He213 Rectal cancer (dpeaa)DE-He213 Plan selection (dpeaa)DE-He213 Library of plans (dpeaa)DE-He213 Plan of the day (dpeaa)DE-He213 Normal tissue sparing (dpeaa)DE-He213 Crama, K. F. verfasserin aut Visser, J. verfasserin aut van Wieringen, N. verfasserin aut Wiersma, J. verfasserin aut Geijsen, E. D. verfasserin aut Bel, A. verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 09. Juli (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:09 month:07 https://dx.doi.org/10.1186/s13014-020-01597-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 09 07 |
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Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. 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2020 |
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de Jong, R. Crama, K. F. Visser, J. van Wieringen, N. Wiersma, J. Geijsen, E. D. Bel, A. |
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Elektronische Aufsätze |
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de Jong, R. |
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10.1186/s13014-020-01597-1 |
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610 |
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title_sort |
online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit |
title_auth |
Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit |
abstract |
Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). |
abstractGer |
Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). |
abstract_unstemmed |
Background To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer. Methods The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy. For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient. Results Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 $ cm^{3} $ in LCRT, while the average difference per patient ranged from − 206 $ cm^{3} $ to − 40 $ cm^{3} $. For SCRT the median difference was − 62 $ cm^{3} $, while the range of the average difference per patient was − 105 cm3 to − 51 $ cm^{3} $. For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%. Conclusions Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage. Trial registration Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands). |
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title_short |
Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit |
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https://dx.doi.org/10.1186/s13014-020-01597-1 |
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Crama, K. F. Visser, J. van Wieringen, N. Wiersma, J. Geijsen, E. D. Bel, A. |
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