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• W2062350046 abstract "Multicriteria optimization (MCO)-based planning for IMRT has been shown to be superior in terms of both planning efficiency and dose distribution quality compared with the current trial and error-based IMRT planning approach for several tumor localizations. MCO based IMRT is currently implemented in a routine clinical setting. However, the role of MCO planning has not been investigated for large target volumes. Whole abdomen radiation therapy using IMRT (WART-IMRT) for advanced gynecological carcinoma is a typical example of a challenging and time consuming planning procedure which might benefit from this approach. In this exploratory study, we tested the feasibility of MCO-based planning for step-and -shoot WART-IMRT. Our goal was to determine the best setting of parameters to achieve a high quality plan in a straightforward manner. Based on a dataset of 6 patients treated for advanced endometrial cancer a database of plans was created that met the inverse planning goals, using the MCO software. The planning target volume (PTV) included the entire peritoneal cavity with the 1cm outer surface of the liver and the pelvic and para-aortal node regions. Organs at risk (OAR) were kidneys, liver, heart, vertebral bodies, and pelvic bones. We prescribed a total dose of 30 Gy in 1.5 Gy fractions to the median of PTV. For a 6MV linac, a configuration of 2 isocenters with a total of 21 beams was used. The contouring to the final plan was performed entirely by a trained physician. MCO planning resulted in an excellent coverage of the PTV and an effective sparing of the OAR. A total of 11 to 12 objective functions were included into the formulation. We used the uniform dose function to achieve target homogeneity, the dose fall-off function to reduce kidneys and heart dose and a DVH function to reduce the dose in the central part of the liver. Once the templates for the formulation were created, the final plan selection took approximately 5 minutes by navigating the Pareto surface. The treatment delivery time for an average plan of 298 segments and 2073 MU was 40 min (beam on time). MCO based WART-IMRT is feasible, efficient and fast. Once a template of constraints and objectives is created, the final plan selection is done within few minutes compared with hours using current IMRT planning systems. From a physician's point of view, navigating the Pareto surface is simple and intuitive and allows physicians to take a more active role in the IMRT planning procedure. Next step will be reducing the treatment delivery time by implementing MCO into Volumetric Modulated Arc Therapy (VMAT)." @default.
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• W2062350046 date "2012-11-01" @default.
• W2062350046 modified "2023-09-26" @default.
• W2062350046 title "Multicriteria Optimization in Intensity Modulated Radiation Therapy Treatment Planning for Large Target Volumes: First Experience With Whole Abdomen Radiation Therapy" @default.
• W2062350046 doi "https://doi.org/10.1016/j.ijrobp.2012.07.2055" @default.
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