Wu Junxiang,Kang Shengwei,Wang Pei,Tang Bin,Wu Fan,Xu Jinghui,Li Jie.Dosimetric comparison between automated and manual volumetric modulated arc therapy planning for postoperative cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2018,38(1):26-31
Dosimetric comparison between automated and manual volumetric modulated arc therapy planning for postoperative cervical cancer
Received:July 20, 2017  
DOI:10.3760/cma.j.issn.0254-5098.2018.01.006
KeyWords:Automated VMAT plan  Manual VMAT plan  Postoperative cervical cancer  Dosimetry
FundProject:四川省医学科研青年创新课题(Q16071)
Author NameAffiliationE-mail
Wu Junxiang Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Kang Shengwei Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Wang Pei Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Tang Bin Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Wu Fan Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Xu Jinghui Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China  
Li Jie Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu 610041, China jie.li@yeah.net 
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Abstract::
      Objective To compare dosimetric parameters between automated and manual volumetric modulated arc therapy(VMAT) plans in the treatment of postoperative cervical cancer patients, and to investigatethe feasibility and dosimetric advantage of the automated VMAT planning. Methods Automated and manual VMAT plans were generated with Pinnacle3 treatment planning system(TPS)for twenty-three postoperative cervical cancer patients, including eight patients in stage ⅡA and fifteen in stage ⅡB, respectively. The differences in Dmean, D95,conformity index (CI) and homogeneity index (HI) of target, as well as dose volume histogram (DVH) of organs at risk (OAR),planning time, average optimization time and monitor unit (MU) were compared between automated and manual VMAT plans. Results The average Dmean, CI and HI of automated VMAT plans were better than those of manual VMAT plans (t=4.65-14.92, P<0.05). There was no significant difference in D95 (P>0.05). The automated VMAT plans achieved better average dosimetric parameters on OARs compared with the manual VMAT plans (t=3.30-14.42, P<0.05). Automated VMAT plans had a significantly shorter planning time (72 min, t=3.85, P<0.05) and interruption frequency (twice, t=5.41, P<0.05) than manual VMAT plans. However, automated VMAT plans had a higher average MU than manual VMAT plans with an average MU of 819±53 and 638±41 for automated and manual VMAT plans, respectively. Conclusions It is feasible to generate automated VMAT plans with Pinnacle3 TPS for postoperative cervical cancer patients. The automated VMAT plans increase the plan quality and reduce the optimization time compare with manual VMAT plans. Automated technique also eliminates the influence of human factors on the plan quality.
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