In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 9 ( 2021-9-10), p. e0257216-
Abstract:
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 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 〈 0.001) and rectum (474 cGy and 604 cGy, p 〈 0.001) with the MCO. Planning evaluation and dosimetric measurements showed that the VMAT-MCO plan using visualized navigation can provide sparing of OAR doses without compromising the target coverage in the same OAR dose constraints.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0257216
DOI:
10.1371/journal.pone.0257216.g001
DOI:
10.1371/journal.pone.0257216.g002
DOI:
10.1371/journal.pone.0257216.g003
DOI:
10.1371/journal.pone.0257216.g004
DOI:
10.1371/journal.pone.0257216.g005
DOI:
10.1371/journal.pone.0257216.t001
DOI:
10.1371/journal.pone.0257216.t002
DOI:
10.1371/journal.pone.0257216.t003
DOI:
10.1371/journal.pone.0257216.t004
DOI:
10.1371/journal.pone.0257216.s001
DOI:
10.1371/journal.pone.0257216.s002
DOI:
10.1371/journal.pone.0257216.s003
DOI:
10.1371/journal.pone.0257216.r001
DOI:
10.1371/journal.pone.0257216.r002
DOI:
10.1371/journal.pone.0257216.r003
DOI:
10.1371/journal.pone.0257216.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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