IMRT and SBRT Treatment Planning Study for the First Clinical Biology-Guided Radiotherapy System

Purpose: The first clinical biology-guided radiation therapy (BgRT) system—RefleXionTM X1—was installed and commissioned for clinical use at our institution. This study aimed at evaluating the treatment plan quality and delivery efficiency for IMRT/SBRT cases without PET guidance. Methods: A total o...

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Published in:	Technology in cancer research & treatment Vol. 21; p. 15330338221100231
Main Authors:	Pham, Daniel, Simiele, Eric, Breitkreutz, Dylan, Capaldi, Dante, Han, Bin, Surucu, Murat, Oderinde, Seyi, Vitzthum, Lucas, Gensheimer, Michael, Bagshaw, Hilary, Chin, Alex, Xing, Lei, Chang, DT, Kovalchuk, Natalyia
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 2022 Sage Publications Ltd SAGE Publishing
Subjects:	Anus Biology Humans Jaw Lung cancer Male Organs at Risk Original Planning Radiation therapy Radiosurgery Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Radiotherapy, Intensity-Modulated Retrospective Studies Dosimetry stereotactic body radiation therapy stereotactic radiotherapy radiation dosimetry stereotactic radiosurgery
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Summary:	Purpose: The first clinical biology-guided radiation therapy (BgRT) system—RefleXionTM X1—was installed and commissioned for clinical use at our institution. This study aimed at evaluating the treatment plan quality and delivery efficiency for IMRT/SBRT cases without PET guidance. Methods: A total of 42 patient plans across 6 cancer sites (conventionally fractionated lung, head, and neck, anus, prostate, brain, and lung SBRT) planned with the EclipseTM treatment planning system (TPS) and treated with either a TrueBeam® or Trilogy® were selected for this retrospective study. For each Eclipse VMAT plan, 2 corresponding plans were generated on the X1 TPS with 10 mm jaws (X1-10mm) and 20 mm jaws (X1-20mm) using our institutional planning constraints. All clinically relevant metrics in this study, including PTV D95%, PTV D2%, Conformity Index (CI), R50, organs-at-risk (OAR) constraints, and beam-on time were analyzed and compared between 126 VMAT and RefleXion plans using paired t-tests. Results: All but 3 planning metrics were either equivalent or superior for the X1-10mm plans as compared to the Eclipse VMAT plans across all planning sites investigated. The Eclipse VMAT and X1-10mm plans generally achieved superior plan quality and sharper dose fall-off superior/inferior to targets as compared to the X1-20mm plans, however, the X1-20mm plans were still considered acceptable for treatment. On average, the required beam-on time increased by a factor of 1.6 across all sites for X1-10mm compared to X1-20mm plans. Conclusions: Clinically acceptable IMRT/SBRT treatment plans were generated with the X1 TPS for both the 10 mm and 20 mm jaw settings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1533-0346 1533-0338 1533-0338
DOI:	10.1177/15330338221100231