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Comparative Study
. 2021 Jan-Dec:20:15330338211033050.
doi: 10.1177/15330338211033050.

Evaluation of Auto-Planning for Left-Side Breast Cancer After Breast-Conserving Surgery Based on Geometrical Relationship

Yijiang Li  1 , Han Bai  1 , Danju Huang  1 , Feihu Chen  1 , Yaoxiong Xia  1
Affiliations
Comparative Study

Evaluation of Auto-Planning for Left-Side Breast Cancer After Breast-Conserving Surgery Based on Geometrical Relationship

Yijiang Li et al. Technol Cancer Res Treat. 2021 Jan-Dec.

Abstract

Purpose: This study aimed to evaluate (1) the performance of the Auto-Planning module embedded in the Pinnacle treatment planning system (TPS) with 30 left-side breast cancer plans and (2) the dose-distance correlations between dose-based patients and overlap volume histogram-based (OVH) patients.

Method: A total of 30 patients with left-side breast cancer after breast-conserving surgery were enrolled in this study. The clinical manual-planning (MP) and the Auto-Planning (AP) plans were generated by Monaco and by the Auto-Planning module in Pinnacle respectively. The geometric information between organ at risk (OAR) and planning target volume (PTV) of each patient was described by the OVH. The AP and MP plans were ranked to compare with the geometry-based patients from OVH. The Pearson product-moment correlation coefficient (R) was used to describe the correlations between dose-based patients (APs and MPs) and geometry-based patients (OVH). Dosimetric differences between MP and AP plans were evaluated with statistical analysis.

Result: The correlation coefficient (mean R = 0.71) indicated that the AP plans have a high correlation with geometry-based patients from OVH, whereas the correlation coefficient (mean R = 0.48) shows a weak correlation between MP plans and geometry-based patients. The dosimetric comparison revealed a statistically significant improvement in the ipsilateral lung V5Gy and V10Gy, and in the heart V5Gy of AP plans compared to MP plans, while statistical reduction was seen in PTV V107% for MP plans compared to AP plans.

Conclusion: The overall results of AP plans were superior to MP plans. The dose distribution in AP plans was more consistent with the distance-dose relationship described by OVH. After eliminating the interference of human factors, the AP was able to provide more stable and objective plans for radiotherapy patients.

Keywords: OVH; VMAT; auto-planning; breast cancer; geometrical relationship.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
An example of OVH for 2 OARs; for the same volume V, the extended distance r1 < r2 indicates dose absorbed on OAR D1 > D2.
Figure 2.
Figure 2.
OVH of the ipsilateral lung for 25 patients ranked from (A) V5Gy, (B) V10Gy, and (C) V20Gy, and OVH of heart for 25 patients ranked from (D) V5Gy. The ranking of 25 patients from superior to inferior can be identified sequentially from right to left on the legend.
Figure 3.
Figure 3.
Ranking of OVHs, APs, and MPs in (A) ipsilateral lung V5, (B) ipsilateral lung V10, (C) ipsilateral lung V20, and (D) heart V5. R is the correlation coefficient between AP and MP ranking, respectively, and OVH-based ranking.
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A.Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. - PubMed
    1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG); Darby S, McGale P, Correa C, et al.Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–1716. - PMC - PubMed
    1. Mansouri S, Naim A, Glaria L, Marsiglia H. Dosimetric evaluation of 3-D conformal and intensity-modulated radiotherapy for breast cancer after conservative surgery. Asian Pac J Cancer Prev. 2014;15(11):4727–4732. - PubMed
    1. Fong A, Bromley R, Beat M, Vien D, Dineley J, Morgan G. Dosimetric comparison of intensity modulated radiotherapy techniques and standard wedged tangents for whole breast radiotherapy. J Med Imaging Radiat Oncol. 2009;53(1):92–99. - PubMed
    1. Zhao H, He M, Cheng G, et al.A comparative dosimetric study of left sided breast cancer after breast-conserving surgery treated with VMAT and IMRT. Radiat Oncol. 2015;10:231. - PMC - PubMed

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