Author, as appears in the article.: Lambri, N; Dei, D; Hernandez, V; Castiglioni, I; Clerici, E; Crespi, L; De Philippis, C; Loiacono, D; Navarria, P; Reggiori, G; Rusconi, R; Tomatis, S; Bramanti, S; Scorsetti, M; Mancosu, P
Department: Ciències Mèdiques Bàsiques
URV's Author/s: Hernandez Masgrau, Victor
Keywords: Vmat Total-body irradiation Tmi Retrospective studies Randomized-trial Radiotherapy, intensity-modulated Radiotherapy planning, computer-assisted Radiotherapy dosage Radiotherapy Organs at risk Lower extremity Leukemia Humans Helical tomotherapy Guided total-marrow Field junction Feasibility Busulfan Bone marrow Automation
Abstract: Purpose Total marrow (and lymphoid) irradiation (TMI-TMLI) is limited by the couch travel range of modern linacs, which forces the treatment delivery to be split into two plans with opposite orientations: a head-first supine upper-body plan, and a feet-first supine lower extremities plan. A specific field junction is thus needed to obtain adequate target coverage in the overlap region of the two plans. In this study, an automatic procedure was developed for field junction creation and lower extremities plan optimization. Methods Ten patients treated with TMI-TMLI at our institution were selected retrospectively. The planning of the lower extremities was performed automatically. Target volume parameters (CTV_J-V-98% > 98%) at the junction region and several dose statistics (D-98%, D-mean, and D-2%) were compared between automatic and manual plans. The modulation complexity score (MCS) was used to assess plan complexity. Results The automatic procedure required 60-90 min, depending on the case. All automatic plans achieved clinically acceptable dosimetric results (CTV_J-V-98% > 98%), with significant differences found at the junction region, where D-mean and D-2% increased on average by 2.4% (p < 0.03) and 3.0% (p < 0.02), respectively. Similar plan complexity was observed (median MCS = 0.12). Since March 2022, the automatic procedure has been introduced in our clinic, reducing the TMI-TMLI simulation-to-delivery schedule by 2 days. Conclusion The developed procedure allowed treatment planning of TMI-TMLI to be streamlined, increasing efficiency and standardization, preventing human errors, while maintaining the dosimetric plan quality and complexity of manual plans. Automated strategies can simplify the future adoption and clinical implementation of TMI-TMLI treatments in new centers.
Thematic Areas: Radiology, nuclear medicine and imaging Radiology, nuclear medicine & medical imaging Oncology General medicine
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: victor.hernandez@urv.cat
Author identifier: 0000-0003-3770-8486
Record's date: 2024-08-03
Papper version: info:eu-repo/semantics/publishedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Strahlentherapie Und Onkologie. 199 (4): 412-419
APA: Lambri, N; Dei, D; Hernandez, V; Castiglioni, I; Clerici, E; Crespi, L; De Philippis, C; Loiacono, D; Navarria, P; Reggiori, G; Rusconi, R; Tomatis, S (2023). Automatic planning of the lower extremities for total marrow irradiation using volumetric modulated arc therapy. Strahlentherapie Und Onkologie, 199(4), 412-419. DOI: 10.1007/s00066-022-02014-0
Entity: Universitat Rovira i Virgili
Journal publication year: 2023
Publication Type: Journal Publications
Repositori URV