TY - JOUR
T1 - Multi-centre real-world validation of automated treatment planning for breast radiotherapy
AU - Fiandra, C.
AU - Zara, S.
AU - Richetto, V.
AU - Rossi, L.
AU - Leonardi, M. C.
AU - Ferrari, P.
AU - Marrocco, M.
AU - Gino, E.
AU - Cora, S.
AU - Loi, G.
AU - Rosica, F.
AU - Ren Kaiser, S.
AU - Verdolino, E.
AU - Strigari, L.
AU - Romeo, N.
AU - Placidi, L.
AU - Comi, S.
AU - De Otto, G.
AU - Roggio, A.
AU - Di Dio, A.
AU - Reversi, L.
AU - Pierpaoli, E.
AU - Infusino, E.
AU - Coeli, E.
AU - Licciardello, T.
AU - Ciarmatori, A.
AU - Caivano, R.
AU - Poggiu, A.
AU - Ciscognetti, N.
AU - Ricardi, U.
AU - Heijmen, B.
N1 - Publisher Copyright:
© 2024 Associazione Italiana di Fisica Medica e Sanitaria
PY - 2024/7
Y1 - 2024/7
N2 - Purpose: To present the results of the first multi-centre real-world validation of autoplanning for whole breast irradiation after breast-sparing surgery, encompassing high complexity cases (e.g. with a boost or regional lymph nodes) and a wide range of clinical practices. Methods: The 24 participating centers each included 10 IMRT/VMAT/Tomotherapy patients, previously treated with a manually generated plan (‘manplan’). There were no restrictions regarding case complexity, planning aims, plan evaluation parameters and criteria, fractionation, treatment planning system or treatment machine/technique. In addition to dosimetric comparisons of autoplans with manplans, blinded plan scoring/ranking was conducted by a clinician from the treating center. Autoplanning was performed using a single configuration for all patients in all centres. Deliverability was verified through measurements at delivery units. Results: Target dosimetry showed comparability, while reductions in OAR dose parameters were 21.4 % for heart Dmean, 16.7 % for ipsilateral lung Dmean, and 101.9 %, 45.5 %, and 35.7 % for contralateral breast D0.03cc, D5% and Dmean, respectively (all p < 0.001). Among the 240 patients included, the clinicians preferred the autoplan for 119 patients, with manplans preferred for 96 cases (p = 0.01). Per centre there were on average 5.0 ± 2.9 (1SD) patients with a preferred autoplan (range [0–10]), compared to 4.0 ± 2.7 with a preferred manplan ([0,9]). No differences were observed regarding deliverability. Conclusion: The automation significantly reduced the hands-on planning workload compared to manual planning, while also achieving an overall superiority. However, fine-tuning of the autoplanning configuration prior to clinical implementation may be necessary in some centres to enhance clinicians’ satisfaction with the generated autoplans.
AB - Purpose: To present the results of the first multi-centre real-world validation of autoplanning for whole breast irradiation after breast-sparing surgery, encompassing high complexity cases (e.g. with a boost or regional lymph nodes) and a wide range of clinical practices. Methods: The 24 participating centers each included 10 IMRT/VMAT/Tomotherapy patients, previously treated with a manually generated plan (‘manplan’). There were no restrictions regarding case complexity, planning aims, plan evaluation parameters and criteria, fractionation, treatment planning system or treatment machine/technique. In addition to dosimetric comparisons of autoplans with manplans, blinded plan scoring/ranking was conducted by a clinician from the treating center. Autoplanning was performed using a single configuration for all patients in all centres. Deliverability was verified through measurements at delivery units. Results: Target dosimetry showed comparability, while reductions in OAR dose parameters were 21.4 % for heart Dmean, 16.7 % for ipsilateral lung Dmean, and 101.9 %, 45.5 %, and 35.7 % for contralateral breast D0.03cc, D5% and Dmean, respectively (all p < 0.001). Among the 240 patients included, the clinicians preferred the autoplan for 119 patients, with manplans preferred for 96 cases (p = 0.01). Per centre there were on average 5.0 ± 2.9 (1SD) patients with a preferred autoplan (range [0–10]), compared to 4.0 ± 2.7 with a preferred manplan ([0,9]). No differences were observed regarding deliverability. Conclusion: The automation significantly reduced the hands-on planning workload compared to manual planning, while also achieving an overall superiority. However, fine-tuning of the autoplanning configuration prior to clinical implementation may be necessary in some centres to enhance clinicians’ satisfaction with the generated autoplans.
UR - http://www.scopus.com/inward/record.url?scp=85195382585&partnerID=8YFLogxK
U2 - 10.1016/j.ejmp.2024.103394
DO - 10.1016/j.ejmp.2024.103394
M3 - Article
C2 - 38852364
AN - SCOPUS:85195382585
SN - 1120-1797
VL - 123
JO - Physica Medica
JF - Physica Medica
M1 - 103394
ER -