Source:Practical Radiation Oncology
Author(s): Mariët J van Duren-Koopman, Jim P Tol, Max Dahele, Ewa Bucko, Philip Meijnen, Ben J Slotman, Wilko FAR Verbakel
PurposeBreast cancer patients who require locoregional lymph node (LLN) irradiation can be treated using a hybrid RapidArc technique combining two tangential and three RapidArc fields. Since the creation of hybrid RapidArc plans is complex and labor-intensive, we developed an automated treatment planning workflow using the scripting application programming interface of the Eclipse treatment planning system.Methods and Materials15 patients (5 right and10 left-sided) previously treated with breast+LLN radiotherapy were replanned using the script. The automated workflow included: i) optimal placement of the tangential fields based on the planning target volume (PTV) and organ-at-risk (OAR) contours, followed by optimization of field weights and beam energy, ii) positioning of the RapidArc fields, iii) subsequent RapidArc optimization using the RapidPlan knowledge-based planning solution.ResultsAverage total planning times were 163±97 and 33±5 minutes for the manual and automated plans, respectively, with approximately 130 and5 minutes of user interaction. Dosimetrically, both sets of plans were very similar, with comparable PTV dose homogeneity values and OAR mean dose differences of ≤.19Gy. In14/15 patients, the physician judged that the automated plan was either preferred (n=4) or equal (n=10) to the manual plan.ConclusionsThe complex hybrid RapidArc planning process for patients requiring breast+LLN irradiation was automated by optimizing the tangential field setup and integrating RapidPlan. The quality of the automated and manual plans was comparable while automated planning times were substantially shorter. The principles described here could be used to automate other planning workflows.
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