scholarly journals PO-0674: SABR for lung tumors of 5cm or more: can knowledge-based planning detect high-risk treatment plans?

2017 ◽  
Vol 123 ◽  
pp. S352-S353
Author(s):  
S. Van 't Hof ◽  
M. Dahele ◽  
H. Tekatli ◽  
A. Delaney ◽  
J. Tol ◽  
...  
Keyword(s):  
High Risk ◽  
Lung Tumors ◽  
Knowledge Based ◽  
Knowledge Based Planning ◽  
Treatment Plans ◽  
Risk Treatment

scholarly journals Validation of in-house knowledge-based planning model for advance-stage lung cancer patients treated using VMAT radiotherapy

2020 ◽  
Vol 93 (1106) ◽  
pp. 20190535
Author(s):  
Nilesh S Tambe ◽  
Isabel M Pires ◽  
Craig Moore ◽  
Christopher Cawthorne ◽  
Andrew W Beavis
Keyword(s):  
Lung Volume ◽  
Clinical Implementation ◽  
Lung Dose ◽  
Treatment Delivery ◽  
Lung Cancer Patients ◽  
Knowledge Based ◽  
Knowledge Based Planning ◽  
Dose Metrics ◽  
Treatment Plans ◽  
Stage Lung Cancer

Objectives: Radiotherapy plan quality may vary considerably depending on planner’s experience and time constraints. The variability in treatment plans can be assessed by calculating the difference between achieved and the optimal dose distribution. The achieved treatment plans may still be suboptimal if there is further scope to reduce organs-at-risk doses without compromising target coverage and deliverability. This study aims to develop a knowledge-based planning (KBP) model to reduce variability of volumetric modulated arc therapy (VMAT) lung plans by predicting minimum achievable lung volume-dose metrics. Methods: Dosimetric and geometric data collected from 40 retrospective plans were used to develop KBP models aiming to predict the minimum achievable lung dose metrics via calculating the ratio of the residual lung volume to the total lung volume. Model accuracy was verified by replanning 40 plans. Plan complexity metrics were calculated using locally developed script and their effect on treatment delivery was assessed via measurement. Results: The use of KBP resulted in significant reduction in plan variability in all three studied dosimetric parameters V5, V20 and mean lung dose by 4.9% (p = 0.007, 10.8 to 5.9%), 1.3% (p = 0.038, 4.0 to 2.7%) and 0.9 Gy (p = 0.012, 2.5 to 1.6Gy), respectively. It also increased lung sparing without compromising the overall plan quality. The accuracy of the model was proven as clinically acceptable. Plan complexity increased compared to original plans; however, the implication on delivery errors was clinically insignificant as demonstrated by plan verification measurements. Conclusion: Our in-house model for VMAT lung plans led to a significant reduction in plan variability with concurrent decrease in lung dose. Our study also demonstrated that treatment delivery verifications are important prior to clinical implementation of KBP models. Advances in knowledge: In-house KBP models can predict minimum achievable lung dose-volume constraints for advance-stage lung cancer patients treated with VMAT. The study demonstrates that plan complexity could increase and should be assessed prior to clinical implementation.

PD-0191: Knowledge-based planning improves plan quality for high-risk prostate cancer with four dose levels

2020 ◽  
Vol 152 ◽  
pp. S94-S95
Author(s):  
K. Fjellanger ◽  
H.E.S. Pettersen ◽  
J.A. Hundvin ◽  
B. Nygaard ◽  
K. Revheim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Plan Quality ◽  
Knowledge Based ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer ◽  
Knowledge Based Planning ◽  
Dose Levels

scholarly journals Personalising treatment plan quality review with knowledge-based planning in the TROG 15.03 trial for stereotactic ablative body radiotherapy in primary kidney cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nicholas Hardcastle ◽  
Olivia Cook ◽  
Xenia Ray ◽  
Alisha Moore ◽  
Kevin L. Moore ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Real Time ◽  
Kidney Cancer ◽  
Treatment Plan ◽  
Plan Quality ◽  
Knowledge Based ◽  
Trade Offs ◽  
Stereotactic Ablative Body Radiotherapy ◽  
Knowledge Based Planning ◽  
Treatment Plans

Abstract Introduction Quality assurance (QA) of treatment plans in clinical trials improves protocol compliance and patient outcomes. Retrospective use of knowledge-based-planning (KBP) in clinical trials has demonstrated improved treatment plan quality and consistency. We report the results of prospective use of KBP for real-time QA of treatment plan quality in the TROG 15.03 FASTRACK II trial, which evaluates efficacy of stereotactic ablative body radiotherapy (SABR) for kidney cancer. Methods A KBP model was generated based on single institution data. For each patient in the KBP phase (open to the last 31 patients in the trial), the treating centre submitted treatment plans 7 days prior to treatment. A treatment plan was created by using the KBP model, which was compared with the submitted plan for each organ-at-risk (OAR) dose constraint. A report comparing each plan for each OAR constraint was provided to the submitting centre within 24 h of receiving the plan. The centre could then modify the plan based on the KBP report, or continue with the existing plan. Results Real-time feedback using KBP was provided in 24/31 cases. Consistent plan quality was in general achieved between KBP and the submitted plan. KBP review resulted in replan and improvement of OAR dosimetry in two patients. All centres indicated that the feedback was a useful QA check of their treatment plan. Conclusion KBP for real-time treatment plan review was feasible for 24/31 cases, and demonstrated ability to improve treatment plan quality in two cases. Challenges include integration of KBP feedback into clinical timelines, interpretation of KBP results with respect to clinical trade-offs, and determination of appropriate plan quality improvement criteria.

Knowledge-Based Planning

1993 ◽  
Author(s):  
Drew McDermott ◽  
Gregory Hager
Keyword(s):  
Knowledge Based ◽  
Knowledge Based Planning

scholarly journals OpenKBP: The open‐access knowledge‐based planning grand challenge and dataset

2021 ◽  
Author(s):  
Aaron Babier ◽  
Binghao Zhang ◽  
Rafid Mahmood ◽  
Kevin L. Moore ◽  
Thomas G. Purdie ◽  
...  
Keyword(s):  
Open Access ◽  
Grand Challenge ◽  
Knowledge Based ◽  
Knowledge Based Planning

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

Sign in / Sign up

Export Citation Format

Share Document