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The Effect On Therapeutic Gain of Using AXB in Replacement of AAA in HCC SBRT Treatment Planning
M Cheung1,2*, D Poon2 , V Yeung2 , L Lee2 , A Chan1,2 , (1) The Chinese University of Hong Kong, Hong Kong, (2) Prince of Wales Hospital, Hong Kong,
Presentations
SU-I-GPD-T-522 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall
Purpose: To assess the change in therapeutic gain of using AXB to replace AAA in treatment planning of hepatocellular carcinoma (HCC) SBRT.
Methods: Treatment plans of 30 HCC SBRT patients in Prince of Wales Hospital were originally optimized based on the dose distribution calculated by AAA. These plans were then re-calculated using AXB while keeping all the plan parameters like MU and MLC sequence unchanged. A TCP/NTCP model was fitted using the tumour mean dose and normal liver (liver minus tumour) mean dose calculated by AXB and the clinical data of these patients. After that, the treatment plans were re-optimized based on the dose distribution calculated by AXB. The tumour mean dose, normal liver mean dose, TCP, NTCP and the therapeutic gain, defined as TCP times (1-NTCP), of the re-optimized plans were then compared to that of the original plans using paired sample T-test.
Results: The paired sample T-test showed that the tumour mean dose and TCP of the plans optimized based on AXB were 3.1 ± 1.1 % (p < 0.001) and 2.1 ± 1.4 % (p < 0.001) higher than that of the plans optimized based on AAA, respectively. On the other hand, the normal liver mean dose and the NTCP of the plans optimized based on AXB were 3.9 ± 1.0 % (p < 0.001) and 0.9 ±0.6 % (p < 0.001) higher than that of the plans optimized based on AAA, respectively. Finally, the therapeutic gain of the plans optimized based on AXB was 1.3 ± 1.6 % (p < 0.001) higher than that of the plans optimized based on AAA.
Conclusion: The use of AXB to replace AAA in treatment planning of HCC SBRT can increase therapeutic gain with statistical significance.
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