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RapidPlan Modeling for Radiotherapy Plan Quality Assurance of NRG Oncology RTOG 0617

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C Cheng

C Cheng1*, H Geng2 , H Zhong3 , M Huang4 , J Bradley5 , K Forster6 , Y Xiao7 , (1) University of Pennsylvania, Philadelphia, PA, (2) University of Pennsylvania, Philadelphia, PA, (3) University of Pennsylvania, Philadelphia, PA, (4) University of Pennsylvania, Philadelphia, PA, (5) Washington Univ. School of Medicine, Saint Louis, MO, (6) University of South Alabama, Dallas, TX, (7) University of Pennsylvania, Philadelphia, PA


MO-L-GePD-T-5 (Monday, July 31, 2017) 1:15 PM - 1:45 PM Room: Therapy ePoster Lounge

Purpose: Use knowledge-based planning(KBP) RapidPlan technique in Eclipse treatment planning system as a quality assurance(QA) tool for radiation therapy (RT) treatment plans submitted to clinical trial RTOG 0617(A randomized phase III comparison of standard-dose (60 Gy) versus high-dose (74 Gy) conformal radiotherapy with concurrent and consolidation Carboplatin/Paclitaxel +/- Cetuximab (IND #103444) in patients with stage IIIA/IIIB NON-SMALL CELL LUNG CANCER).

Methods: A RapidPlan model was built in Eclipse system (Varian, Inc) based on RTOG 1308 clinical trial (phase III randomized trial comparing overall survival after photon versus proton radiochemotherapy for inoperable stage II-IIIB NSCLC). With fine adjustment of model parameters, it is applied to cases submitted to RTOG 0617 for plan QA and re-optimization. 380 IMRT planQAs of RTOG 0617 were included in the study. 20 plans were chosen for re-optimization using KBP. D95 of the PTV for each plan was normalized to the prescription dose.

Results: Quality evaluation using the criteria from RTOG0617 showed that 94 plans fail to fulfill target coverage, 37 and 81 plans fail to spare the lungs and esophagus. The re-optimized plans reduce PTV Dmax and its standard deviation by 3.23Gy and 2.01Gy. The Heart V30 is reduced by 5.38%, and V45 by 1.50%. The Lung-CTV V20 reduces by 5.51%, V5 reduces by 4.40%, and Dmean reduces by 2.21Gy. The Esophagus Dmax reduces by 4.07Gy.

Conclusion: RapidPlan model can be a plausible tool for RT QA and plan optimization. Implementing model based treatment planning has potential to improve quality and uniformity among institutions.

Funding Support, Disclosures, and Conflict of Interest: This project was supported by grants U10CA180868(NRG Oncology Operations), U10CA180822(NRG Oncology SDMC), U24CA180803(IROC), UG1CA189867(NCORP), from the National Cancer Institute(NCI), Eli Lilly. This project is funded, in part, under a grant with the Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.

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