Alexandrian AN, Mavroidis P, Narayanasamy G, McConnell KA, Kabat CN, George RB, Defoor DL, Kirby N, Papanikolaou N, Stathakis S. Incorporating biological modeling into patient‐specific plan verification.
J Appl Clin Med Phys 2020;
21:94-107. [PMID:
32101368 PMCID:
PMC7075379 DOI:
10.1002/acm2.12831]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose
Dose–volume histogram (DVH) measurements have been integrated into commercially available quality assurance systems to provide a metric for evaluating accuracy of delivery in addition to gamma analysis. We hypothesize that tumor control probability and normal tissue complication probability calculations can provide additional insight beyond conventional dose delivery verification methods.
Methods
A commercial quality assurance system was used to generate DVHs of treatment plan using the planning CT images and patient‐specific QA measurements on a phantom. Biological modeling was performed on the DVHs produced by both the treatment planning system and the quality assurance system.
Results
The complication‐free tumor control probability, P+, has been calculated for previously treated intensity modulated radiotherapy (IMRT) patients with diseases in the following sites: brain (−3.9% ± 5.8%), head‐neck (+4.8% ± 8.5%), lung (+7.8% ± 1.3%), pelvis (+7.1% ± 12.1%), and prostate (+0.5% ± 3.6%).
Conclusion
Dose measurements on a phantom can be used for pretreatment estimation of tumor control and normal tissue complication probabilities. Results in this study show how biological modeling can be used to provide additional insight about accuracy of delivery during pretreatment verification.
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