P Qi*, S Chao, E Murphy, E Balagamwala, J Suh, P Xia, The Cleveland Clinic Foundation, Cleveland, OH

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  P Qi

PO-GePV-T-399 (Sunday, 7/25/2021)   [Eastern Time (GMT-4)]

Purpose: To evaluate automatic spinal stereotactic body radiation therapy (SBRT) treatment planning using Pinnacle scripting.

Methods: Pinnacle scripts were developed and implemented for generating spine SBRT plans in Pinnacle v16.2 environment. The script interface allows plan generation using different fractionations for different target locations and organs-at-risk such as spinal cord or cauda equina. In combining with Pinnacle Auto-Planning, the scripts allows the user to enter the prescription, select the beam energy and arrangement. It automatically optimizes the plan and generate an evaluation scorecard. We tested the script for patients with thoracic or lumbar spine tumors. The treatment plan was created with the prescription of 16 Gy or 18 Gy in 1 fraction, 24 Gy in 2 fractions, or 30 Gy in 4 fractions following the guidelines from RTOG 0631 or our internal protocols. For the treatment of the thoracic spine, 3 VMAT arcs with the energy of 6 MV FFF or 10 MV FFF were used. For treatment of lumbar spine, 3 VMAT arcs with the energy of 10 MV FFF were used. Each plan was evaluated with protocol recommended DVH constraints and the Paddick conformity index (CI) and gradient index (GI).

Results: We used these Pinnacle scripts to generate 10 spine SBRT plans. All except one plan was successfully created on the first pass and met the DVH criteria for the targets and organs-at-risk. The CI was on average 1.03 ± 0.04 and the GI was on average 3.67 ± 0.39. All plans passed patient-specific QA (> 95%) with the threshold of 3%/2 mm.

Conclusion: Plans created with our Pinnacle scripts were all clinically acceptable. Automatic planning for spine SBRT using scripting reduces human errors, improves efficiency, and standardizes plan quality.

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