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Evaluation of Personalized Planning Tool for Head and Neck Cancer

S Ahmed*, T Gray, C Liu, D LaHurd, E Murray, N Woody, S Koyfman, P Xia, The Cleveland Clinic Foundation, Cleveland, OH

Presentations

(Saturday, 3/26/2022)   [Central Time (GMT-5)]

Purpose: To evaluate the “personalized planning” module of the Pinnacle treatment planning system (TPS) for head-and-neck cancer (HN).

Methods: Ten patients with oropharyngeal HN cancer treated between 2019-2021 were selected. All patients received 70 Gy and 56 Gy to the primary tumor (HD-PTV) and elective neck nodes (LD-PTV), respectively. Personalized planning (PP) module includes a modified template-based auto-planning optimization engine constructed on Broyden-Fletcher-Goldfarb-Shanno (LBFGS) and Layered Graph algorithms. The PP plans were created using Pinnalce Evolution TPS (version 16.4.3) and compared with clinically approved plans (CP) generated on Pinnacle v. 16.2 as well as the manual plans generated on Ray Station (RS) TPS (v. 10B). All plans were normalized to have 95% of HD-PTV and LD-PTV receive respective prescription doses. We used our institutional criteria to evaluate the plan quality and OAR doses for 19 critical structures including serial and parallel organs. PP and CP plans were delivered and verified using EPID-based quality assurance (QA) system.

Results: The PP and RS plans were hotter than those of CP plans but were meeting the institutional criteria of V73.5Gy <15%. The average of HD-PTV D0.03cc were 75.1 ± 0.69 Gy and 75.93 ± 0.98 Gy, 75.08 ± 0.99 Gy, for PP, RS and CP plans, respectively. The average dose differences in OARs were 1.13 ± 1.60 Gy, 0.35 ±1.75Gy and 1.5 ± 2.05Gy for PP vs CP, PP vs RS, and RS vs CP, respectively. For the PP vs CP, the largest average difference was found in the mean dose to the lips. All delivered PP plans passed the ?-analysis at 3%/2mm with average passing rates of 99.4±0.8%.

Conclusion: The personalized planning can produce plans with similar qualities as the current clinical plans and Ray Station plan. The plans were found clinically acceptable and deliverable.

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