TY  - JOUR
AU  - Leitao, Joana
AU  - Bijman, Rik
AU  - Wahab Sharfo, Abdul
AU  - Brus, Yori
AU  - Rossi, Linda
AU  - Breedveld, Sebastiaan
AU  - Heijmen, Ben
TI  - Automated multi-criterial planning with beam angle optimization to establish non-coplanar VMAT class solutions for nasopharyngeal carcinoma.
JO  - Physica medica
VL  - 101
SN  - 1120-1797
CY  - Amsterdam
PB  - Elsevier
M1  - DKFZ-2022-01512
SP  - 20 - 27
PY  - 2022
N1  - #EA:E041#
AB  - Complexity in selecting optimal non-coplanar beam setups and prolonged delivery times may hamper the use of non-coplanar treatments for nasopharyngeal carcinoma (NPC). Automated multi-criterial planning with integrated beam angle optimization was used to define non-coplanar VMAT class solutions (CSs), each consisting of a coplanar arc and additional 1 or 2 fixed, non-coplanar partial arcs.Automated planning was used to generate a coplanar VMAT plan with 5 complementary computer-optimized non-coplanar IMRT beams (VMAT+5) for each of the 20 included patients. Subsequently, the frequency distribution of the 100 patient-specific non-coplanar IMRT beam directions was used to select non-coplanar arcs for supplementing coplanar VMAT. A second investigated CS with only one non-coplanar arc consisted of coplanar VMAT plus a partial arc at 90° couch angle (VMATCS90). Plans generated with the two VMATCSs were compared to coplanar VMAT.VMAT+5 analysis resulted in VMATCS60: two partial non-coplanar arcs at couch angles 60° and -60° to complement coplanar VMAT. Compared to coplanar VMAT, the non-coplanar VMATCS60 and VMATCS90 yielded substantial average dose reductions in OARs associated with xerostomia and dysphagia, i.e., parotids, submandibular glands, oral cavity and swallowing muscles (p < 0.05) for the same PTV coverage and without violating hard constraints. Impact of non-coplanar treatment and superiority of either VMACS60 and VMATCS90 was highly patient dependent.Compared to coplanar VMAT, dose to OARs was substantially reduced with a CS with one or two non-coplanar arcs. Preferences for coplanar or one or two additional arcs are highly patient-specific, balancing plan quality and treatment time.
KW  - Automated multi-criterial planning with beam angle optimization (Other)
KW  - Nasopharyngeal carcinoma (Other)
KW  - Non-coplanar VMAT class solutions (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:35853387
DO  - DOI:10.1016/j.ejmp.2022.06.017
UR  - https://inrepo02.dkfz.de/record/180721
ER  -