Re-irradiation volumetric modulated arc therapy optimization based on cumulative biologically effective dose objectives

J Appl Clin Med Phys. 2018 Nov;19(6):341-345. doi: 10.1002/acm2.12481. Epub 2018 Oct 29.

Abstract

The objective of this note is to introduce a clinical tool that generates ideal base plan dose distributions to enable re-irradiation volumetric modulated arc therapy (VMAT) optimization based on cumulative biological effective dose objectives for specific organs at risk (OARs). The tool is demonstrated with a lung cancer case that required re-irradiation at our clinic. First, previous treatment dose is deformed onto the retreatment computed tomography (CT) using commercial software. Then, the in-house Matlab tool alters the deformed previous dose using radiobiological concepts on a voxel-by-voxel manner to generate an ideal base plan dose distribution. Ideal base plans that were generated using the in-house Matlab tool were compatible with the Varian Eclipse™ treatment planning system. The tool enabled optimization of VMAT re-irradiation plans using cumulative dose limits for OARs and all OAR cumulative dose objectives were met on the first optimization for the recurrent lung cancer case tested.

Keywords: VMAT dose optimization algorithms; adaptive replanning; linear-quadratic model; radiobiology.

MeSH terms

  • Algorithms
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Lung Neoplasms / radiotherapy*
  • Neoplasm Recurrence, Local / radiotherapy*
  • Organs at Risk / radiation effects*
  • Prognosis
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Radiotherapy Planning, Computer-Assisted / standards*
  • Radiotherapy, Intensity-Modulated / methods
  • Radiotherapy, Intensity-Modulated / standards*
  • Re-Irradiation / standards*
  • Retrospective Studies
  • Software
  • Tomography, X-Ray Computed / methods