Plan quality assessment in clinical practice : Results of the 2020 ESTRO survey on plan complexity and robustness
Kaplan, Laura Patricia (Department of Clinical Medicine. Aarhus University)
Placidi, Lorenzo (Fondazione Policlinico Universitario ''A. Gemelli'' IRCCS)
Bäck, Anna (Department of Medical Radiation Sciences. Sahlgrenska Academy. University of Gothenburg)
Canters, Richard (Maastricht University Medical Centre (Maastricht, Països Baixos))
Hussein, Mohammad (Metrology for Med Phys Centre. National Physical Laboratory)
Vaniqui, Ana (Maastricht University Medical Centre (Maastricht, Països Baixos))
Fusella, Marco (Veneto Institute of Oncology IOV - IRCCS)
Piotrowski, Tomasz (Department of Electroradiology. Poznan University of Medical Sciences and Department of Med Phys. Greater Poland Cancer Centre)
Hernandez, Victor (Institut d'Investigació Sanitària Pere Virgili)
Jornet, Nuria (Institut d'Investigació Biomèdica Sant Pau)
Hansen, Christian Ronn (Department of Clinical Research. University of Southern Denmark)
Widesott, Lamberto (Centro di protonterapia. APSS) [...] Mostra tots els 12 autors

Data:	2022
Resum:	Purpose: Plan complexity and robustness are two essential aspects of treatment plan quality but there is a great variability in their management in clinical practice. This study reports the results of the 2020 ESTRO survey on plan complexity and robustness to identify needs and guide future discussions and consensus. Methods: A survey was distributed online to ESTRO members. Plan complexity was defined as the modulation of machine parameters and increased uncertainty in dose calculation and delivery. Robustness was defined as a dose distribution's sensitivity towards errors stemming from treatment uncertainties, patient setup, or anatomical changes. Results: A total of 126 radiotherapy centres from 33 countries participated, 95 of them (75%) from Europe and Central Asia. The majority controlled and evaluated plan complexity using monitor units (56 centres) and aperture shapes (38 centres). To control robustness, 98 (97% of question responses) photon and 5 (50%) proton centres used PTV margins for plan optimization while 75 (94%) and 5 (50%), respectively, used margins for plan evaluation. Seventeen (21%) photon and 8 (80%) proton centres used robust optimisation, while 10 (13%) and 8 (80%), respectively, used robust evaluation. Primary uncertainties considered were patient setup (photons and protons) and range calculation uncertainties (protons). Participants expressed the need for improved commercial tools to control and evaluate plan complexity and robustness. Conclusion: Clinical implementation of methods to control and evaluate plan complexity and robustness is very heterogeneous. Better tools are needed to manage complexity and robustness in treatment planning systems. International guidelines may promote harmonization.
Nota:	Altres ajuts: DCCC Radiotherapy - The Danish National Research Centre for Radiotherapy, Danish Cancer Society (R191-A11526); Danish Comprehensive Cancer Centre, and the Danish Cancer Society (R167-A11003).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	International survey ; Plan quality ; Plan complexity ; Plan robustness
Publicat a:	Radiotherapy and oncology, Vol. 173 (august 2022) , p. 254-261, ISSN 1879-0887

DOI: 10.1016/j.radonc.2022.06.005
PMID: 35714808

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