S1821
Physics - Dose prediction/calculation, optimisation and applications for photon and electron planning
ESTRO 2026
Results:
Dynamic collimator rotation during arc delivery can enhance dose conformity and gradient performance for both multiple metastases and irregular targets, reducing dose bridges and improving overall plan quality compared with static collimator settings. Keywords: Dynamic collimator rotation, optimization, arcs Digital Poster 1170 Evaluating the use of PlanCHECK as a radiotherapy treatment planning feasibility tool in clinical practice Emma Durkin, Andrew Robinson, Jennifer Mehrer, Hannah Chantler, Sarah Brooke Radiotherapy Physics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom Purpose/Objective: Radiotherapy planning aims to achieve optimal tumour coverage while minimising toxicity to organs at risk (OARs), thus maximising the therapeutic ratio. Traditionally, this has been a highly manual and planner-dependent process. Feasibility tools have recently emerged to standardise planning, provide quality control, and enable real-time assessment of OAR optimisation against benchmark datasets. This study aimed to evaluate the clinical usability and implementation of one such feasibility tool, PlanCHECK (Sun Nuclear Corporation, Florida), within a clinical radiotherapy department. Material/Methods: Thirty prostate volumetric modulated arc therapy (VMAT) and thirty non-small cell lung cancer (NSCLC) VMAT treatment plans delivered at Addenbrooke’s Hospital were retrospectively analysed using PlanCHECK. Population dose–volume histograms (DVHs) were generated using mean OAR DVHs and their associated 95% confidence intervals. Replans were carried out for a subset of the prostate cohort using PlanCHECK as a guide for further optimisation. For a cohort of prostate cases, replans were performed guided by PlanCHECK feasibility data. The original and replanned population DVHs were compared, and planners provided usability feedback and re-optimisation times.
For the NSCLC cohort, all clinical OAR population DVHs were contained within the 95% confidence interval of the corresponding feasibility DVHs. In contrast, within the prostate cohort, the rectum, bladder, and bilateral femoral heads exhibited regions exceeding the feasibility limits, shown in Figure 1. Replans guided by PlanCHECK achieved consistent reductions in OAR doses across all structures compared with the original clinical plans, illustrated in Figure 2. Planners reported the tool as intuitive and supportive for objective plan evaluation and further optimisation, whilst acknowledging that additional time was required for re-optimisation and analysis, with a mean additional time of 66.5 minutes (range: 45–90 minutes).
Conclusion: Feasibility tools offer an effective method to evaluate radiotherapy planning dose distributions in real time and can direct further optimisation for improved OAR sparing and plan standardisation. Future work should assess the dosimetric and clinical impact of these improvements, including effects on target coverage, plan conformality, and monitor units, and develop local guidelines for efficient clinical integration. References: [1] Robinson, A., Gleeson, I., Ajithkuma, T. Can the use of knowledge-based planning systems improve stereotactic radiotherapy planning? A systematic review. J Radiother Pract, vol. 22, 2023 https://doi.org/10.1017/S1460396922000437. [2] Ge, Y., Wu, Q. Knowledge - based planning for intensity - modulated radiation therapy: A review of data - driven approaches. Med Phys, vol. 46, 2019 https://doi.org/10.1002/mp.13526. Keywords: Feasibility, PlanCHECK, Optimisation
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