S1961
Physics - Dose prediction/calculation, optimisation and applications for photon and electron planning
ESTRO 2026
Conclusion: This study demonstrates that both VMAT and hybrid techniques are effective in achieving planning objectives and constraints for WB RT with SIB, with improved dose conformity to the boost PTV compared to 3D-CRT. VMAT offers significant advantages in reducing maximum heart dose. These findings support the use of VMAT and hybrid techniques as viable alternatives to 3D-CRT in RT of WB with SIB in our intitution. References: [1] Gagliardi G, Lax I, Ottolenghi A, Rutqvist LE. Long- term cardiac mortality after radiotherapy of breast cancer-application of the relative seriality model. Br J Radiol. 1996 Sep;69(825):839-46. doi: 10.1259/0007- 1285-69-825-839. Keywords: Breast cancer, radiotherapy, treatment plan Digital Poster 3911 The Role of Scripts in Process Optimization for Elekta Systems Bruno Oliveira 1,2 , Joana Lourenço 3 , Iola Cardoso 4,2 , Renato Castro 5 , Katia Jacob 4,2 , Gonçalo Fernandez 2 1 Clinical Intelligence, MercuriusHealth, Lisbon, Portugal. 2 Radiotherapy, Hospital Cuf Descobertas, Lisbon, Portugal. 3 Clinical Implementation, MercuriusHealth, Lisbon, Portugal. 4 Radiotherapy, MercuriusHealth, Lisbon, Portugal. 5 Eplanning, MercuriusHealth, Lisbon, Portugal Purpose/Objective: Radiotherapy is a crucial area in oncological treatment, where precision and efficiency are decisive for clinical effectiveness. This study aims to explore the role of scripts in optimizing processes within Elekta radiotherapy systems, highlighting how these automated tools can enhance efficiency, reduce errors, and standardize complex procedures. Material/Methods: This study was centered on analysing the scripting capabilities of Elekta radiotherapy systems, considering their practical application in treatment planning and delivery processes. The analysis included Monaco Scripting tools in the Elekta systems (1). For task automation, such as treatment plan generation, QAs, and treatment verification, a combination of Case studies and technical literature were employed to understand the impact of scripts on reducing execution times and increasing the safety and uniformity of procedures, as well as the entire programming language involved in the API (1,2). In addition, the experience of professionals in using these tools was considered, alongside the technical requirements necessary for their implementation.
Results: All plans met the target volume objectives and OAR constraints. VMAT plans showed a median increase in the heart mean dose of 10.4% (range -8.4% to 30.4%, p < 0.05), while hybrid plans had a 2.2% median increase (range -2.3% to 12.0%, p > 0.05), compared to 3D-CRT. Heart maximum dose was reduced by up to 53.5% with VMAT (p < 0.05) and 4.7% with hybrid plans (p < 0.05). No significant difference in ipsilateral lung mean dose was observed with VMAT, hybrid plans showed a median increase of 10.2% (range 1.8% to 21.6%, p < 0.05). The V16Gy was significantly lower with VMAT and higher with hybrid plan. Both VMAT and hybrid plan improved dose conformity to the boost PTV, compared to 3D-CRT (p < 0.05). NTCP for the heart was 0% across all techniques. Results are summarized in Table 1.
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