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Clinical implications in the use of the PBC algorithm versus the AAA by comparison of different NTCP models/parameters.

Bufacchi A, Nardiello B, Capparella R, Begnozzi L - Radiat Oncol (2013)

Bottom Line: The paired Student t-test was used for statistical comparison of all results obtained from the use of the two algorithms.Also NTCPAAA regarding the risk of radiation pneumonitis in the lung treatments was found to be lower than NTCPPBC for each of the eight sets of NTCP parameters; the maximum mean decrease was 4.5%.The NTCP is strongly affected by the wide-ranging values of radiobiological parameters.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Physics, PioXI Clinic and UOC Medical Physics, S Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy. ant.buf@tiscali.it

ABSTRACT

Purpose: Retrospective analysis of 3D clinical treatment plans to investigate qualitative, possible, clinical consequences of the use of PBC versus AAA.

Methods: The 3D dose distributions of 80 treatment plans at four different tumour sites, produced using PBC algorithm, were recalculated using AAA and the same number of monitor units provided by PBC and clinically delivered to each patient; the consequences of the difference on the dose-effect relations for normal tissue injury were studied by comparing different NTCP model/parameters extracted from a review of published studies. In this study the AAA dose calculation is considered as benchmark data. The paired Student t-test was used for statistical comparison of all results obtained from the use of the two algorithms.

Results: In the prostate plans, the AAA predicted lower NTCP value (NTCPAAA) for the risk of late rectal bleeding for each of the seven combinations of NTCP parameters, the maximum mean decrease was 2.2%. In the head-and-neck treatments, each combination of parameters used for the risk of xerostemia from irradiation of the parotid glands involved lower NTCPAAA, that varied from 12.8% (sd=3.0%) to 57.5% (sd=4.0%), while when the PBC algorithm was used the NTCPPBC's ranging was from 15.2% (sd=2.7%) to 63.8% (sd=3.8%), according the combination of parameters used; the differences were statistically significant. Also NTCPAAA regarding the risk of radiation pneumonitis in the lung treatments was found to be lower than NTCPPBC for each of the eight sets of NTCP parameters; the maximum mean decrease was 4.5%. A mean increase of 4.3% was found when the NTCPAAA was calculated by the parameters evaluated from dose distribution calculated by a convolution-superposition (CS) algorithm. A markedly different pattern was observed for the risk relating to the development of pneumonitis following breast treatments: the AAA predicted higher NTCP value. The mean NTCPAAA varied from 0.2% (sd = 0.1%) to 2.1% (sd = 0.3%), while the mean NTCPPBC varied from 0.1% (sd = 0.0%) to 1.8% (sd = 0.2%) depending on the chosen parameters set.

Conclusions: When the original PBC treatment plans were recalculated using AAA with the same number of monitor units provided by PBC, the NTCPAAA was lower than the NTCPPBC, except for the breast treatments. The NTCP is strongly affected by the wide-ranging values of radiobiological parameters.

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Comparison of inhomogeneity index for treatment plans computed with the AAA (ordinate) and the PBC algorithm (abscissa) for the breast, NSCLC, head-and-neck and prostate treatments. Each symbol represents data of an individual patient. The dotted line indicates the line of identity.
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Figure 4: Comparison of inhomogeneity index for treatment plans computed with the AAA (ordinate) and the PBC algorithm (abscissa) for the breast, NSCLC, head-and-neck and prostate treatments. Each symbol represents data of an individual patient. The dotted line indicates the line of identity.

Mentions: This type of treatment showed a markedly different pattern. The present study showed no clinically significant differences for any of the evaluated PTV dose parameters (Table 9). The type of algorithm did not affect the II (Figure 4). Across the two algorithms, the TCP was within 2.0%. Regarding the rectum, the AAA predicted slightly higher values for the dose parameters (though statistically significant) except D2%. But on the other hand when the PBC was used, low percentage of rectum volume was exposed to a higher dose than had been obtained with the AAA and the NTCPPBC was higher than NTCPAAA (Figure 5).


Clinical implications in the use of the PBC algorithm versus the AAA by comparison of different NTCP models/parameters.

Bufacchi A, Nardiello B, Capparella R, Begnozzi L - Radiat Oncol (2013)

Comparison of inhomogeneity index for treatment plans computed with the AAA (ordinate) and the PBC algorithm (abscissa) for the breast, NSCLC, head-and-neck and prostate treatments. Each symbol represents data of an individual patient. The dotted line indicates the line of identity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750611&req=5

Figure 4: Comparison of inhomogeneity index for treatment plans computed with the AAA (ordinate) and the PBC algorithm (abscissa) for the breast, NSCLC, head-and-neck and prostate treatments. Each symbol represents data of an individual patient. The dotted line indicates the line of identity.
Mentions: This type of treatment showed a markedly different pattern. The present study showed no clinically significant differences for any of the evaluated PTV dose parameters (Table 9). The type of algorithm did not affect the II (Figure 4). Across the two algorithms, the TCP was within 2.0%. Regarding the rectum, the AAA predicted slightly higher values for the dose parameters (though statistically significant) except D2%. But on the other hand when the PBC was used, low percentage of rectum volume was exposed to a higher dose than had been obtained with the AAA and the NTCPPBC was higher than NTCPAAA (Figure 5).

Bottom Line: The paired Student t-test was used for statistical comparison of all results obtained from the use of the two algorithms.Also NTCPAAA regarding the risk of radiation pneumonitis in the lung treatments was found to be lower than NTCPPBC for each of the eight sets of NTCP parameters; the maximum mean decrease was 4.5%.The NTCP is strongly affected by the wide-ranging values of radiobiological parameters.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Physics, PioXI Clinic and UOC Medical Physics, S Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy. ant.buf@tiscali.it

ABSTRACT

Purpose: Retrospective analysis of 3D clinical treatment plans to investigate qualitative, possible, clinical consequences of the use of PBC versus AAA.

Methods: The 3D dose distributions of 80 treatment plans at four different tumour sites, produced using PBC algorithm, were recalculated using AAA and the same number of monitor units provided by PBC and clinically delivered to each patient; the consequences of the difference on the dose-effect relations for normal tissue injury were studied by comparing different NTCP model/parameters extracted from a review of published studies. In this study the AAA dose calculation is considered as benchmark data. The paired Student t-test was used for statistical comparison of all results obtained from the use of the two algorithms.

Results: In the prostate plans, the AAA predicted lower NTCP value (NTCPAAA) for the risk of late rectal bleeding for each of the seven combinations of NTCP parameters, the maximum mean decrease was 2.2%. In the head-and-neck treatments, each combination of parameters used for the risk of xerostemia from irradiation of the parotid glands involved lower NTCPAAA, that varied from 12.8% (sd=3.0%) to 57.5% (sd=4.0%), while when the PBC algorithm was used the NTCPPBC's ranging was from 15.2% (sd=2.7%) to 63.8% (sd=3.8%), according the combination of parameters used; the differences were statistically significant. Also NTCPAAA regarding the risk of radiation pneumonitis in the lung treatments was found to be lower than NTCPPBC for each of the eight sets of NTCP parameters; the maximum mean decrease was 4.5%. A mean increase of 4.3% was found when the NTCPAAA was calculated by the parameters evaluated from dose distribution calculated by a convolution-superposition (CS) algorithm. A markedly different pattern was observed for the risk relating to the development of pneumonitis following breast treatments: the AAA predicted higher NTCP value. The mean NTCPAAA varied from 0.2% (sd = 0.1%) to 2.1% (sd = 0.3%), while the mean NTCPPBC varied from 0.1% (sd = 0.0%) to 1.8% (sd = 0.2%) depending on the chosen parameters set.

Conclusions: When the original PBC treatment plans were recalculated using AAA with the same number of monitor units provided by PBC, the NTCPAAA was lower than the NTCPPBC, except for the breast treatments. The NTCP is strongly affected by the wide-ranging values of radiobiological parameters.

Show MeSH
Related in: MedlinePlus