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    Probabilistic evaluation of plan quality for time-dependent anatomical deformations in head and neck cancer patients

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    Authors
    Robbins, Jennifer
    van Herk, Marcel
    Eiben, B.
    Green, Andrew
    Vásquez Osorio, Eliana
    Affiliation
    The University of Manchester, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom.
    Issue Date
    2023
    
    Metadata
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    Abstract
    Purpose: In addition to patient set-up uncertainties, anatomical deformations, e.g., weight loss, lead to time-dependent differences between the planned and delivered dose in a radiotherapy course that currently cannot easily be predicted. The aim of this study was to create time-varying prediction models to describe both the average and residual anatomical deformations. Methods: Weekly population-based principal component analysis models were generated from on-treatment cone-beam CT scans (CBCTs) of 30 head and neck cancer patients, with additional data of 35 patients used as a validation cohort. We simulated treatment courses accounting for a) anatomical deformations, b) set-up uncertainties and c) a combination of both. The dosimetric effects of the simulated deformations were compared to a direct dose accumulation based on deformable registration of the CBCT data. Results: Set-up uncertainties were seen to have a larger effect on the organ at risk (OAR) doses than anatomical deformations for all OARs except the larynx and the primary CTV. Distributions from simulation results were in good agreement with those of the accumulated dose. Conclusions: We present a novel method of modelling time-varying organ deformations in head and neck cancer. The effect on the OAR doses from these deformations are smaller than the effect of set-up uncertainties for most OARs. These models can, for instance, be used to predict which patients could benefit from adaptive radiotherapy, prior to commencing treatment.
    Citation
    Robbins J, van Herk M, Eiben B, Green A, Vásquez Osorio E. Probabilistic evaluation of plan quality for time-dependent anatomical deformations in head and neck cancer patients. Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 2023 May;109:102579. PubMed PMID: 37068428. Epub 2023/04/18. eng.
    Journal
    Physica Medica
    URI
    http://hdl.handle.net/10541/626234
    DOI
    10.1016/j.ejmp.2023.102579
    PubMed ID
    37068428
    Additional Links
    https://dx.doi.org/10.1016/j.ejmp.2023.102579
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ejmp.2023.102579
    Scopus Count
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    All Paterson Institute for Cancer Research

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