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Abstract

Introduction:

There are various open access head and neck knowledge-based planning (KBP) models available but have varying performance. This study evaluates a new open access RapidPlan (RP) model, HN-SIB-BPI, which was created using a previous best performing model as a foundation. The goal of the new model was to increase conformality and further reduce dose to organs-at-risks (OARs), including parotid glands, with the quantification of improvement evaluated with a dosimetric scorecard. The model’s performance was tested in a clinic in India and compared to existing plans.

Materials and Methods:

A total of 18 head and neck plans treated with volumetric modulated arc therapy with Planning Target Volumes (PTVs), abutting or overlapping bilateral parotid glands, were replanned manually (TrueBeam Manual Comparator Plans [TB-MCP]) and with HN-SIB-BPI. Each patient had either two or three dose level PTVs. Plans were recreated with both C arm and ring gantry delivery systems using four arcs as specified in HN-SIB-BPI documentation.

Results:

C arm and O gantry plans showed similar coverage for low, intermediate, and high-risk target volumes. Both delivery systems reduced doses to brain stem, spinal cord, larynx, and bilateral parotid glands. C arm plans demonstrated mean dose reduction in left and right parotid glands 3.57 ± 2.65 Gy (p < 0.01) and 1.60 ± 2.13 Gy (p = 0.01), respectively, compared with TB-MCP. However, there was increased mean dose to the lips by 1.65 ± 2.76 Gy with C arm plans (p = 0.03). Similarly, O gantry plans reduced the mean doses in left and right parotid glands by 2.80 ± 2.84 Gy (p < 0.01) and 1.41 ± 2.20 Gy (p = 0.01), respectively, but increased the mean dose to the lips by 1.20 ± 2.22 Gy (p = 0.04).

Conclusion:

The HN-SIB-BPI open access KBP model was validated in our local Indian patient population, demonstrating significant reduction in parotid glands dose while maintaining similar target volume coverage. Applying this KBP model improved plan quality in this study. The authors plan to implement the HN-SIB-BPI model as the default model in clinical practice.

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Evaluation of Open Access RapidPlan Model Developed for Treatment of Head and Neck Cancer in a Network of Cancer Centers