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Comparison of biological-based and dose volume-based intensity-modulated radiotherapy plans generated using the same treatment planning system

1 Department of Medical Physics, Karnataka Cancer Therapy and Research Institute, Hubli, Karnataka; Research and Development Centre, Bharathiar University, Coimbatore, Tamil Nadu, India
2 Research and Development Centre, Bharathiar University, Coimbatore, Tamil Nadu; Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Correspondence Address:
KJ Maria Das,
Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226 014, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_956_16

Purpose: Nowadays, most of the radiotherapy (RT) treatment planning systems (TPSs) uses dose or dose-volume (DV)-based cost functions for Intensity modulated radiation therapy (IMRT) fluence optimization. Recently, some of the TPSs incorporated biological-based cost function for IMRT optimization. Most of the previous studies compared IMRT plans optimized using biological-based and DV-based cost functions in two different TPSs. Hence, the purpose of the study is to compare equivalent uniform dose (EUD)-based and DV-based IMRT plans generated using the same TPS. Materials and Methods: Twenty patients with prostate cancer were retrospectively selected for this study. For each patient, two IMRT plans were generated using EUD-based cost function (EUD_TP) and DV-based cost (DV_Treatment Plan (TP)), respectively. The generated IMRT plans were evaluated using both physical and biological dose evaluation indices. Results: Biological-based plans ended up with a highly inhomogeneous target dose when compared to DV-based plans. For serial organs, Dnear-max or D2% (Gy) of EUD-based plans showed significant difference with DV-based plans (P = 0.003). For both rectum and bladder, there was a significant difference in mean dose and D30% (Gy) dose between EUD-based plans and DV-based plans. Conclusion: In this study, we decoupled the influence of optimization parameters from the potential use of EUD-based cost functions on plan quality by generating both plans in the same TPS.

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