Skip to main content
Journal cover image

Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning.

Publication ,  Journal Article
Younge, KC; Marsh, RB; Owen, D; Geng, H; Xiao, Y; Spratt, DE; Foy, J; Suresh, K; Wu, QJ; Yin, F-F; Ryu, S; Matuszak, MM
Published in: Int J Radiat Oncol Biol Phys
March 15, 2018

PURPOSE: To use knowledge-based planning (KBP) as a method of producing high-quality, consistent, protocol-compliant treatment plans in a complex setting of spine stereotactic body radiation therapy on NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631. METHODS AND MATERIALS: An internally developed KBP model was applied to an external validation cohort of 22 anonymized cases submitted under NRG Oncology RTOG 0631. The original and KBP plans were compared via their protocol compliance, target conformity and gradient index, dose to critical structures, and dose to surrounding normal tissues. RESULTS: The KBP model generated plans meeting all protocol objectives in a single optimization when tested on both internal and protocol-submitted NRG Oncology RTOG 0631 cases. Two submitted plans that were considered to have a protocol-unacceptable deviation were made protocol compliant through the use of the model. There were no statistically significant differences in protocol spinal cord metrics (D10% and D0.03cc) between the manually optimized plans and the KBP plans. The volume of planning target volume receiving prescription dose increased from 93.3% ± 3.2% to 98.3% ± 1.4% (P = .01) when using KBP. High-dose spillage to surrounding normal tissues (V105%) showed no significant differences (2.1 ± 7.3 cm3 for manual plans to 1.8 ± 0.6 cm3 with KBP), and dosimetric outliers with large amounts of spillage were eliminated through the use of KBP. Knowledge-based planning plans were also found to be significantly more consistent in several metrics, including target coverage and high dose outside of the target. CONCLUSION: Incorporation of KBP models into the clinical trial setting may have a profound impact on the quality of trial results, owing to the increase in consistency and standardization of planning, especially for treatment sites or techniques that are nonstandard.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

March 15, 2018

Volume

100

Issue

4

Start / End Page

1067 / 1074

Location

United States

Related Subject Headings

  • Spine
  • Spinal Neoplasms
  • Relative Biological Effectiveness
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiosurgery
  • Radiation Oncology
  • Quality of Life
  • Quality Improvement
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Younge, K. C., Marsh, R. B., Owen, D., Geng, H., Xiao, Y., Spratt, D. E., … Matuszak, M. M. (2018). Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning. Int J Radiat Oncol Biol Phys, 100(4), 1067–1074. https://doi.org/10.1016/j.ijrobp.2017.12.276
Younge, Kelly C., Robin B. Marsh, Dawn Owen, Huaizhi Geng, Ying Xiao, Daniel E. Spratt, Joseph Foy, et al. “Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning.Int J Radiat Oncol Biol Phys 100, no. 4 (March 15, 2018): 1067–74. https://doi.org/10.1016/j.ijrobp.2017.12.276.
Younge KC, Marsh RB, Owen D, Geng H, Xiao Y, Spratt DE, et al. Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning. Int J Radiat Oncol Biol Phys. 2018 Mar 15;100(4):1067–74.
Younge, Kelly C., et al. “Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning.Int J Radiat Oncol Biol Phys, vol. 100, no. 4, Mar. 2018, pp. 1067–74. Pubmed, doi:10.1016/j.ijrobp.2017.12.276.
Younge KC, Marsh RB, Owen D, Geng H, Xiao Y, Spratt DE, Foy J, Suresh K, Wu QJ, Yin F-F, Ryu S, Matuszak MM. Improving Quality and Consistency in NRG Oncology Radiation Therapy Oncology Group 0631 for Spine Radiosurgery via Knowledge-Based Planning. Int J Radiat Oncol Biol Phys. 2018 Mar 15;100(4):1067–1074.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

March 15, 2018

Volume

100

Issue

4

Start / End Page

1067 / 1074

Location

United States

Related Subject Headings

  • Spine
  • Spinal Neoplasms
  • Relative Biological Effectiveness
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiosurgery
  • Radiation Oncology
  • Quality of Life
  • Quality Improvement