Fully automatic treatment planning for external-beam radiation therapy of locally advanced cervical cancer : a tool for low-resource clinics

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dc.contributor.authorKisling, Kellyen_ZA
dc.contributor.authorZhang, Lifeien_ZA
dc.contributor.authorSimonds, Hannah M.en_ZA
dc.contributor.authorFakie, Naziaen_ZA
dc.contributor.authorYang, Jinzhongen_ZA
dc.contributor.authorMcCarroll, Rachelen_ZA
dc.contributor.authorBalter, Peteren_ZA
dc.contributor.authorBurger, Hesteren_ZA
dc.contributor.authorBogler, Oliveren_ZA
dc.contributor.authorHowell, Rebeccaen_ZA
dc.contributor.authorSchmeler, Kathleenen_ZA
dc.contributor.authorMejia, Mikeen_ZA
dc.contributor.authorBeadle, Beth M.en_ZA
dc.contributor.authorJhingran, Anujaen_ZA
dc.contributor.authorCourt, Laurenceen_ZA
dc.date.accessioned2021-11-30T13:55:40Z
dc.date.available2021-11-30T13:55:40Z
dc.date.issued2019
dc.descriptionCITATION: Kisling, K., et al. 2019. Fully automatic treatment planning for external-beam radiation therapy of locally advanced cervical cancer : a tool for low-resource clinics. Journal of Global Oncology, 5:1-7, doi:10.1200/JGO.18.00107.
dc.descriptionThe original publication is available at https://ascopubs.org/
dc.description.abstractPURPOSE: The purpose of this study was to validate a fully automatic treatment planning system for conventional radiotherapy of cervical cancer. This system was developed to mitigate staff shortages in low-resource clinics. METHODS: In collaboration with hospitals in South Africa and the United States, we have developed the Radiation Planning Assistant (RPA), which includes algorithms for automating every step of planning: delineating the body contour, detecting the marked isocenter, designing the treatment-beam apertures, and optimizing the beam weights to minimize dose heterogeneity. First, we validated the RPA retrospectively on 150 planning computed tomography (CT) scans. We then tested it remotely on 14 planning CT scans at two South African hospitals. Finally, automatically planned treatment beams were clinically deployed at our institution. RESULTS: The automatically and manually delineated body contours agreed well (median mean surface dis- tance, 0.6 mm; range, 0.4 to 1.9 mm). The automatically and manually detected marked isocenters agreed well (mean difference, 1.1 mm; range, 0.1 to 2.9 mm). In validating the automatically designed beam apertures, two physicians, one from our institution and one from a South African partner institution, rated 91% and 88% of plans acceptable for treatment, respectively. The use of automatically optimized beam weights reduced the maximum dose significantly (median, −1.9%; P , .001). Of the 14 plans from South Africa, 100% were rated clinically acceptable. Automatically planned treatment beams have been used for 24 patients with cervical cancer by physicians at our institution, with edits as needed, and its use is ongoing. CONCLUSION: We found that fully automatic treatment planning is effective for cervical cancer radiotherapy and may provide a reliable option for low-resource clinics. Prospective studies are ongoing in the United States and are planned with partner clinics.en_ZA
dc.description.urihttps://ascopubs.org/doi/abs/10.1200/JGO.18.00107
dc.description.versionPublisher's version
dc.format.extent7 pages ; illustrations
dc.identifier.citationKisling, K., et al. 2019. Fully automatic treatment planning for external-beam radiation therapy of locally advanced cervical cancer : a tool for low-resource clinics. Journal of Global Oncology, 5:1-7, doi:10.1200/JGO.18.00107
dc.identifier.issn2378-9506 (online)
dc.identifier.otherdoi:10.1200/JGO.18.00107
dc.identifier.urihttp://hdl.handle.net/10019.1/123509
dc.language.isoen_ZAen_ZA
dc.publisherAmerican Society of Clinical Oncology
dc.rights.holderAmerican Society of Clinical Oncology
dc.subjectCervix uteri -- Cancer -- Radiotherapy -- Developing countriesen_ZA
dc.subjectPhoton beam radiation therapy -- Developing countriesen_ZA
dc.subjectPhoton beam radiation therapy -- Strategic planningen_ZA
dc.subjectRadiotherapy -- Strategic planningen_ZA
dc.titleFully automatic treatment planning for external-beam radiation therapy of locally advanced cervical cancer : a tool for low-resource clinicsen_ZA
dc.typeArticleen_ZA
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