N Patrik Brodin1, Maja V Maraldo2, Marianne C Aznar3, Ivan R Vogelius4, Peter M Petersen5, Søren M Bentzen6, Lena Specht5. 1. Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, New York, New York. 2. Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: dra.maraldo@gmail.com. 3. Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Niels Bohr Institute, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark. 4. Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Hematology, Rigshospitalet, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark. 6. Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Human Oncology, University of Wisconsin Medical School, Madison, Wisconsin.
Abstract
PURPOSE: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). METHODS AND MATERIALS: A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose-response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A "relevance score" was assigned to each data source, reflecting how relevant the input data are to current RT for HL. RESULTS: The tool is applied to visualize the local steepness of dose-response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL. CONCLUSION: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.
PURPOSE: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). METHODS AND MATERIALS: A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose-response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A "relevance score" was assigned to each data source, reflecting how relevant the input data are to current RT for HL. RESULTS: The tool is applied to visualize the local steepness of dose-response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL. CONCLUSION: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.
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