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Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis

Kyroudi, A. ; Petersson, K. LU ; Ozsahin, E. ; Bourhis, J. ; Bochud, F. and Moeckli, R. (2020) In Physics and imaging in radiation oncology 14. p.82-86
Abstract

Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients... (More)

Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. Results: The plans in the central region of the Pareto front (1–4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5–4% PTV under-dosage) while medical physicists preferred better PTV coverage (1–2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5–1% PTV under-dosage). Conclusion: We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
CGA, Clinical decision making, Pareto fronts, Prostate, Trade-offs
in
Physics and imaging in radiation oncology
volume
14
pages
82 - 86
publisher
Elsevier
external identifiers
  • pmid:33458319
  • scopus:85086454665
ISSN
2405-6316
DOI
10.1016/j.phro.2020.05.008
language
English
LU publication?
no
additional info
Publisher Copyright: © 2020 The Authors
id
acc67871-c749-46cb-ab4d-00e9578ab533
date added to LUP
2021-11-03 18:18:53
date last changed
2024-05-04 16:20:51
@article{acc67871-c749-46cb-ab4d-00e9578ab533,
  abstract     = {{<p>Introduction: Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials: Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. Results: The plans in the central region of the Pareto front (1–4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5–4% PTV under-dosage) while medical physicists preferred better PTV coverage (1–2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5–1% PTV under-dosage). Conclusion: We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them.</p>}},
  author       = {{Kyroudi, A. and Petersson, K. and Ozsahin, E. and Bourhis, J. and Bochud, F. and Moeckli, R.}},
  issn         = {{2405-6316}},
  keywords     = {{CGA; Clinical decision making; Pareto fronts; Prostate; Trade-offs}},
  language     = {{eng}},
  pages        = {{82--86}},
  publisher    = {{Elsevier}},
  series       = {{Physics and imaging in radiation oncology}},
  title        = {{Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis}},
  url          = {{http://dx.doi.org/10.1016/j.phro.2020.05.008}},
  doi          = {{10.1016/j.phro.2020.05.008}},
  volume       = {{14}},
  year         = {{2020}},
}