Automatic genetic planning for volumetric modulated arc therapy: A large multi-centre validation for prostate cancer

Christian Fiandra, Linda Rossi, Alessandro Alparone, Stefania Zara, Claudio Vecchi, Anna Sardo, Sara Bartoncini, Gianfranco Loi, Carla Pisani, Eva Gino, Maria Grazia Ruo Redda, Gian Marco Deotto, Paolo Tini, Stefania Comi, Dario Zerini, Gianluca Ametrano, Valentina Borzillo, Lidia Strigari, Silvia Strolin, Alessandro SaviniAntonino Romeo, Sonia Reccanello, Imad Abu Rumeileh, Nunzia Ciscognetti, Flavia Guerrisi, Gabriella Balestra, Umberto Ricardi, Ben Heijmen

Research output: Contribution to journalArticlepeer-review


PURPOSE: The first clinical genetic autoplanning algorithm (Genetic Planning Solution, GPS) was validated in ten radiotherapy centres for prostate cancer VMAT by comparison with manual planning (Manual).

METHODS: Although there were large differences among centres in planning protocol, GPS was tuned with the data of a single centre and then applied everywhere without any centre-specific fine-tuning. For each centre, ten Manual plans were compared with autoGPS plans, considering dosimetric plan parameters and the Clinical Blind Score (CBS) resulting from blind clinician plan comparisons. AutoGPS plans were used as is, i.e. there was no patient-specific fine-tuning.

RESULTS: For nine centres, all ten plans were clinically acceptable. In the remaining centre, only one plan was acceptable. For the 91% acceptable plans, differences between Manual and AutoGPS in target coverage were negligible. OAR doses were significantly lower in AutoGPS plans (p < 0.05); rectum D15% and Dmean were reduced by 8.1% and 17.9%, bladder D25% and Dmean by 5.9% and 10.3%. According to clinicians, 69% of the acceptable AutoGPS plans were superior to the corresponding Manual plan. In case of preferred Manual plans (31%), perceived advantages compared to autoGPS were minor. QA measurements demonstrated that autoGPS plans were deliverable. A quick configuration adjustment in the centre with unacceptable plans rendered 100% of plans acceptable.

CONCLUSION: A novel, clinically applied genetic autoplanning algorithm was validated in 10 centres for in total 100 prostate cancer patients. High quality plans could be generated at different centres without centre-specific algorithm tuning.

Original languageEnglish
Pages (from-to)126-132
Number of pages7
JournalRadiotherapy and Oncology
Publication statusPublished - Jul 2020


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