Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy
Purpose: A scoring mechanism called the scorecard that objectively quantifies the dosimetric plan quality of pancreas stereotactic body radiation therapy treatment plans is introduced. Methods and Materials: A retrospective analysis of patients with pancreatic ductal adenocarcinoma receiving stereot...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109423001239 |
| _version_ | 1797785138843615232 |
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| author | Kareem Rayn, MD Ryan Clark, MS, CMD Anthony Magliari, MS, CMD Brian Jeffers, BS Elizaveta Lavrova, BS Ingrid Valencia Lozano, PhD Michael J. Price, PhD Lesley Rosa, MS, CMD David P. Horowitz, MD |
| author_facet | Kareem Rayn, MD Ryan Clark, MS, CMD Anthony Magliari, MS, CMD Brian Jeffers, BS Elizaveta Lavrova, BS Ingrid Valencia Lozano, PhD Michael J. Price, PhD Lesley Rosa, MS, CMD David P. Horowitz, MD |
| author_sort | Kareem Rayn, MD |
| collection | DOAJ |
| description | Purpose: A scoring mechanism called the scorecard that objectively quantifies the dosimetric plan quality of pancreas stereotactic body radiation therapy treatment plans is introduced. Methods and Materials: A retrospective analysis of patients with pancreatic ductal adenocarcinoma receiving stereotactic body radiation therapy at our institution between November 2019 and November 2020 was performed. Ten patients were identified. All patients were treated to 36 Gy in 5 fractions, and organs at risk (OARs) were constrained based on Alliance A021501. The scorecard awarded points for OAR doses lower than those cited in Alliance A021501. A team of 3 treatment planners and 2 radiation oncologists, including a physician resident without plan optimization experience, discussed the relative importance of the goals of the treatment plan and added additional metrics for OARs and plan quality indexes to create a more rigorous scoring mechanism. The scorecard for this study consisted of 42 metrics, each with a unique piecewise linear scoring function which is summed to calculate the total score (maximum possible score of 365). The scorecard-guided plan, the planning and optimization for which were done exclusively by the physician resident with no prior plan optimization experience, was compared with the clinical plan, the planning and optimization for which were done by expert dosimetrists, using the Sign test. Results: Scorecard-guided plans had, on average, higher total scores than those clinically delivered for each patient, averaging 280.1 for plans clinically delivered and 311.7 for plans made using the scorecard (P = .003). Additionally, for most metrics, the average score of each metric across all 10 patients was higher for scorecard-guided plans than for clinically delivered plans. The scorecard guided the planner toward higher coverage, conformality, and OAR sparing. Conclusions: A scorecard tool can help clarify the goals of a treatment plan and provide an objective method for comparing the results of different plans. Our study suggests that a completely novice treatment planner can use a scorecard to create treatment plans with enhanced coverage, conformality, and improved OAR sparing, which may have significant effects on both tumor control and toxicity. These tools, including the scorecard used in this study, have been made freely available. |
| first_indexed | 2024-03-13T00:49:50Z |
| format | Article |
| id | doaj.art-e6c560942a2140b5ba5060fb6a00783e |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-03-13T00:49:50Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-e6c560942a2140b5ba5060fb6a00783e2023-07-08T04:19:04ZengElsevierAdvances in Radiation Oncology2452-10942023-11-0186101295Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation TherapyKareem Rayn, MD0Ryan Clark, MS, CMD1Anthony Magliari, MS, CMD2Brian Jeffers, BS3Elizaveta Lavrova, BS4Ingrid Valencia Lozano, PhD5Michael J. Price, PhD6Lesley Rosa, MS, CMD7David P. Horowitz, MD8Department of Radiation Oncology, Columbia University Irving Medical Center, New York, New York; Varian Medical Systems Inc, Palo Alto, California; Corresponding author: Kareem Rayn, MDVarian Medical Systems Inc, Palo Alto, CaliforniaVarian Medical Systems Inc, Palo Alto, CaliforniaDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, New YorkDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, New YorkDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, New YorkDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, New YorkVarian Medical Systems Inc, Palo Alto, CaliforniaDepartment of Radiation Oncology, Columbia University Irving Medical Center, New York, New YorkPurpose: A scoring mechanism called the scorecard that objectively quantifies the dosimetric plan quality of pancreas stereotactic body radiation therapy treatment plans is introduced. Methods and Materials: A retrospective analysis of patients with pancreatic ductal adenocarcinoma receiving stereotactic body radiation therapy at our institution between November 2019 and November 2020 was performed. Ten patients were identified. All patients were treated to 36 Gy in 5 fractions, and organs at risk (OARs) were constrained based on Alliance A021501. The scorecard awarded points for OAR doses lower than those cited in Alliance A021501. A team of 3 treatment planners and 2 radiation oncologists, including a physician resident without plan optimization experience, discussed the relative importance of the goals of the treatment plan and added additional metrics for OARs and plan quality indexes to create a more rigorous scoring mechanism. The scorecard for this study consisted of 42 metrics, each with a unique piecewise linear scoring function which is summed to calculate the total score (maximum possible score of 365). The scorecard-guided plan, the planning and optimization for which were done exclusively by the physician resident with no prior plan optimization experience, was compared with the clinical plan, the planning and optimization for which were done by expert dosimetrists, using the Sign test. Results: Scorecard-guided plans had, on average, higher total scores than those clinically delivered for each patient, averaging 280.1 for plans clinically delivered and 311.7 for plans made using the scorecard (P = .003). Additionally, for most metrics, the average score of each metric across all 10 patients was higher for scorecard-guided plans than for clinically delivered plans. The scorecard guided the planner toward higher coverage, conformality, and OAR sparing. Conclusions: A scorecard tool can help clarify the goals of a treatment plan and provide an objective method for comparing the results of different plans. Our study suggests that a completely novice treatment planner can use a scorecard to create treatment plans with enhanced coverage, conformality, and improved OAR sparing, which may have significant effects on both tumor control and toxicity. These tools, including the scorecard used in this study, have been made freely available.http://www.sciencedirect.com/science/article/pii/S2452109423001239 |
| spellingShingle | Kareem Rayn, MD Ryan Clark, MS, CMD Anthony Magliari, MS, CMD Brian Jeffers, BS Elizaveta Lavrova, BS Ingrid Valencia Lozano, PhD Michael J. Price, PhD Lesley Rosa, MS, CMD David P. Horowitz, MD Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy Advances in Radiation Oncology |
| title | Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy |
| title_full | Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy |
| title_fullStr | Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy |
| title_full_unstemmed | Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy |
| title_short | Scorecards: Quantifying Dosimetric Plan Quality in Pancreatic Ductal Adenocarcinoma Stereotactic Body Radiation Therapy |
| title_sort | scorecards quantifying dosimetric plan quality in pancreatic ductal adenocarcinoma stereotactic body radiation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2452109423001239 |
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