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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Biological optimization for mediastinal lymphoma radiotherapy - a preliminary study

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  2. Tumour control probability after Ruthenium-106 brachytherapy for choroidal melanomas

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  3. Use of primary health care and participation in colorectal cancer screening - a Danish national register-based study

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  4. Circulating tumour DNA alterations as biomarkers for head and neck cancer: a systematic review

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  1. Deep learning for identification of critical regions associated with toxicities after liver stereotactic body radiation therapy

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  2. Harnessing data science to advance radiation oncology

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Purpose: In current radiotherapy (RT) planning and delivery, population-based dose-volume constraints are used to limit the risk of toxicity from incidental irradiation of organs at risks (OARs). However, weighing tradeoffs between target coverage and doses to OARs (or prioritizing different OARs) in a quantitative way for each patient is challenging. We introduce a novel RT planning approach for patients with mediastinal Hodgkin lymphoma (HL) that aims to maximize overall outcome for each patient by optimizing on tumor control and mortality from late effects simultaneously.Material and Methods: We retrospectively analyzed 34 HL patients treated with conformal RT (3DCRT). We used published data to model recurrence and radiation-induced mortality from coronary heart disease and secondary lung and breast cancers. Patient-specific doses to the heart, lung, breast, and target were incorporated in the models as well as age, sex, and cardiac risk factors (CRFs). A preliminary plan of candidate beams was created for each patient in a commercial treatment planning system. From these candidate beams, outcome-optimized (O-OPT) plans for each patient were created with an in-house optimization code that minimized the individual risk of recurrence and mortality from late effects. O-OPT plans were compared to VMAT plans and clinical 3DCRT plans.Results: O-OPT plans generally had the lowest risk, followed by the clinical 3DCRT plans, then the VMAT plans with the highest risk with median (maximum) total risk values of 4.9 (11.1), 5.1 (17.7), and 7.6 (20.3)%, respectively (no CRFs). Compared to clinical 3DCRT plans, O-OPT planning reduced the total risk by at least 1% for 9/34 cases assuming no CRFs and 11/34 cases assuming presence of CRFs.Conclusions: We developed an individualized, outcome-optimized planning technique for HL. Some of the resulting plans were substantially different from clinical plans. The results varied depending on how risk models were defined or prioritized.

Original languageEnglish
JournalActa Oncologica
Volume59
Issue number8
Pages (from-to)879-887
Number of pages9
ISSN0284-186X
DOIs
Publication statusPublished - Aug 2020

ID: 60921780