Biologically guided automated treatment planning and evaluation: potential for treatment adaptation in head and neck cancer

Figures & data

Figure 1. Automated planning workflow.

Table 1. OAR desired clinical dose and acceptance criteria.

	Priority	Clinical goal type	Volume	Acceptance criteria (Gy)
Spinal cord	1	Dose at volume	2%	50
Mandible	4	Dose at volume	2%	75
Brain stem	1	Dose at volume	2%	60
Parotids	4	Average dose (single gland)		20
		Average dose (at least one gland)		30
Oesophagus	4	Average dose		55
		Dose at absolute volume	0.03 ml	60
Cochlea	4	Dose at volume	2%	55

Table 2. TCP parameter values.

Parameter	Value
n	35
α	0.32 Gy^–1
α/β	10 Gy
TCP	0.95

Figure 2. Axial view corresponding to (a) pO₂ distribution derived from FMISO-PET, (b) number of clonogenic cells per voxel derived from FDG-PET, (c) prescription dose to targets, (d) dose map to be mimicked, (e) planned dose distribution, and (f) DVHs. In solid lines, the volumes of interest: PTV, CTV, GTV, and HTV are light pink, dark pink, red, and dark blue, respectively; mandible, neck, parotid glands, and spinal cord are red, orange, light green, and light pink.

Table 3. Parameters used for NTCP calculation for selected OARs.

OAR name	TD50 (Gy)	n	m	α/β (Gy)	End point
Spinal cord	66.5	0.05	0.175	3	Myelopathy
Parotids	46	0.7	0.18	3	Xerostomia
Mandible	72	0.07	0.1	3.5	Osteoradionecrosis
Brain stem	65	0.16	0.14	2	Necrosis

Figure 3. Axial view corresponding to (a) EQD2 of the planned physical doses, (b) surviving cell number distribution after 35 fractions, and (c) marked voxels with failing control. In solid lines, the volumes of interest: patient body contour, PTV and CTV are green, dark brown, and brown, respectively; mandible, neck, parotids, and spinal cord are red, orange, light green, and light pink.

Data availability statement

The data that support the findings of this study are available from the corresponding author, AU, upon reasonable request.