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Original Articles: BiGART 2023 Issue

Plan robustness evaluation strategies in whole-pelvic proton therapy for high-risk prostate cancer patients within a randomised clinical trial

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Pages 1455-1460 | Received 23 May 2023, Accepted 15 Sep 2023, Published online: 29 Sep 2023

Figures & data

Figure 1. Original nominal treatment plan for one of the included patients. Transversal views at the level of the lymph nodes (top), seminal vesicles (Middle) and prostate (bottom). dose shown in color wash with a lower limit of 53.2 Gy and an upper limit of 81.5 Gy. Primary target outlined in red, elective target in light red, rectum in brown, bladder in yellow, bowel bag in green. Markers within the prostate volume in red, blue and green.

Figure 1. Original nominal treatment plan for one of the included patients. Transversal views at the level of the lymph nodes (top), seminal vesicles (Middle) and prostate (bottom). dose shown in color wash with a lower limit of 53.2 Gy and an upper limit of 81.5 Gy. Primary target outlined in red, elective target in light red, rectum in brown, bladder in yellow, bowel bag in green. Markers within the prostate volume in red, blue and green.

Figure 2. Dose/volume histogram for the original treatment plan for a patient including 14 pre-treatment robust evaluation scenarios for each volume of interest. Primary clinical target volume (CTVp) in red, elective clinical target volume (CTVe) in light red, rectum in brown, bladder in yellow, and bowel in green.

Figure 2. Dose/volume histogram for the original treatment plan for a patient including 14 pre-treatment robust evaluation scenarios for each volume of interest. Primary clinical target volume (CTVp) in red, elective clinical target volume (CTVe) in light red, rectum in brown, bladder in yellow, and bowel in green.

Figure 3. Figure of dose/volume measures for the Pre-treatment robust evaluation associated with the planning computed tomography scan (pCT) and the during-treatment robust evaluations associated with the weekly control computed tomography scans (cCTs) for one patient. The red dashed lines mark the constraint values corresponding to the dose/volume measures. A circular dot signifies a nominal treatment plan with no distal edge uncertainty, a cross means that the value corresponds to a scenario with distal edge uncertainty +3.5% and equivalently, a square signifies a −3.5% distal edge uncertainty scenario. Note that a DRE measure outside the PRE interval does not necessarily signify a constraint violation for the dose/volume measure and DRE scenario in question – or vice versa.

Figure 3. Figure of dose/volume measures for the Pre-treatment robust evaluation associated with the planning computed tomography scan (pCT) and the during-treatment robust evaluations associated with the weekly control computed tomography scans (cCTs) for one patient. The red dashed lines mark the constraint values corresponding to the dose/volume measures. A circular dot signifies a nominal treatment plan with no distal edge uncertainty, a cross means that the value corresponds to a scenario with distal edge uncertainty +3.5% and equivalently, a square signifies a −3.5% distal edge uncertainty scenario. Note that a DRE measure outside the PRE interval does not necessarily signify a constraint violation for the dose/volume measure and DRE scenario in question – or vice versa.

Table 1. Results from the during-treatment robust evaluation (DRE) versus pre-treatment robust evaluation (PRE) analysis.

Supplemental material

Supplemental Material

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Data availability statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.

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