Treatment plan comparison using grading analysis based on clinical judgment

Figures & data

Figure 1. A screen capture showing how the dose distribution for treatment plans were presented side-by-side for the radiation oncologists, in the Oncentra treatment planning system. To the left is the helical tomotherapy plan, and to the right the step-and-shoot intensity-modulated radiation therapy plan, for treatment of an intrathoracic tumor (case I 3).

Table I. Clinical grading results with a gray-value scale accentuating the results.

Bold p-values highlight significant data in favor of the helical tomotherapy plans and underlined bold values that the results were in favor of the step-and-shoot intensity-modulated plan.

Table II. Dose-volume statistics and EUD-data.

	Dose-volume statistics (HTT/SS-IMRT)			EUD-data (HTT/SS-IMRT)
Case	V95%, CTV (%)	V95%, PTV (%)	AMDOAR (Gy)	EUDCTV (Gy)	EUDPTV (Gy)	fEUD
B 1	100/100	100/99.9	24.0/22.4	55.1/55.1	55.3/55.3	0.21/0.21
B 2	99.7/99.6	99.7/99.1	23.5/23.8	48.1/48.2	48.1/48.1	0.22/0.22
B 3	100/100	99.5/97.0	14.7/14.3	54.0/53.8	53.9/53.3	0.19/0.19
B 4	100/100	100/98.9	9.77/8.97	50.3/50.3	50.3/50.0	0.33/0.34
B 5	100/100	99.9/99.7	20.0/19.1	54.6/54.5	54.3/54.2	0.39/0.40
H 1	99.2/96.9	98.8/93.9	25.3/24.4	45.6/44.4	45.4/43.6	0.27/0.27
H 2	100/100	99.9/99.6	36.5/32.0	69.9/70.2	69.5/69.7	0.41/0.44
H 3	100/99.9	99.6/98.2	33.5/28.7	67.9/67.6	67.7/67.1	0.55/0.58
H 4	100/99.9	99.8/97.7	22.6/22.3	53.9/53.7	53.7/53.5	0.35/0.35
H 5	100/100	99.5/99.2	32.8/32.4	68.6/68.7	68.5/68.3	0.44/0.44
I 1	100/100	99.8/99.5	19.6/16.0	64.7/64.9	64.5/64.6	0.30/0.33
I 2	99.8/99.9	96.5/96.3	21.9/21.8	43.8/43.8	43.5/43.5	0.27/0.27
I 3	100/99.9	99.6/98.3	15.4/14.7	39.9/40.0	39.9/39.9	0.23/0.24
I 4	100/100	99.9/97.7	20.7/19.0	45.2/45.4	45.2/45.1	0.21/0.22
I 5	100/100	100/99.3	7.88/7.31	25.1/25.1	25.1/25.0	0.46/0.48
I 6	100/99.8	99.5/95.9	15.9/14.8	44.9/45.0	44.8/44.6	0.22/0.23
I 7	99.9/100	99.9/99.9	14.8/12.3	35.9/36.1	35.9/36.0	0.23/0.26
I 8	100/100	99.5/99.8	16.0/11.8	44.4/44.4	44.2/44.3	0.32/0.36
A 1	100/100	100/98.1	14.5/13.0	50.3/50.4	50.3/50.1	0.36/0.38
A 2	100/100	100/99.8	14.0/11.2	50.5/50.4	50.6/50.5	0.41/0.44
P 1	99.8/98.5	99.3/97.3	32.5/33.0	60.0/59.5	59.9/59.4	0.51/0.51
P 2	100/100	98.9/98.1	33.1/32.9	46.8/46.7	46.8/46.7	0.23/0.23
P 3	100/100	99.7/97.5	25.6/24.0	49.9/49.6	50.1/49.8	0.37/0.37

Bold values indicate that the difference in value between plans correlates with a significant result in the clinical grading analysis favoring the helical tomotherapy plans, and underlined bold values that the results favored the step-and-shoot intensity-modulated plan.