Quality optimization of volumetric modulated arc therapy plans for breast cancer via Ethos system(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2026年第1期
- Page:
- 1-8
- Research Field:
- 医学放射物理
- Publishing date:
Info
- Title:
- Quality optimization of volumetric modulated arc therapy plans for breast cancer via Ethos system
- Author(s):
- YAO Kaining; WANG Meijiao; LIU Jiacheng; SHI Chen; YUE Haizhen; WU Hao; DU Yi; WANG Ruoxi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing)/Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Keywords:
- Keywords: Ethos system automatic planning customized field arrangement breast cancer radiotherapy
- PACS:
- R318；R811.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2026.01.001
- Abstract:
- Abstract: Objective To address the issue of the suboptimal dose distribution caused by the fixed field arrangements in Ethos 2.0 planning system for breast cancer radiotherapy, an improved workflow integrating Eclipse pre-planned fields is proposed for ensuring the quality of complex treatment plans and enhancing the efficiency of plan design through customized field arrangements. Methods? retrospective analysis was conducted on 20 patients with right-sided breast cancer and sentinel lymph node metastasis, classified as clinical stage T1-2N1M0. Target areas and organs-at-risk were contoured in accordance with the ESTRO guidelines. Pre-plans were designed using the Eclipse planning system and then imported into Ethos system for re-optimization via its intelligent optimization engine. Subsequently, a comparison of Ethos automatic plans with customized field arrangements against Eclipse reference plans was conducted in Eclipse system, focusing on target coverage, conformity index, and organ-at-risk doses. Results?oth the target doses and organs-at-risk doses of the Ethos plans with customized field arrangements met clinical requirements. Compared with the Eclipse reference plans, the Ethos plans with customized field arrangements improved the conformity index of PTVbreast and PTVboost from 0.84 to 0.90 and from 0.73 to 0.81, respectively, decreased V107% of PTVboost by 7.71%, and reduced the mean liver dose by 0.67 Gy, with all differences being statistically significant (P<0.05). The Ethos automatic workflow reduced human-computer interaction time by 90%, substantially alleviating the workload of physicists. Conclusion?he integrated workflow established in this study overcomes the field arrangement limitations of the Ethos system in breast cancer radiotherapy. Ethos plans with customized field arrangements achieves near-identical quality to that of Eclipse plans while significantly improving planning efficiency. This workflow provides a standardized procedure for complex breast cancer cases and an extensible field arrangement framework for adaptive breast radiotherapy techniques.
Last Update: 2026-01-26