Evaluation of fully automated a priori MCO treatment planning in VMAT for head-and-neck cancer

Automated Planning for Prostate Stereotactic Body Radiation Therapy on the 1.5 T MR-Linac

“…The set of constraints and prioritized objectives for a specific treatment site and protocol defines a “wish list.” Applications of Erasmus-iCycle were reported for various anatomic sites such as head and neck, 6 , 7 cervix, 8 prostate, 9 and lungs. 10 More recently, Erasmus-iCycle was implemented into the Monaco TPS 11 , 12 , 13 as “mCycle,” the main novelty being the adoption of the physical and radiobiological cost functions of Monaco into the lexicographic logic.…”

Comprehensive dosimetric and clinical evaluation of lexicographic optimization-based planning for cervical cancer

“…Despite the capabilities of mCycle to deal with multiple dose prescriptions, in the current study, we only dealt with a single dose prescription. As it has already been demonstrated by other authors in head and neck cases ( 9 ) or prostate with simultaneous boost ( 10 ), multiple prescriptions are easily handled by mCycle WL exploiting the LO capability to spare OAR as much as possible without affecting a higher dose target coverage: the PTV coverage request should be doubled and differentiated for the PTV boost, and the goal values of OAR cost functions coherently adapted. This would lead to fine-tune the presented WL on a different subset.…”

“…A completely new code has been written to embed this approach in the Monaco environment with a different mathematical solver, a different patient model, the typical Monaco cost functions, and a Monte Carlo Algorithm (XVMC) ( 8 ). The published experiences are mainly focused on iCycle application in several anatomic sites, while applications of the novel mCycle are reported only for head and neck, prostate and rectal cancer volumetric-modulated arc therapy (VMAT) treatment planning ( 8 , 9 ), and prostate treatment on an MR-Linac ( 10 ). This is the first feasibility study of mCycle implementation for cervical cancer treatment.…”

Minimum non-isotropic and asymmetric margins for taking into account intrafraction prostate motion during moderately hypofractionated radiotherapy

“…One hundred and forty four VMAT treatment plans were re-computed using increased CTV-to-PTV margins with mCycle auto-planning solution, which is implemented in a research version of Monaco TPS (V.5.59.11, Elekta AB, Stockholm). This concept, using lexicographic Multi Criteria Optimization (MCO) has been extensively described before (19). To summarize, the first step is defining a "tumor and protocol" specific wish-list containing the constraints and prioritized objectives.…”

“…The CTV structure was perturbed with the recorded prostate displacements using the voxel shifting method and the static dose cloud approximation (18). Then, to evaluate the effectiveness of NI-AS margins, treatment plans were re-computed using an autoplanning algorithm (19). Several studies dealing with intrafraction prostate monitoring during treatment can be found in the literature (9)(10)(11)20) as well as many margins recipes that consider interfractional motion (16,17,21).…”