Dosimetric and Radiobiological Evaluation of Dose Volume Optimizer (DVO) and Progressive Resolution Optimizer (PRO) Algorithm against Photon Optimizer on IMRT and VMAT Plan for Prostate Cancer

This study aimed to compare the performance of previous optimization algorithms against new a photon optimizer (PO) algorithm for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans for prostate cancer. Eighteen patients with prostate cancer were retrospectively selected and planned to receive 78 Gy in 39 fractions of the planning target volume (PTV). All plans for each patient optimized with the dose volume optimizer (DVO) and progressive resolution optimizer (PRO) algorithms for IMRT and VMAT were compared against plans optimized with the PO within Eclipse version 13.7. No interactive action was performed during optimization. Dosimetric and radiobiological indices for the PTV and organs at risk were analyzed. The monitor units (MU) per plan were recorded. Based on the plan quality for the target coverage, prostate IMRT and VMAT plans using the PO showed an improvement over DVO and PRO. In addition, the PO generally showed improvement in the tumor control probability for the PTV and normal tissue control probability for the rectum. From a technical perspective, the PO generated IMRT treatment plans with fewer MUs than DVO, whereas it produced slightly more MUs in the VMAT plan, compared with PRO. The PO showed over potentiality of DVO and PRO whenever available, although it led to more MUs in VMAT than PRO. Therefore, the PO has become the preferred choice for planning prostate IMRT and VMAT at our institution