Objective Automatic planning is a commonly used alternative to manual planning. This study evaluated the clinical performance of automatic plans available in commercial treatment planning systems for nasopharyngeal carcinoma (NPC) treatment by comparing automatic planning with manual planning.
Methods A total of 14 patients with nasopharyngeal carcinoma were enrolled in the study. For each patient, three different sets of clinical goals were used to generate three hybrid automatic plans based on 3D dose distribution prediction and three automatic plans based on script, respectively, which were compared with the manual plans used in clinic.
Results The dose coverage performance of the automatic planning based on 3D dose distribution prediction on the planning target volume (PTV) was comparable to that of the manual planning. Automatic planning based on 3D dose prediction achieved the level of manual planning in most organs at risk. However, automatic planning based on scripts did not perform well in the prediction of some organs at risk, especially the parotid gland.
Conclusion The hybrid automatic plan based on 3D dose distribution prediction can reach the level of manual planning and have good robustness with the change of clinical objective.