{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:54:38Z","timestamp":1760709278685,"version":"3.41.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T00:00:00Z","timestamp":1485216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["7172048"],"award-info":[{"award-number":["7172048"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["11505012"],"award-info":[{"award-number":["11505012"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The enhanced dosimetric performance of knowledge\u2010based volumetric modulated arc therapy (<jats:styled-content style=\"fixed-case\">VMAT<\/jats:styled-content>) planning might be jointly contributed by the patient\u2010specific optimization objectives, as estimated by the RapidPlan model, and by the potentially improved Photon Optimizer (<jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content>) algorithm than the previous Progressive Resolution Optimizer (<jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content>) engine. As <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> is mandatory for RapidPlan estimation but optional for conventional manual planning, appreciating the two optimizers may provide practical guidelines for the algorithm selection because knowledge\u2010based planning may not replace the current method completely in a short run. Using a previously validated dose\u2013volume histogram (<jats:styled-content style=\"fixed-case\">DVH<\/jats:styled-content>) estimation model which can produce clinically acceptable plans automatically for rectal cancer patients without interactive manual adjustment, this study reoptimized 30 historically approved plans (referred as clinical plans that were created manually with <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content>) with RapidPlan solution (<jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> plans). Then the <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> algorithm was utilized to optimize the plans again using the same dose\u2013volume constraints as <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> plans, where the line objectives were converted as a series of point objectives automatically (<jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> plans). On the basis of comparable target dose coverage, the combined applications of new objectives and <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> algorithm have significantly reduced the organs\u2010at\u2010risk (<jats:styled-content style=\"fixed-case\">OAR<\/jats:styled-content>) exposure by 23.49\u201332.72% than the clinical plans. These discrepancies have been largely preserved after substituting <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content>, indicating the dosimetric improvements were mostly attributable to the refined objectives. Therefore, Eclipse users of earlier versions may instantly benefit from adopting the model\u2010generated objectives from other RapidPlan\u2010equipped centers, even with <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> algorithm. However, the additional contribution made by the <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> relative to <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> accounted for 1.54\u20133.74%, suggesting <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> should be selected with priority whenever available, with or without RapidPlan solution as a purchasable package. Significantly increased monitor units were associated with the model\u2010generated objectives but independent from the optimizers, indicating higher modulation in these plans. As a summary, <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content> prevails over <jats:styled-content style=\"fixed-case\">PRO<\/jats:styled-content> algorithm for <jats:styled-content style=\"fixed-case\">VMAT<\/jats:styled-content> planning with or without knowledge\u2010based technique.<\/jats:p>","DOI":"10.1002\/acm2.12038","type":"journal-article","created":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T16:14:06Z","timestamp":1489680846000},"page":"9-14","source":"Crossref","is-referenced-by-count":17,"title":["Photon Optimizer (<scp>PO<\/scp>) prevails over Progressive Resolution Optimizer (<scp>PRO<\/scp>) for <scp>VMAT<\/scp> planning with or without knowledge\u2010based solution"],"prefix":"10.1002","volume":"18","author":[{"given":"Fan","family":"Jiang","sequence":"first","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing) Department of Radiation Oncology Peking University Cancer Hospital &amp; Institute Beijing Cancer Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing) Department of Radiation Oncology Peking University Cancer Hospital &amp; Institute Beijing Cancer Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haizhen","family":"Yue","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing) Department of Radiation Oncology Peking University Cancer Hospital &amp; Institute Beijing Cancer Hospital Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The First Affiliated Hospital of Zhengzhou University and Department of Radiation Oncology Basic Medical College of Zhengzhou University Zhengzhou Henan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yibao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing) Department of Radiation Oncology Peking University Cancer Hospital &amp; 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