{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:51:29Z","timestamp":1777351889272,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purposes of this work are to (a) investigate whether the use of auto\u2010planning and multiple iterations improves quality of head and neck (HN) radiotherapy plans; (b) determine whether delivery methods such as step\u2010and\u2010shoot (SS) and volumetric modulated arc therapy (VMAT) impact plan quality; (c) report on the observations of plan quality predictions of a commercial feasibility tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Twenty HN cases were retrospectively selected from our clinical database for this study. The first ten plans were used to test setting up planning goals and other optimization parameters in the auto\u2010planning module. Subsequently, the other ten plans were replanned with auto\u2010planning using step\u2010and\u2010shoot (AP\u2010SS) and VMAT (AP\u2010VMAT) delivery methods. Dosimetric endpoints were compared between the clinical plans and the corresponding AP\u2010SS and AP\u2010VMAT plans. Finally, predicted dosimetric endpoints from a commercial program were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All AP\u2010SS and AP\u2010VMAT plans met the clinical dose constraints. With auto\u2010planning, the dose coverage of the low dose planning target volume (PTV) was improved while the dose coverage of the high dose PTV was maintained. Compared to the clinical plans, the doses to critical organs, such as the brainstem, parotid, larynx, esophagus, and oral cavity were significantly reduced in the AP\u2010VMAT (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05); the AP\u2010SS plans had similar homogeneity indices (HI) and conformality indices (CI) and the AP\u2010VMAT plans had comparable HI and improved CI. Good agreement in dosimetric endpoints between predictions and AP\u2010VMAT plans were observed in five of seven critical organs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>With improved planning quality and efficiency, auto\u2010planning module is an effective tool to enable planners to generate HN IMRT plans that are meeting institution specific planning protocols. DVH prediction is feasible in improving workflow and plan quality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.12652","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T13:06:36Z","timestamp":1562245596000},"page":"39-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Evaluation of auto\u2010planning in IMRT and VMAT for head and neck cancer"],"prefix":"10.1002","volume":"20","author":[{"given":"Zi","family":"Ouyang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhilei","family":"Liu Shen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of 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