{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:29:16Z","timestamp":1747182556766,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T00:00:00Z","timestamp":1559001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>It is not always apparent when the optimal <jats:styled-content style=\"fixed-case\">IMRT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">VMAT<\/jats:styled-content> plan for post\u2010prostatectomy radiotherapy (<jats:styled-content style=\"fixed-case\">PPRT<\/jats:styled-content>) has been achieved. Individual variation in patient anatomy is a key contributor. This study aimed to create a model to determine the probability of rectum and\/or bladder doses exceeding planning goals based on individual patient anatomy prior to planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">IMRT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">VMAT PPRT<\/jats:styled-content> plans from 200 men were randomly and evenly allocated into the Training Cohort and the Validation Cohort. Univariate and multivariate analysis of the Training Cohort identified variables which impacted bladder and rectal doses. Significant variables were included in a Classification and Regression Tree (<jats:styled-content style=\"fixed-case\">CART<\/jats:styled-content>) analysis. The resultant algorithm was then applied to the Validation Cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On multivariate analysis, prescription dose; bladder and rectal volume; lymph node treatment; and percentage of bladder and rectal overlap with the <jats:styled-content style=\"fixed-case\">PTV<\/jats:styled-content> were significant variables. Following <jats:styled-content style=\"fixed-case\">CART<\/jats:styled-content> analysis, the overlap volume (<jats:styled-content style=\"fixed-case\">OV<\/jats:styled-content>) for both rectum (rectum overlap\u00a0&gt;\u00a020%) and bladder (bladder overlap\u00a0&gt;\u00a020%) were the key drivers of meeting planning goals. Treatment of pelvic lymph nodes was included as the secondary driving factor for bladder (but not rectal) dose. On application to the Validation Cohort, <jats:styled-content style=\"fixed-case\">CART<\/jats:styled-content> analysis predicted 95% and 87% of patients who would meet bladder and rectal planning goals respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A simple algorithm was developed to predict plan quality by using the <jats:styled-content style=\"fixed-case\">OV<\/jats:styled-content> of the bladder and rectum with the <jats:styled-content style=\"fixed-case\">PTV<\/jats:styled-content>. This algorithm may be used a priori to assess the planning process in the context of variable anatomy, and to optimise planning quality and efficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12902","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T12:59:18Z","timestamp":1559048358000},"page":"546-551","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A simple algorithm to predict non\u2010compliance with organ at risk dose\u2010volume constraints when planning intensity modulated post\u2010prostatectomy radiation treatment: \u2018Why we should put the <scp>CART<\/scp> before the horse\u2019"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3191-699X","authenticated-orcid":false,"given":"Natalie","family":"Collier","sequence":"first","affiliation":[{"name":"Northern Sydney Cancer Centre Radiation Oncology Royal North Shore Hospital St 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