Improved Planning Efficiency with RapidPlanPT In Proton Breast Therapy
Abstract
Purpose
To evaluate the clinical efficacy and planning efficiency of RapidPlanPT for proton beam breast cancer treatment planning.
Methods
A RapidPlanPT model was developed for proton breast treatment delivering 40.05 Gy to the whole breast with a 48.00 Gy boost over 15 fractions. Seventy-two historical plans from 2022–2024 (64% left-sided, 36% right-sided) were used for model training. Following validation using 35 plans, the model was approved for clinical use and has since been applied prospectively to 53 patients. For each use, dosimetrists completed a questionnaire documenting whether the RapidPlanPT output contributed to the final plan, any subsequent plan modifications, and estimated time savings.
Results
Validation demonstrated strong agreement between predicted and achieved DVHs. RapidPlanPT plans achieved reduced brachial plexus dose compared with historical clinical plans. Although RapidPlanPT optimizes only physical dose, the biological dose to the brachial plexus met clinical constraints in 91% of validation cases. Of the 53 prospectively planned cases, 45 were further refined and approved for treatment. Reported time savings included no savings (n=3), <3 hours (n=9), <8 hours (n=8), and 1–2 days (n=25). The coronary artery most frequently required additional optimization, followed by the skin and ipsilateral lung. The number of subsequent optimization iterations ranged from 0 to 15, with a median of 3. Dosimetrists reported that RapidPlanPT was particularly valuable for establishing an initial optimization starting point and for generating comparison plans for insurance authorization.
Conclusion
Clinical implementation of RapidPlanPT for breast proton therapy improves planning efficiency.