Workflow Automation and Optimization In VMAT Treatment Planning for Cervical Cancer with Simultaneous Integrated Boost Via Scripting In a Radiotherapy Center In a Middle Income Country
Abstract
Purpose
To develop and evaluate a workflow based on scripting for the automation and optimization of volumetric modulated arc therapy (VMAT) treatment planning with simultaneous integrated boost (SIB) for cervical cancer, aiming to improve planning efficiency, standardization, and reproducibility in a clinical environment.
Methods
A treatment planning automation tool was developed using the Eclipse Scripting Application Programming Interface (ESAPI v18.0) and implemented in C# on the .NET Framework 4.8. A graphical user interface was designed using Windows Presentation Foundation (WPF) to facilitate clinical usability. The automated workflow covered key planning steps, including creation of optimization structures for treatment planning, configuration of plan, beam parameters and VMAT field setup. Dose volume histogram (DVH) objectives were estimated and applied using a knowledge based planning approach supported by RapidPlan models. The script executed these tasks sequentially, minimizing manual user interaction while maintaining compatibility with standard clinical planning procedures for cervical cancer SIB treatments.
Results
The automated workflow successfully generated VMAT SIB treatment plans for cervical cancer with consistent plan structure and optimization settings. Planning time was substantially reduced compared to conventional manual planning workflows by decreasing repetitive tasks and standardizing key planning steps. The generated plans met institutional planning objectives, demonstrating adequate planning target volume (PTV) coverage and acceptable compliance with organ at risk (OAR) dose constraints compared to manually created plans. The graphical interface enabled intuitive interaction, allowing planners to review and adjust parameters when required while preserving automation benefits.
Conclusion
Automation of VMAT treatment planning for cervical cancer with SIB implemented through scripting is feasible and effective for improving workflow efficiency and plan consistency. The proposed approach demonstrates the potential of tools developed using the ESAPI to optimize complex treatment planning processes, reduce planning time, and support standardized clinical practice without compromising plan quality.