Session in Memory of Marilyn Stovall: Evolution of Dose Evaluations for Brachytherapy: From Adoption of Model-Based Dose Calculations to Impact on Patient Treatments
Description
Dose evaluations for brachytherapy have traditionally followed the TG-43 formalism, with its simplifying assumptions of a water-equivalent patient. However, patient-specific model-based dose calculation algorithms (MBDCAs) can offer more accurate doses for treatment planning that enable personalized treatment approaches, development of reliable dose-response models, and enhanced dose reporting accuracy. A growing body of research supports the importance of adopting MBDCAs for brachytherapy and aligns with the guidance of the joint AAPM-ESTRO-ABG-ABS Task Group 186 on model-based dose calculation techniques in brachytherapy and WGDCAB Report 372. This scientific session will include contributions from experts who are the forefront of developing, applying, and learning from MBDCAs for patient-specific dose evaluations for brachytherapy. This session will be unique in its consideration of the evolution of brachytherapy dose evaluation from state-of-the-art in MBDCAs to their impact on patient treatments. The context will be set via an overview of dose evaluations in brachytherapy. Drawing on the most recent research, the motivations for adopting MBDCAs in brachytherapy will be presented. The practical steps required for clinical adoption and implementation will be described, considering commissioning and use of test cases developed by the Working Group for Model-Based Dose Algorithms for Brachytherapy. Findings from a multi-institution cross-Canada study considering the largest patient cohorts studied (to date) for prostate and breast low-dose rate brachytherapy will be presented, including dosimetric data, analysis of differences across difference clinical practices, outcomes, and revision of prescription doses. The session will close with discussion on the current state of the field and outlook.