INTEGRATION OF RADIOTHERAPY PLANNING SYSTEMS AND RADIOTHERAPY TREATMENT EQUIPMENT - 11 YEARS EXPERIENCE

Purpose: We have investigated the requirements, design, implementation , and operation of a computer-controlled medical accelerator with mult ileaf collimator (MLC), integrated with a radiation treatment-planning system (RTPS), and we report on the performance, benefits, and lesson s learned from this experience. Methods and Materials: In 1984 the Uni versity of Washington installed a computer-controlled radiation therap y machine (the Clinical Neutron Therapy System, or CNTS) with a multil eaf collimator. Since the beginning of operation the control system co mputer has been connected by commercially available network hardware a nd software to three generations of radiation treatment-planning syste ms. Semiautomated setup and completely computerized check and confirm were incorporated into the system from the beginning of clinical opera tion in 1984. The system cannot deliver a patient treatment without a computer-prepared treatment plan. Results: The CNTS has been in use fo r routine patient treatments for over 11 years. The cost of the networ k connection and software was an insignificant fraction of the facilit y cost. Operation has been efficient and reliable. Of the 441 machine- related session reschedulings (out of 18,432 sessions total) during th e past 9 years, only 20 were due to problems with data transfer betwee n the RTPS and CNTS, associated primarily with two incidents. Close in tegration with the treatment-planning system allows complex treatments to be delivered. Dramatic evolution of the departmental treatment-pla nning system has not required any changes or redesign of either the ac celerator control system or the network connection. Conclusions: Our e xperience shows that a large degree of automation is possible with rea sonable effort, by using well-known software and hardware design strat egies. The lessons we have learned from this can be carried over into photon therapy now that photon accelerators with MLC facilities are co mmercially available. (C) 1997 Elsevier Science Inc.