Multicriteria optimization enables less experienced planners to efficiently produce high quality treatment plans in head and neck cancer radiotherapy

Table 1 Overview of the conventional IMRT and MCO-plan quality scores and the inter-rater reliability

	Technique
	Conventional IMRT	MCO
Item	Mean (SD)	Mean (SD)	p- value	ICC agreement (95% CI)
1: Dose hot spots in PTV_boost	4.7 (0.5)	4.7 (0.5)	1.00	0.26 (−0.36 – 0.6)
2: Dose hotspots in PTV_prophylactic	4.4 (0.9)	4.6 (0.5)	0.15	0.51 (0.28 – 0.79)
3: Dose cold spots in PTV_boost	3.9 (0.9)	3.5 (0.9)	0.01	0.57 (0.22 – 0.77)
4: Dose cold spots in PTV_prophylactic	4.0 (1.2)	3.9 (1.1)	0.45	0.70 (0.45 – 0.84)
5: Conformity of 95% isodose around PTV_boost	3.8 (1.0)	3.5 (0.8)	0.11	0.19 (−0.45 – 0.56)
6: Conformity of 95% isodose around PTV_prophylactic	4.0 (1.1)	3.7 (1.1)	0.07	0.61 (0.29 – 0.79)
7: Maximum dose to spinal cord	4.9 (0.5)	5.0 (0.2)	0.28	0.83 (0.70 – 0.91)
8: Parotid gland dose	4.4 (0.7)	4.3 (0.7)	0.62	0.67 (0.40 – 0.82)
9: Dose in unspecified tissue	4.0 (0.8)	3.7 (0.8)	0.07	0.28 (−0.31 – 0.61)
10: General plan quality	3.8 (1.2)	3.6 (1.1)	0.29	0.44 (−0.33 – 0.69)
Total	41.7 (6.4)	40.4 (5.4)	0.15	0.65 (0.57 – 0.71)

The plan quality scores range from 1–5 with 5 the highest score. Abbreviations: IMRT intensity-modulated radiotherapy, MCO multicriteria optimization, PTV planning target volume, SD standard deviation, ICC intra-class correlation coefficient, CI confidence interval. Level of statistically significant differences was set to p < 0.005; Bonferroni correction with α = 0.05/10 questions.

ISSN: 1748-717X