Treatment Prescription

The treatment prescription to be used for this competition is detailed on this page. Please note that these are intended to be plausible clinical objectives and constraints according to scientific publications and recent clinical trials, however they should not be considered recommendations. The same prescription will be used for all cases of a particular type, and it should be noted that no consideration of the clinical status of the patients has been taken into account.

"But these don't match what we do in our clinic!" - Don't Panic! This challenge is about automation of the workflow - we still want your participation. Read the section at the end of the page to see how you can participate.

Planning objectives

For the purpose of this challenge please assume all patients have no SV involvement, and are intermediate-risk (impacts definition of proximal SVs). Which case should be planned to which prescription is indicated in the spreadsheet available to download with the data.

Prostate Only

The dose to the target regions will be defined, broadly following [1], as:

Prostate + Nodes

The prostate primary PTV regions will have the same objectives as the Prostate only. Additionally, two objectives will be applied for the lymph node PTV region.

ProstateBed + Nodes

The prescribed dose to the prostate bed follows the RADICALS-RT trial [2]. The minimum and maximum have been set using the same percentage of the prescribed dose as for the Prostate + nodes. Nodal objectives have been set according to NRG guidelines [3].

OAR Constraints

The OAR constraints will be the same for all cases, and will broadly follow the PIVOTAL trial. The following is modified from from the supplementary material to Dearnaley et al. [1]. Modifications, to aid scoring, are shown in bold italics.

But these don't match what we do in our clinic!

There are so many different choices for prostate prescription, that we know there is a good chance you don't do the above protocol in your clinic. Please enter anyway! If you can adapt your automated planning to hit the objectives then give it a go. But if you can't then please don't be put off entering. You might not score highly in the main ranking table, but we are more interested in knowing about full automation than about whether you can hit this particular objective. In the survey to be submitted with the results we will give you an opportunity to say what objectives you planned to instead (and depending on numbers - we may recalculate scores for a range of objectives. The choice of prescription is likely to be a point of discussion in the workshop (and paper). 

References

1. Dearnaley D, Griffin CL, Lewis R, et al. Toxicity and Patient-Reported Outcomes of a Phase 2 Randomized Trial of Prostate and Pelvic Lymph Node Versus Prostate only Radiotherapy in Advanced Localised Prostate Cancer (PIVOTAL). Int J Radiat Oncol Biol Phys 2019; 103: 605–17.
2. Parker CC, Clarke NW, Cook AD et al. Timing of radiotherapy after radical prostatectomy (RADICALS-RT): a randomised, controlled phase 3 trial. The Lancet. 2020 Oct 31;396(10260):1413-21.
3. Hall WA, Paulson E, Davis BJ et al. NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer. Int J Radiat Oncol Biol Phys (2021) 109:174–85.