Implementation of automated personalised breast radiotherapy planning techniques with scripting in Raystation

Objective: Implement scripted automatic breast plan-ning (AP) for breast techniques within Raystation.Methods: Manual plans (MPs) were re-planned and compared with AP plans for whole breast (WB), partial breast (PB), hybrid volumetric modulated arc therapy simultaneous integrated boost (VMAT SIB) and VMAT nodal plans.Results: WB AP plans took 7 min comparing well to MP. One WB AP failed a mandatory dose constraint. Small statisti-cally significant differences showed improved coverage for AP at expense of slightly hotter plans, however abso-lute differences were small (mean differences < 1% or 0.5cc<0.2 Gy). PB AP plans took 9 min, showing improved coverage (V 24.7Gy97.6 vs96.4 %). One PB AP case failed a mandatory constraint. Other dosimetric differences were non-significant. SIB AP plans took 14 min with one case failing a mandatory constraint with minor differences compared with MP except larger V 42.8Gy (3 vs1.5 %) and more MU. VMAT AP plans took 12 min and were hotter for PTVp_4000 but had higher nodal coverage. Contra_Lung V 2.5Gy was higher (8.8 %) than MP plans (6.5 %).Conclusion: Automatic planning of modern breast tech-niques has been successfully introduced using a commercial planning system. AP plans are very similar to MP, requiring little manual interaction for most cases with significant timesaving potential.Advances in knowledge: Scripted breast plans produced within minutes for WB, PB, SIB and VMAT. Successfully introduced into large busy department. Plans similar to manual plans, requiring little manual interaction.