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There are a number of different dwell positions and time optimisation options available in the Oncentra ®  Brachy (Elekta Brachytherapy Solutions, Veenendaal, The Netherlands) brachytherapy treatment planning system. The purpose of this case study was to compare graphical ( GRO ) and inverse planning by simulated annealing ( IPSA ) optimisation techniques for interstitial head and neck ( HN ) and prostate plans considering dosimetry, modelled radiobiology outcome and planning time. Four retrospective brachytherapy patients were chosen for this study, two recurrent  HN  and two prostatic boosts. Manual  GRO  and  IPSA  plans were generated for each patient. Plans were compared using dose–volume histograms ( DVH ) and dose coverage metrics including; conformity index ( CI ), homogeneity index ( HI ) and conformity number ( CN ). Logit and relative seriality models were used to calculate tumour control probability ( TCP ) and normal tissue complication probability ( NTCP ). Approximate planning time was also recorded. There was no significant difference between  GRO  and  IPSA  in terms of dose metrics with mean  CI  of 1.30 and 1.57 ( P  > 0.05) respectively.  IPSA  achieved an average  HN TCP  of 0.32 versus 0.12 for  GRO  while for prostate there was no significant difference. Mean  GRO  planning times were greater than 75 min while average  IPSA  planning times were less than 10 min. Planning times for  IPSA  were greatly reduced compared to  GRO  and plans were dosimetrically similar. For this reason,  IPSA  makes for a useful planning tool in  HN  and prostate brachytherapy.

Comparison of Oncentra ® Brachy IPSA and graphical optimisation techniques: a case study of HDR brachytherapy head and neck and prostate plans