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Prostate Cancer Diagnosis and Treatment / Radiation Therapy and Dosimetry / Advanced Radiotherapy Techniques · Journal article
Radiation Oncology · August 13, 2026
Early or partial results. Treat as a signal, not a conclusion.
This feasibility study demonstrates that uTPS can optimize treatment plans for dual-layer MLC Halcyon accelerators with dosimetric quality comparable to Eclipse for some indications, and superior organ-at-risk sparing in hypopharyngeal and breast cancer cases. All plans were successfully delivered with gamma passing rates >97%, confirming technical feasibility. However, the small sample, surrogate endpoints only, and mixed dosimetric results across cancer types limit the strength of evidence for clinical implementation.
Comparative feasibility study with dosimetric analysis. Patients with hypopharyngeal (n=5), esophageal (n=5), breast (n=5), or cervical (n=5) cancer scheduled for volumetric modulated arc therapy on Halcyon 2.0 dual-layer MLC accelerator.. Intervention: uTPS (Shanghai United Imaging Healthcare Co., Ltd., version R001) treatment plan optimization using stochastic platform optimizer for Halcyon 2.0 accelerator.. Compared with: Eclipse photon optimizer (clinical reference system) with same Halcyon 2.0 beam data and Acuros external beam calculation algorithm.. n = 20.
Hypopharyngeal cancer: uTPS reduced brainstem D₀.₁cc by 34.48%, left parotid Dmean by 11.8%, and left parotid V₃₀Gy by 6.9% (all P < 0.05) Breast cancer: uTPS reduced spinal cord D₀.₁cc by 49.6% (P < 0.05) Esophageal and cervical cancer: no significant differences in CI, HI, and OAR doses between uTPS and Eclipse
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The superior organ-at-risk sparing shown for hypopharyngeal and breast cancer is promising but requires validation in larger cohorts and clinical outcome studies before routine adoption. Clinicians should view this as supporting further evaluation of uTPS for dual-layer MLC planning, not as evidence for immediate practice change.
Single-centre feasibility study with small sample (n=20) and surrogate endpoints (dosimetric indices); demonstrates technical capability but lacks hard clinical outcomes or patient data.
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The superior organ-at-risk sparing shown for hypopharyngeal and breast cancer is promising but requires validation in larger cohorts and clinical outcome studies before routine adoption. Clinicians should view this as supporting further evaluation of uTPS for dual-layer MLC planning, not as evidence for immediate practice change.
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Dual-layer multileaf collimator (MLC) accelerators, such as Halcyon, are increasingly used in clinical settings; however, the ability of treatment planning systems (TPS) to effectively optimize treatment plans for such accelerators remains an important consideration. This study evaluates the feasibility of using uTPS to optimize treatment plans for dual-layer MLC accelerators, with Eclipse as a clinical reference. Standard radiation data from the Halcyon 2.0 accelerator were used to model the beam in the uTPS (Shanghai United Imaging Healthcare Co., Ltd., version R001). Twenty cases were selected, with five each for hypopharyngeal, esophageal, breast, and cervical cancers. Volumetric modulated arc therapy plans were generated using the uTPS stochastic platform optimizer and the Eclipse photon optimizer (PO). All plans were calculated using the Acuros external beam (AXB) algorithm for dosimetric comparison. Key indicators, such as the conformity index (CI), homogeneity index (HI), and organ-at-risk (OAR) doses, were analyzed and compared. The feasibility of delivering uTPS plans on the Halcyon accelerator was validated. The dosimetric accuracy was confirmed using ArcCheck, and Wilcoxon signed-rank tests with Benjamini–Hochberg false discovery rate correction were performed. uTPS and Eclipse plans exhibited similar dosimetric qualities for esophageal and cervical cancer cases, with no significant differences in CI, HI, and OAR doses. However, uTPS demonstrated superior OAR sparing in specific cases: in hypopharyngeal cancer, uTPS significantly reduced the brainstem \(\:{D}_{0.1cc}\) by 34.48%, the left parotid \(\:\:{D}_{mean}\) by 11.8%, and the left parotid \(\:{V}_{30Gy}\) by 6.9% (all P < 0.05); in breast cancer, uTPS significantly reduced the spinal cord \(\:{D}_{0.1cc}\:\) by 49.6% ( P < 0.05). No statistically significant differences were observed in other dosimetric parameters. No significant differences in total monitor units were observed between the uTPS and Eclipse plans. All uTPS plans were successfully delivered on the Halcyon accelerator, with gamma passing rates exceeding 97%. The commercially available uTPS supports effective plan optimization for dual-layer MLC Halcyon accelerators, offering plan quality comparable to that of Eclipse.
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