title: Intelligent ePR system for evidence-based research in radiotherapy: proton therapy for prostate cancer.
abstract: OBJECTIVE
  Proton therapy (PT) utilizes high energy particle proton beam to kill cancer cells at the target region for target cancer therapy. Due to the physical properties of the proton beam, PT delivers dose with higher precision and no exit dose compared to conventional radiotherapy. In PT, patient data are distributed among multiple systems, a hindrance to research on efficacy and effectiveness. A data mining method and a treatment plan navigator utilizing the infrastructure and data repository of a PT electronic patient record (ePR) was developed to minimize radiation toxicity and improve outcomes in prostate cancer treatment.                                               MATERIALS/METHOD(S):                          The workflow of a proton therapy treatment in a radiation oncology department was reviewed, and a clinical data model and data flow were designed. A prototype PT ePR system with DICOM compliance was developed to manage prostate cancer patient images, treatment plans, and related clinical data. The ePR system consists of four main components: (1) Data Gateway; (2) ePR Server; (3) Decision Support Tools; and (4) Visualization and Display Tools. Decision support and visualization tools are currently developed based on DICOM images, DICOM-RT and DICOM-RT-ION objects data from prostate cancer patients treated with hypofractionation protocol proton therapy were used for evaluating ePR system effectiveness. Each patient data set includes a set of computed tomography (CT) DICOM images and four DICOM-RT and RT-ION objects. In addition, clinical outcomes data collected from PT cases were included to establish a knowledge base for outcomes analysis.
  
  
  RESULTS
  A data mining search engine and an intelligent treatment plan navigator (ITPN) were developed and integrated with the ePR system. Evaluation was based on a data set of 39 PT patients and a hypothetical patient.
  
  
  CONCLUSIONS
  The ePR system was able to facilitate the proton therapy workflow. The PT ePR system was feasible for prostate cancer patient treated with hypofractionation protocol in proton therapy. This ePR system improves efficiency in data collection and integration to facilitate outcomes analysis.
authors.affiliation: IPILab, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA. anhhle@gmail.com
authors.forename: Anh H
authors.initials: AH
authors.lastname: Le
authors.forename: Brent
authors.initials: B
authors.lastname: Liu
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schulte
authors.forename: H K
authors.initials: HK
authors.lastname: Huang
mesh_terms: D035843:Biomedical Research; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D061766:Proton Therapy; D018787:Radiation Oncology / Q000379:methods; D011522:Protons
chemical_list: D011522:Protons