Quality assurance for deep learning-based proton therapy planning in routine clinical use for oropharyngeal cancer.

Quality assurance is required to ensure safe and reliable use of deep learning (DL)-based intensity modulated proton therapy (IMPT) planning for oropharyngeal cancer patients. This study presents a range of quality assurance measures applied during routine clinical use and include manual adjustments to DL-based plans, independent organ-of-interest dose guidance and multidisciplinary plan review. DL-based plans were clinically acceptable for all 78 patients and achieved 1.1 Gy (RBE) lower parotid dose than manual plans. The implemented quality assurance measures enabled safe routine clinical use of DL-based IMPT planning over 28-months.