The technology advances have allowed radiation oncologists to better locate and target tumors, resulting in better treatment outcomes. However, the technology advance comes with price. Several issues exist, limiting the application of the advanced technology: (1) precision and complexity of high technology increase the risk that patients will experience serious detrimental effects even if a minute error occurs in treatment planning and deliver; (2) inadequate training and shortage of experienced professionals cause different efficacy of radiotherapy between experienced and less-experienced hospitals and between planners with different levels of skills; (3) benefits and efficacy of new technologies could be regrettably degraded due to inadequate mastery of the technology and may never be realized if the operators who use them are inadequately trained; (4) ever shrinking health care resources available to treat out patients and shortage of well-trained professionals make it difficult to treat patients with the best available technology. Our hypothesis is that mdaccAutoPlan system is an efficient and cost-effective way to improve plan quality while reducing cost of radiotherapy.