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IMRT1

Rx: 50.4Gy/28fx to Anal target and 45Gy to nodal target (simultaneous integrated boost)

2013 AAMD / ROR Plan Challenge

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2:58 IMRT treatment field delivery time

Beams
DVH
Metrics

Name (ID): Z002444-ANAL, AAPM (AAPM Z002444-ANAL)
Plan or PlanSum ID: IMRT9field1

Structure IDStructure CodePatient StructureDVH ObjectiveEvaluatorVariationPriorityMetAchieved
PTV_5040PTV_5040V50.4Gy[%]>=9590Goal95.08 %
PTV_5040PTV_5040V47.88Gy[%]>=9997Goal100.00 %
PTV_5040PTV_5040D0.03cc[Gy]<=52.9255.44Goal52.591 Gy
PTV_4500 EVALPTV4500evalV45.0Gy[%]>=9590Goal95.28 %
PTV_4500 EVALPTV4500evalV42.75Gy[%]>=9997Goal99.95 %
BOWELBOWELV45.0Gy[cc]<320Goal1.54 cc
BOWELBOWELMax[Gy]<50Goal46.488 Gy
BLADDERBLADDERV35.0Gy[%]<530Goal4.75 %
BLADDERBLADDERV40.0Gy[%]<215Goal1.78 %
GENITALIA_EXTGENITALIA_EXTV40.0Gy[%]<0.0015Variation0.13 %
RECTUMRECTUMV30.0Gy[%]<=3560Goal31.96 %
FEMUR_RFEMUR_RV44.0Gy[%]<=0.0015Goal0.00 %
FEMUR_LFEMUR_LV44.0Gy[%]<=0.0015Goal0.00 %
Technical Plan Comments

Nine (9) field IMRT plan with manually selected gantry positions which followed the shape of the targets in the transverse view and unique collimator rotations selected for each field during an evaluation of the low dose target shape from the beams eye view.  This plan came together relatively quickly with the biggest challenge proving to be controlling the dose comformality of the highly irregular low dose target.  Surprisingly, even with 1cm leaves (the effect of which seems to be negated by rotating the collimator to unique angles per gantry position) this plan scores higher than 100% of the 157 plans submitted in that year’s plan study.  Due to the slender isolated “dose island” type of target the lower dose nodal volume created, employing the VMAT technique would likely have resulted in a plan which would struggle to score as high as this static field IMRT plan.

Comparative Plan Quality
Links

Review 3rd party software generated full treatment plan report

PDF

                              

Download full DICOM CT, struct, plan and dose file         

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Any reference to a "plan study" are simply what the organizers call each case and may not be a "study" in the FDA sense as they may not have been published in a peer reviewed journal.
Varian does not provide medical advice and these are illustrative examples only.
Leading plans by expert planner. Your results may vary.

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