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IMRT1

Rx: 70Gy/35fx to PTV70, also PTV63 and PTV56 (simultaneous integrated boost)

2013 Pinnacle ROR Plan Challenge

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3:43 IMRT treatment field delivery time

Beams
DVH
Metrics

Name (ID): ROQS-22, HN(PinPC2013) (ROQS-22)
Plan or PlanSum ID: sf9smKVm5IDS1

Structure IDStructure CodePatient StructureDVH ObjectiveEvaluatorVariationPriorityMetAchieved
PTV7000orgPTV7000orgV70.0Gy[%]>=9590Goal95.79 %
PTV7000orgPTV7000orgV66.5Gy[%]>=9997Goal100.00 %
PTV7000orgPTV7000orgD0.03cc[Gy]<=72.877Variation73.198 Gy
PTV_6300_EVALPTV_6300_EVALV63.0Gy[%]>=9590Goal96.73 %
PTV_6300_EVALPTV_6300_EVALV59.85Gy[%]>=9997Goal99.86 %
PTV_5600_EVALPTV_5600_EVALV56.0Gy[%]>=9590Goal97.44 %
PTV_5600_EVALPTV_5600_EVALV53.2Gy[%]>=9997Goal99.60 %
SPINAL_CORDSPINAL_CORDD0.03cc[Gy]<48Goal44.531 Gy
SPINAL_CORD_PRV5SPINAL_CORD_PRV5D1.0cc[Gy]<=5054Goal46.501 Gy
BRAINSTEMBRAINSTEMD0.03cc[Gy]<54Goal52.030 Gy
BRAINSTEM_PRV5BRAINSTEM_PRV5D1.0cc[Gy]<=5760Goal55.319 Gy
PAROTID_LPAROTID_LMean[Gy]<=2640Goal25.394 Gy
PAROTID_RPAROTID_RV30.0Gy[%]<=5065Goal48.86 %
LARYNXLARYNXMean[Gy]<=4055Goal25.489 Gy
SUBMND_SALV_LSUBMND_SALV_LMean[Gy]<=3565Variation35.401 Gy
COCHLEA_LCOCHLEA_LD0.03cc[Gy]<=1540Goal13.786 Gy
COCHLEA_RCOCHLEA_RD0.03cc[Gy]<=1540Goal13.027 Gy
MANDIBLEMANDIBLEV70.0Gy[%]<=05Variation0.41 %
LIPSLIPSV30.0Gy[%]<=030Variation0.17 %
POST_NECKPOST_NECKV35.0Gy[%]<=1040Goal6.48 %
Technical Plan Comments

This plan utilized nine (9) fields with manually selected gantry positions to follow the shape of the low dose target in the transverse view.  Also, beam edges were placed so a sharp gradient could be achieved against the highest value OARs  (parotids, submandibular glad, oral cavity, spinal cord).  From a beam's eye view, unique collimator rotations per field were selected to match the general angle of the target volume.

This static field IMRT plan scored better, retrospectivly, than any plan submitted to this 2012 plan challenge.

Physician Comments

This 9F IMRT plan for an oropharyngeal primary treated bilaterally shows adequate coverage of the target, with no significant heterogeneities and outside of the target hotspots.  Sharp gradients are achieved around all OARs, with all being well within assigned constraints. The sharp gradients are so remarkable that it would be interesting to plan recurrent H&N cases for SBRT with this technique. This is a clinically acceptable 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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