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VMATv2

Rx: 21Gy+18Gy/1fx

Five brain mets, three on the same plane

 

Beams
DVH
Metrics

Name (ID): P3Brain, P3Brain (P3Brain)
Plan or PlanSum ID: SX2_6noBrid

Structure IDStructure CodePatient StructureDVH ObjectiveEvaluatorVariationPriorityMetAchieved
4GyBrain_noPTVBRAIN_PTVV4Gy[cc]192.54 cc
12GyBrain_noPTVBRAIN_PTVV12Gy[cc]20.20 cc
21GyBrain_noPTVBRAIN_PTVV21Gy[cc]0.86 cc
Brain_noPTVBRAIN_PTVMean[Gy]2.178 Gy
PTV11PTV_LP_21V100%[%]>=99Goal99.67 %
GTV11GTV_LPMax[%]150.3 %
GTV11GTV_LPMax[Gy]31.559 Gy
GTV11GTV_LPMin[Gy]25.990 Gy
GTV11GTV_LPV100%[cc]0.22 cc
GTV11GTV_LPVolume[cc]0.22 cc
PTV22PTV_LPG_21V100%[%]>=99Goal99.57 %
GTV22GTV_LPGMax[%]147.1 %
GTV22GTV_LPGMax[Gy]30.895 Gy
GTV22GTV_LPGMin[Gy]22.511 Gy
GTV22GTV_LPGV100%[cc]1.15 cc
GTV22GTV_LPGVolume[cc]1.15 cc
PTV33PTV_RP_21V100%[%]>=99Goal99.05 %
GTV33GTV_RPMax[%]143.0 %
GTV33GTV_RPMax[Gy]30.023 Gy
GTV33GTV_RPMin[Gy]23.059 Gy
GTV33GTV_RPV100%[cc]1.37 cc
GTV33GTV_RPVolume[cc]1.37 cc
PTV44PTV_RF_21V100%[%]>=99Goal99.30 %
GTV44GTV_RFMax[%]140.8 %
GTV44GTV_RFMax[Gy]29.562 Gy
GTV44GTV_RFMin[Gy]24.930 Gy
GTV44GTV_RFV100%[cc]0.07 cc
GTV44GTV_RFVolume[cc]0.07 cc
PTV55PTV_RT_18V18Gy[%]>=99Goal99.49 %
GTV55GTV_RTMax[%]122.2 %
GTV55GTV_RTMax[Gy]25.663 Gy
GTV55GTV_RTMin[Gy]19.200 Gy
GTV55GTV_RTV100%[cc]1.34 cc
GTV55GTV_RTVolume[cc]1.91 cc
BrainstemBrainstemMax[Gy]9.263 Gy
ChiasmChiasmMax[Gy]6.018 Gy
OpticNerve_LOptNrv_LMax[Gy]4.533 Gy
OpticNerve_ROptNrv_RMax[Gy]7.108 Gy
Eye_LEye_LMax[Gy]3.234 Gy
Eye_REye_RMax[Gy]4.359 Gy
Technical Plan Comments

This plan was created with .5cm effective MLC leaf width utilizing a works-in-progress software configuration.  Also of note, this plan doesn't include imaging dose in the final calculation.  Otherwise, this plan used simple optimization objectives: max dose constraints to OARs and miniumum dose contraints to targets.  The manual NTO was employed with Priority 140, Distance .3cm, Start Dose 100%, End Dose 8%, Fall Off .25.  Extended convergence mode was selected in the Photon Optimizater calculation options in Eclipse V15.5+.

Multiple distinct targets on the same plane can be a challenge when utilizing coplanar deliver methods.  For this case a special otpimization structure was created to prevent "dose bridging" at the 50% isodoe level.

Links

Review 3rd party software generated full treatment plan report

PDF

                              

Download full DICOM CT, struct, plan and dose file         

ZIP        

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.
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