Language Select
Varian Logo

VARIAN MEDICAL AFFAIRS

Engaging with clinicians around the world to exchange meaningful information and advance clinical research.

VMAT1

Rx: 30Gy/10fx

NRG-CC001

2:19 VMAT treatment arc delivery time

Beams
DVH
Metrics

Name (ID): AAMD2015, HCSWB_SIB (AAMD2015)
Plan or PlanSum ID: HCSWBnorm95

Structure IDStructure CodePatient StructureDVH ObjectiveEvaluatorVariationPriorityMetAchieved
PTV_WB_noSIBPTV_WB_noSIBV30.0Gy[%]>=9590Goal95.11 %
PTV_WB_noSIBPTV_WB_noSIBD98.0%[Gy]>=2625Goal26.325 Gy
PTV_WB_noSIBPTV_WB_noSIBD2.0%[Gy]<=37.540Goal35.127 Gy
HIPPOCAMPUS_TOTLHippocampus_TotlD0.03cc[Gy]<=1617Goal14.334 Gy
HIPPOCAMPUS_TOTLHippocampus_TotlMin[Gy]<=911Goal7.258 Gy
CHIASMChiasmD0.03cc[Gy]>=37.530Variation30.671 Gy
LOPTICLopticD0.03cc[Gy]<=3037.5Variation30.942 Gy
ROPTICRopticD0.03cc[Gy]<=3037.5Variation30.780 Gy
LLENSLLensD0.03cc[Gy]<=610Goal5.858 Gy
RLENSRLensD0.03cc[Gy]<=610Goal5.667 Gy
LEYELeyeMean[Gy]<=815Goal7.876 Gy
REYEReyeMean[Gy]<=815Goal7.924 Gy
BRAINSTEMBrainstemD0.03cc[Gy]<=34.537.5Goal34.305 Gy
LLACRIMALLLacrimalMean[Gy]<=1020Goal8.616 Gy
RLACRIMALRLacrimalMean[Gy]<=1020Goal9.013 Gy
CORDCordD0.03cc[Gy]<=3037.5Goal26.186 Gy
Technical Plan Comments

Four (4) arc VMAT technique was chosen and 4 almost complete arcs were used.  Each arc used a different start and stop angle (offset by 1 degree) to stagger the available control points throughout each arc rotation and unique collimator rotations per field were automatically generated utilizing the arc geometry tool.  The inverse planning optimizer was populated utilizing the free hippocampal sparring RapidPlan model available at www.oncopeer.com.  No changes were made to the objectives, only the model documentation suggested pausing and unpausing of the VMAT optimizer at each MR sub-step.  The RapidPlan model was designed for use with a non-coplanar 4 arc beam arrangement with 2 vertex arcs, but this beam arrangement proved not to be critical as the resulting coplanar plan created here is of high clinical quality (if perhaps a bit less homogeneous than a plan created with a non-coplanar beam arrangement). 

Even though the RapidPlan model was tuned to provide maximal hippocampal sparring, beyond what is requested by the NRG-CC001 protocol, this plan proved impressive in this regard reaching a minimum hippocampal dose almost 2Gy below what is requested by the protocol.  This machine’s ability to produce plans with such aggressively spared hippocampi structures could be attributable to the two-stage stacked and staggered MLC with very low interleaf leakage.

Physician Comments

Whole brain plan to 30 Gy. Hippocampal sparing is achieved with a 7-8 Gy dose to the hipoccampal areas. Nothing remarkable otherwise. Good homogeneity. This is a clinically acceptable plan.

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.
Leading plans by expert planner. Your results may vary.

FOR EDUCATIONAL AND SCIENTIFIC EXCHANGE ONLY – NOT FOR SALES OR PROMOTIONAL USE.

 

  • Follow Us

Production of any of the material contained herein in any format or media without the express written permission of Varian Medical Systems is prohibited.

Varian Logo