IMRT SX1

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
Simple DVH Metrics

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

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
PTV_5040   PTV_5040 V50.4Gy[%] >=95 90   Goal 95.08 %
PTV_5040   PTV_5040 V47.88Gy[%] >=99 97   Goal 100.00 %
PTV_5040   PTV_5040 D0.03cc[Gy] <=52.92 55.44   Goal 52.591 Gy
PTV_4500 EVAL   PTV4500eval V45.0Gy[%] >=95 90   Goal 95.28 %
PTV_4500 EVAL   PTV4500eval V42.75Gy[%] >=99 97   Goal 99.95 %
BOWEL   BOWEL V45.0Gy[cc] <3 20   Goal 1.54 cc
BOWEL   BOWEL Max[Gy] <50     Goal 46.488 Gy
BLADDER   BLADDER V35.0Gy[%] <5 30   Goal 4.75 %
BLADDER   BLADDER V40.0Gy[%] <2 15   Goal 1.78 %
GENITALIA_EXT   GENITALIA_EXT V40.0Gy[%] <0.001 5   Variation 0.13 %
RECTUM   RECTUM V30.0Gy[%] <=35 60   Goal 31.96 %
FEMUR_R   FEMUR_R V44.0Gy[%] <=0.001 5   Goal 0.00 %
FEMUR_L   FEMUR_L V44.0Gy[%] <=0.001 5   Goal 0.00 %
ScoreCard Metrics
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
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3rd party software plan report

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  Dosimetric ScoreCard

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