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

2013 Pinnacle ROR Plan Challenge

3:43 IMRT treatment field delivery time

Simple DVH Metrics

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

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
PTV7000org   PTV7000org V70.0Gy[%] >=95 90   Goal 95.79 %
PTV7000org   PTV7000org V66.5Gy[%] >=99 97   Goal 100.00 %
PTV7000org   PTV7000org D0.03cc[Gy] <=72.8 77   Variation 73.198 Gy
PTV_6300_EVAL   PTV_6300_EVAL V63.0Gy[%] >=95 90   Goal 96.73 %
PTV_6300_EVAL   PTV_6300_EVAL V59.85Gy[%] >=99 97   Goal 99.86 %
PTV_5600_EVAL   PTV_5600_EVAL V56.0Gy[%] >=95 90   Goal 97.44 %
PTV_5600_EVAL   PTV_5600_EVAL V53.2Gy[%] >=99 97   Goal 99.60 %
SPINAL_CORD   SPINAL_CORD D0.03cc[Gy] <48     Goal 44.531 Gy
SPINAL_CORD_PRV5   SPINAL_CORD_PRV5 D1.0cc[Gy] <=50 54   Goal 46.501 Gy
BRAINSTEM   BRAINSTEM D0.03cc[Gy] <54     Goal 52.030 Gy
BRAINSTEM_PRV5   BRAINSTEM_PRV5 D1.0cc[Gy] <=57 60   Goal 55.319 Gy
PAROTID_L   PAROTID_L Mean[Gy] <=26 40   Goal 25.394 Gy
PAROTID_R   PAROTID_R V30.0Gy[%] <=50 65   Goal 48.86 %
LARYNX   LARYNX Mean[Gy] <=40 55   Goal 25.489 Gy
SUBMND_SALV_L   SUBMND_SALV_L Mean[Gy] <=35 65   Variation 35.401 Gy
COCHLEA_L   COCHLEA_L D0.03cc[Gy] <=15 40   Goal 13.786 Gy
COCHLEA_R   COCHLEA_R D0.03cc[Gy] <=15 40   Goal 13.027 Gy
MANDIBLE   MANDIBLE V70.0Gy[%] <=0 5   Variation 0.41 %
LIPS   LIPS V30.0Gy[%] <=0 30   Variation 0.17 %
POST_NECK   POST_NECK V35.0Gy[%] <=10 40   Goal 6.48 %
ScoreCard Metrics
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

3rd party software plan report


  Dosimetric ScoreCard


DICOM patient export         


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.
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