VMAT 40/48Gy

A knowledge-based planning (KBP) model is designed to provide a simple and robust comprehensive VMAT solution for right or left intact breast and post mastectomy comprehensive lymph node (CLN) radiotherapy treatments without increase in low dose wash.

The dose prescription which the model is compatible with is 40Gy in 15 Fractions with the addition of a 48Gy simultaneous integrated boost (SiB) as required.

This model was created using three 6FFF arc Halcyon plans calculated on ARIA Eclipse (Version 16.1.4) with Acuros External Beam (Version 15.6.06) and Photon Optimiser (Version 16.1.0) but is also compatible on TrueBeam with Acuros External Beam (Version 15.6.06) and jaw tracking.  

Overshoot was used via “SkinFlash-Bolus” of at least 0.5cm and is included into the function of model and planning process.

The “Automatic Intermediate Dose” function of the Photon Optimizer was utilized with MR3 level of restart and convergence mode and/or convergence mode: extended selected in the calculation options. These settings should be changed prior to starting the optimization or plan quality will be compromised. Plan normalisation is for all plans to account for skin flash in the optimization.

_{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.}