VMAT SX2

Rx: 21Gy+18Gy/1fx

Five brain mets, three on the same plane

 

Beams
DVH
Simple DVH Metrics

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

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
4GyBrain_noPTV   BRAIN_PTV V4Gy[cc]         192.54 cc
12GyBrain_noPTV   BRAIN_PTV V12Gy[cc]         20.20 cc
21GyBrain_noPTV   BRAIN_PTV V21Gy[cc]         0.86 cc
Brain_noPTV   BRAIN_PTV Mean[Gy]         2.178 Gy
PTV1   1PTV_LP_21 V100%[%] >=99     Goal 99.67 %
GTV1   1GTV_LP Max[%]         150.3 %
GTV1   1GTV_LP Max[Gy]         31.559 Gy
GTV1   1GTV_LP Min[Gy]         25.990 Gy
GTV1   1GTV_LP V100%[cc]         0.22 cc
GTV1   1GTV_LP Volume[cc]         0.22 cc
PTV2   2PTV_LPG_21 V100%[%] >=99     Goal 99.57 %
GTV2   2GTV_LPG Max[%]         147.1 %
GTV2   2GTV_LPG Max[Gy]         30.895 Gy
GTV2   2GTV_LPG Min[Gy]         22.511 Gy
GTV2   2GTV_LPG V100%[cc]         1.15 cc
GTV2   2GTV_LPG Volume[cc]         1.15 cc
PTV3   3PTV_RP_21 V100%[%] >=99     Goal 99.05 %
GTV3   3GTV_RP Max[%]         143.0 %
GTV3   3GTV_RP Max[Gy]         30.023 Gy
GTV3   3GTV_RP Min[Gy]         23.059 Gy
GTV3   3GTV_RP V100%[cc]         1.37 cc
GTV3   3GTV_RP Volume[cc]         1.37 cc
PTV4   4PTV_RF_21 V100%[%] >=99     Goal 99.30 %
GTV4   4GTV_RF Max[%]         140.8 %
GTV4   4GTV_RF Max[Gy]         29.562 Gy
GTV4   4GTV_RF Min[Gy]         24.930 Gy
GTV4   4GTV_RF V100%[cc]         0.07 cc
GTV4   4GTV_RF Volume[cc]         0.07 cc
PTV5   5PTV_RT_18 V18Gy[%] >=99     Goal 99.49 %
GTV5   5GTV_RT Max[%]         122.2 %
GTV5   5GTV_RT Max[Gy]         25.663 Gy
GTV5   5GTV_RT Min[Gy]         19.200 Gy
GTV5   5GTV_RT V100%[cc]         1.34 cc
GTV5   5GTV_RT Volume[cc]         1.91 cc
Brainstem   Brainstem Max[Gy]         9.263 Gy
Chiasm   Chiasm Max[Gy]         6.018 Gy
OpticNerve_L   OptNrv_L Max[Gy]         4.533 Gy
OpticNerve_R   OptNrv_R Max[Gy]         7.108 Gy
Eye_L   Eye_L Max[Gy]         3.234 Gy
Eye_R   Eye_R Max[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

3rd party software plan report

PDF

                              

DICOM patient export         

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