IMRT SX1

Name (ID): Z002442-ABD, AAPM (AAPM Z002442-ABD)
Plan or PlanSum ID: 8fld1

This nine (9) field IMRT utilized manually selected gantry positions to follow the shape of the target in the transverse view.  The biggest challenge in this case proved to be the amount of prescription dose outside of the high dose target (volume of regret) and the metrics assessing max dose (penalty in score above 102% of Rx) and target homogeneity.  This plan still featured a max dose <105%, and these strict metrics may or may not be clinically relevant, however challenging to achieve.  Even with 1cm leaves (the effect of which was minimized by rotating the collimator to unique angles per gantry position) this plan was still able to retrospectivly achieve a score >80% of the plans submitted to the study. 

Both pancreas RT plans were acceptable. The IMRT plan is slightly better. In both cases, the OARs, specifically the bowel. The homogeneity requirements are pretty tight and a priority in this case. These are achieved with good sparing of bowel and kidneys.

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