VMAT SX1

Rx: 79.2Gy/44fx

RTOG-0815

4:08 VMAT treatment arc delivery time

Beams
DVH
Simple DVH Metrics

Name (ID): SBRT, PROSTATE (AAMD_RSS2016PS)
Plan or PlanSum ID: 79Gy4A_0815_T

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
PTV   PTV V79.2Gy[%] >=98     Goal 98.46 %
PTV   PTV D0.03cc[Gy] <=84.744 87.12   Goal 84.554 Gy
PTV   PTV Min[Gy] >=75.24 73.656   Variation 74.802 Gy
BLADDER   Bladder V80.0Gy[%] <=15 20   Goal 0.16 %
BLADDER   Bladder V75.0Gy[%] <=25 30   Goal 0.99 %
BLADDER   Bladder V70.0Gy[%] <=35 40.00001   Goal 2.00 %
BLADDER   Bladder V65.0Gy[%] <=50 55.00001   Goal 3.06 %
RECTUM   Rectum V75.0Gy[%] <=15 20   Goal 2.76 %
RECTUM   Rectum V70.0Gy[%] <=25 30   Goal 6.50 %
RECTUM   Rectum V65.0Gy[%] <=35 40.00001   Goal 10.62 %
RECTUM   Rectum V60.0Gy[%] <=50 55.00001   Goal 15.21 %
PENILE BULB   penile bulb Mean[Gy] <=52.5     Goal 5.423 Gy
Technical Plan Comments

VMAT technique was chosen and 4 almost complete arcs were used.  Each arc used a different start and stop angle (offset by 1 degree) to stagger the available control points throughout each arc rotation.  There really weren’t too many challenges in this case, the only metric that provided a challenge was achieving the minimum PTV coverage constraint.  When a protocol enforces a minimum dose to the target, the temptation is to simply perform a uniform expansion on the target and optimize on the expanded target.  However, in this case, an optimization PTV was created and stretched outward only along the edges of the real PTV where the minimum dose was not met.  Careful attention was paid to minimize stretching where the target interfaced/overlapped with an OAR (rectum).

Physician Comments

Simple prostate only case, fractionated. All constraints on the bladder, rectum, bowel are met. This is a clinically acceptable plan.

Links

3rd party software plan report

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