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Treatment planning - basics. Christian Kirisits. Standard loading pattern. Point A. 20 mg. 10 mg. 10 mg. 15 mg. 20 mg. Point A. 45 Gy EBRT + 4 x BT: 85 Gy αβ 10 60 Gy αβ 10. Standard loading pattern. Standard loading pattern. Standard loading pattern.
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Treatment planning - basics Christian Kirisits
Standard loading pattern Point A 20 mg 10 mg 10 mg 15 mg 20 mg Point A 45 Gy EBRT + 4 x BT: 85 Gyαβ10 60 Gyαβ10
Inverse optimization without thinking
Inverse optimization Taking into account experience from manual opt.
Dose Optimization DVH parameters (D90, D100, D2cc, D0.1cc) Spatial dose distribution (Hot and Cold spots) Dwell time distribution to take into account not contoured structures parametrial tissue vagina nerves vessels ureter
100% 200% 100% 200% A A A A Vpd 96 cm³ V2pd 28 cm³ standard plan: prescribed dose to point A (left and right) no needles
100% 200% + 11 mm 100% 200% A A Vpd 103 cm³ V2pd 30 cm³ optimized plan: prescribed dose to point A (right) 1 needle loaded
100% 200% 100% 200% A A Vpd 109 cm³ V2pd 33 cm³ optimized plan: prescribed dose to point A (right) 2 needles loaded
100% 200% 100% 200% A A Vpd 114 cm³ V2pd 36 cm³ optimized plan: prescribed dose to point A (right) 3 needles loaded
However, every optimization is limited by anatomy, topography and application technique. Jamema et al. Radiother Oncol 2010
Source loading - optimization • Training • Experience (learning curve)