Clinical Treatment Planning in External Photon Beam Radiotherapy

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Link to IAEA Radiation Oncology Physics: A Handbook for Teachers and Students
Slides: Chapter 7. CLINICAL TREATMENT PLANNING IN EXTERNAL PHOTON BEAM RADIOTHERAPY
Text: Chapter 7. CLINICAL TREATMENT PLANNING IN EXTERNAL PHOTON BEAM RADIOTHERAPY

Contents

[edit] Introduction

The art of treatment planning combines knowledge of the physics of photon beams, configuration and use of linear accelerators, physical and functional anatomy, tissue response to radiation with a thorough understanding of the methods employed by physicians and therapists within a clinic to treat patients. The accomplished planner draws upon a large body of knowledge to sculpt dose surfaces that meet multiple objectives. In the case of simple conventional beam arrangments, these surfaces may be quite simple and block like. With more advanced technologies, such as IMRT, these dose surfaces may become much more detailed, exhibiting multiple highly curved layers.

This chapter is intended to acquaint you with the basic concenpts involved in treatment planning. As with any art, expertise is acquired through working with skilled artisans and practice. It is hoped that our treatment here with be a valuable adjunct to a mentored, "hands-on" program.

[edit] Volume Definition

  1. Gross tumor volume (GTV)
  2. Clinical target volume (CTV)
  3. Internal target volume (ITV)
  4. Planning target volume (PTV)
  5. Organ at risk (OAR)

[edit] Dose Specification

[edit] Patient Data Acquisition and Simulation

  1. Need for patient data
  2. Nature of patient data
  3. Treatment simulation
  4. Patient treatment position and immobilization devices
  5. Patient data requirements
  6. Conventional treatment simulation
  7. Computed tomography-based conventional treatment simulation
  8. Computed tomography-based virtual simulation

Addendum 1. Fusion Using Anatomy

  1. Conventional simulator vs. CT simulator
  2. Magnetic resonance imaging for treatment planning
  3. Summary of simulation procedures




[edit] Clinical Considerations for Photon Beams

  1. Beam Angle Selection
  2. Beam Energy Selection
  3. Aperture Definition (Collimator, Blocks, MLC)
  4. Wedge filters
  5. Bolus
  6. Compensating filters
  7. Corrections for contour irregularities
  8. Corrections for tissue inhomogeneities
  9. Intensity Modulated Radiation Therapy

[edit] Treatment Plan Evaluation

  1. Isodose curves
  2. Orthogonal planes and isodose surfaces
  3. Dose statistics
  4. Dose-volume histograms
  5. Treatment Plan evaluation

[edit] Treatment time and monitor unit calculations

  1. Treatment time and monitor unit calculations for fixed SSD set-ups
  2. Monitor units and treatment time calculations for isocentric set-ups
  3. Normalization of dose distributions
  4. Inclusion of output parameters in dose distribution
  5. Treatment time calculation for orthovoltage and cobalt-60 units

[edit] Bibliography

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