Using internal fiducial markers and electronic portal imaging (EPID) to realign patients has been shown to significantly reduce positioning uncertainties in prostate radiation treatment. This creates the possibility of decreasing the planning target volume (PTV) margin added on the clinical target volume (CTV), which in turn may allow for dose escalation. We compared the outcome of two plans: 7...

Intensity-modulated radiation therapy can be conveniently delivered with a multileaf collimator. With this method, the entire field is not delivered at once, but rather it is composed of many subfields defined by the leaf positions as a function of beam on time. At any given instant, only these subfields are delivered. During treatment, if the organ moves, part of the volume may move in or out ...

PURPOSE In this work we explore a method named clinical grading analysis (CGA) which is based on clinical assessments performed by radiation oncologists (ROs). The purpose is to investigate how useful the method is for treatment plan comparisons, and how the CGA results correlate with dosimetric evaluation parameters, traditionally used for treatment plan comparisons. MATERIAL AND METHODS Hel...

treatment plans showed that the D95 and V95 of GTV were 66.9Gy and 98.3%, respectively. The minimum, maximum and mean dose to GTV was 54.8Gy, 77.1Gy and 69.8Gy. The mean fractional dose was 2.32Gy (1.99–2.91Gy). The average doses of the surrounding critical structures were much lower than the tolerance thresholds. Median follow-up was 12 months (range, 2–47 months). The 1-, 2and 3-year local pr...

BACKGROUND AND PURPOSE We performed a retrospective central review of tumour outlines in patients undergoing radiotherapy in the SCALOP trial. MATERIALS AND METHODS The planning CT scans were reviewed retrospectively by a central review team, and the accuracy of investigators' GTV (iGTV) and PTV (iPTV) was compared to the trials team-defined gold standard (gsGTV and gsPTV) using the Jaccard C...

BACKGROUND To analyze setup deviations using daily megavoltage computed tomography (MVCT) and to evaluate three MVCT frequency reducing protocols for gynecologic cancer patients treated with helical tomotherapy. METHODS We recorded the setup errors of 56 patients with gynecological cancer observed throughout their whole course by matching their daily MVCT with the planning CT. Systematic and ...

Dose distributions in HN-IMRT are complex and may be sensitive to the treatment uncertainties. The goals of this study were to evaluate: 1) dose differences between plan and actual delivery and implications on margin requirement for HN-IMRT with rigid setup errors; 2) dose distribution complexity on setup error sensitivity; and 3) agreement between average dose and cumulative dose in fractionat...

PURPOSE/OBJECTIVE(S) Current guidelines for esophageal cancer contouring are derived from traditional 2-dimensional fields based on bony landmarks, and they do not provide sufficient anatomic detail to ensure consistent contouring for more conformal radiation therapy techniques such as intensity modulated radiation therapy (IMRT). Therefore, we convened an expert panel with the specific aim to ...

Variations in daily setup and rectum/bladder filling lead to uncertainties in the delivery of prostate IMRT. The purpose of this study is to determine the optimal PTV margin for CBCT-guided prostate IMRT based on daily CBCT dose calculations using four different margins. Five patients diagnosed with low-risk prostate cancer were treated with prostate IMRT to 70 Gy in 28 fractions using daily CB...

Delivered dose can be calculated by transferring the planned treatment beams onto the daily CBCT. Bladder and rectum volumetric doses were calculated and cor-related to the daily bladder and rectum fullness. Patients for this study underwent hypofractionated prostate IMRT to 70 Gy in 28 fractions. Daily CBCT was utilized for image guidance. A clinically acceptable plan was created using a CTV-t...