1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon, Korea
3Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Daegu, Korea
4Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
5Proton Therapy Center, National Cancer Center, Goyang, Korea
6Department of Radiation Oncology, Korea University Guro Hospital, Seoul, Korea
7Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Korea
8Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
9Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea
10Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
11Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea
12Department of Radiation Oncology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
13Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Korea
14Department of Radiation Oncology, Jeju National University School of Medicine, Jeju, Korea
15Department of Radiation Oncology, Chungbuk National University College of Medicine, Cheongju, Korea
16Department of Radiation Oncology, School of Medicine, Kyungpook National University Daegu, Korea
17Department of Radiation Oncology, Inje University School of Medicine, Busan, Korea
18Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea
Copyright © 2019 by the Korean Cancer Association
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Target/Normal structure |
Constraint |
|
---|---|---|
Per protocol | Acceptable | |
P-GTVa) | V95% ≥ 40 Gy | V93% ≥ 40 Gy |
P-CTVb) | V95% ≥ 25 Gy | V90% ≥ 25 Gy |
Hippocampus | Maximum ≤ 20 Gy | Maximum ≤ 22 Gy |
Maximum to 0.1 cm3 ≤ 16 Gy | Maximum to 0.1 cm3 ≤ 18 Gy | |
Mean ≤ 12 Gy | Mean ≤ 14 Gy | |
Optic chiasm | Maximum ≤ 30 Gy | N/A |
Optic nerve, both | Maximum ≤ 30 Gy | N/A |
P-Lensc), both | Maximum ≤ 5 Gy | Maximum ≤ 6 Gy |
Eyeball, both | Maximum ≤ 10 Gy | Maximum ≤ 12 Gy |
Target/Normal structure | Constraint |
|
---|---|---|
Per protocol | Acceptable | |
P-GTV |
V95% ≥ 40 Gy | V93% ≥ 40 Gy |
P-CTV |
V95% ≥ 25 Gy | V90% ≥ 25 Gy |
Hippocampus | Maximum ≤ 20 Gy | Maximum ≤ 22 Gy |
Maximum to 0.1 cm3 ≤ 16 Gy | Maximum to 0.1 cm3 ≤ 18 Gy | |
Mean ≤ 12 Gy | Mean ≤ 14 Gy | |
Optic chiasm | Maximum ≤ 30 Gy | N/A |
Optic nerve, both | Maximum ≤ 30 Gy | N/A |
P-Lens |
Maximum ≤ 5 Gy | Maximum ≤ 6 Gy |
Eyeball, both | Maximum ≤ 10 Gy | Maximum ≤ 12 Gy |
No. | |
---|---|
Treatment planning system | |
Eclipse | 10 |
Pinnacle3 | 1 |
TomoTherapy | 1 |
Technique | |
VMAT | 6 |
Coplanar | 3 |
Non-coplanar | 3 |
IMRT, step and shoot | 2 |
Coplanar | 1 |
Non-coplanar | 1 |
IMRT, dynamic | 3 |
Coplanar | 1 |
Non-coplanar | 2 |
Helical tomotherapy | 1 |
Target/Normal structure | No. of treatment plans satisfying the dose constraints |
|
---|---|---|
Per protocol | Acceptable | |
P-GTV | 3 | 7 |
P-CTV | 6 | 11 |
Hippocampus, maximum | 6 | 9 |
Hippocampus, maximum to 0.1 cm3 | 5 | 10 |
Hippocampus, mean | 6 | 10 |
Optic chiasm, maximum | 11 | - |
Optic nerve (right, left), maximum | 12, 12 | - |
P-Lens (right, left), maximum | 8, 8 | 12, 11 |
Eyeball (right, left), maximum | 9, 9 | 11, 11 |
P-GTV: planning gross tumor volume=gross target volume (GTV)+2 mm margin, P-CTV: planning clinical target volume=whole brain–hippocampal avoiding region (hippocampus+5 mm margin), P-Lens: planning volume for lens=lens+5 mm margin.
VMAT, volumetric-modulated arc therapy; IMRT, intensity-modulated radiotherapy.
P-GTV, planning gross tumor volume; P-CTV, planning clinical target volume; P-Lens, planning volume for lens.