Para-spinal Tumors Encircling the Spinal Cord IMRT Comparison of Several Target Definitions.
-
date post
18-Dec-2015 -
Category
Documents
-
view
229 -
download
1
Transcript of Para-spinal Tumors Encircling the Spinal Cord IMRT Comparison of Several Target Definitions.
Para-spinal Tumors Encircling the Spinal Cord IMRT
Comparison of Several Target Definitions
SLICE 116
CTV SuperiorBrain stem and L & R eyes
Slice 104 CTV , Spinal cordL & R Parotid glands
Slice 83 Mid Volume CTV 3 – 5 mm separation between spinal cord and CTV
Slice 63Inferior CTV
13 mm Separation of spinal cord and CTV
Planning VolumesCTV 3mm Expansion 63 Gy
Spinal Cord 3mm Expansion 43 Gy
Rt & Lt Eyes 3mm Expansion 3 Gy
Brain Stem 3mm Expansion 43Gy
Parotid Glands 3mm Expansion 30 Gy
Beam Arrangement
Beam Arrangement Gantry 0Gantry 40Gantry 80Gantry 160Gantry 200Gantry 315
Basic Target Type
Dose Statistics 63 GyTarget Type Basic
DVH 63 Gy Target Type Basic
63 Gy @ ~76% Volume
Isodose Slice 104 Basic
Homogenous Target Type
Dose Statistics 63 GyTarget Type Homogenous
DVH 63 Gy
Target Type Homogenous
63Gy @ ~46 % Volume
Isodose Slice 104 Homogenous
IMRS Target Type
Dose Statistics 63 Gy Target Type IMRSEmphasizes Conformality
DVH 63 Gy
Target Type IMRS
63Gy @ ~90% Volume
Isodose Slice 104 IMRS
Esophagus IMRT Sparing Kidneys and Spinal Cord
DVH 50.4Gy
IMRT 5 Field IMRT with Intensity Maps
Intensity Levels 10 Step Increment 1cm MLC leaf 1cm
Step Increment
9991-959-08C
1cm step with 0.5cm MLC 0.5cm step with 0.5cm MLC
Intensity Level Comparison
Lung IMRT 60 Gy 5 Field 6 MV X-rays
Lung IMRT DVH
Large Field IMRT Plan with Dose Painting
Large Complex Treatment Volume
Long (~ 60 cm) volume needed 27 junctioned IMRT fields and an 16 MeV electron field
IMRT plan avoiding spinal cord and kidneys
Superior Tumor Volumes
Treatment Volumes Lower Abdomen
Treatment Volume Change in Dose Nodal Volume
Treatment Volume Pelvis Superficial Nodes
Inferior Volumes Increase in Dose Using an Electron Field
ELECTRON BEAM CHARACTERISTICS
Location of (a)Flattening Filter and (b) Electron Scattering Foils
Isodose Curves for 7 and 18 Mev Electron Beams
Small Fields with Photon Component
12 Mev Beam at 00
12 Mev beam at 400
12 Mev Beam with Density Correction
AXILA TANGENTS & ELECTRON BOOST
Breast Boost Technique
9 Mev Electron Boost Posterior Neck Nodes
Interoperative Radiation Therapy
The benefit of IORT normal tissues are removed fromthe treatment fields and the dose is delivered locally.
The enengy of the electron beams used is usually between 9-16 Mev.
The use in the country has been developed used at large medical centers.
IORT Isodose Curve 15 Mev Electron Beam
ORIGINAL HARD DOCKING COX LL STANDARD LINEAR ACCELERATOR
MGHSOFT DOCKINGLASER SYSTEM IN HEAD OF MACHINE
MOBETRON INTRA-OP ACCELERATOR
MOBETRON HARD DOCKING
Energies Available4, 6, 9 & 12 Mev