radiation protection in radiotherapy
DESCRIPTION
Radiation Protection in Radiotherapy. IAEA Training Material on Radiation Protection in Radiotherapy. Part 10 Good Practice including Radiation Protection in EBT Lecture 3: Radiotherapy Treatment Planning. In BSS Treatment Planning is part of Clinical Dosimetry. - PowerPoint PPT PresentationTRANSCRIPT
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Radiation Protection inRadiotherapyPart 10Good Practice including Radiation Protection in EBTLecture 3: Radiotherapy Treatment PlanningIAEA Training Material on Radiation Protection in Radiotherapy
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
In BSS Treatment Planning is part of Clinical DosimetryBSS appendix II.20. Registrants and licensees shall ensure that the following items be determined and documented: ...(b) for each patient treated with external beam radiotherapy equipment, the maximum and minimum absorbed doses to the planning target volume together with the absorbed dose to a relevant point such as the centre of the planning target volume, plus the dose to other relevant points selected by the medical practitioner prescribing the treatment;
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
and BSS appendix II.21In radiotherapeutic treatments, registrants and licensees shall ensure, within the ranges achievable by good clinical practice and optimized functioning of equipment, that: (a) the prescribed absorbed dose at the prescribed beam quality be delivered to the planning target volume; and (b) doses to other tissues and organs be minimized.
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
Treatment planning is the task to make sure a prescription is put into practice in an optimized wayPrescriptionPlanningTreatment
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
ObjectivesUnderstand the general principles of radiotherapy treatment planningAppreciate different dose calculation algorithms Understand the need for testing the treatment plan against a set of measurementsBe able to apply the concepts of optimization of medical exposure throughout the treatment planning processAppreciate the need for quality assurance in radiotherapy treatment planning
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
Contents of the lectureA. Radiotherapy treatment planning conceptsB. Computerized treatment planningC. Treatment Planning commissioning and QA
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
The need to understand treatment planningIAEA Safety Report Series 17 Lessons learned from accidental exposures in radiotherapy (Vienna 2000): About 1/3 of problems directly related to treatment planning!May affect individual patient or cohort of patients
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
A. Basic Radiotherapy Treatment Planning Conceptsi. Planning process overviewii. Patient data required for planningiii. Machine data required for planningiv. Basic dose calculation
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
i. Planning process overviewCombine machine parameters and individual patient data to customize and optimize treatmentRequires machine data, input of patient data, calculation algorithm Produces output of data in a form which can be used for treatment (the treatment plan)Patient informationPlanningTreatment unit dataTreatment plan
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
The treatment planning processIndividual patientRadiotherapy treatment unitsBeam data: radiation quality, PDD, profiles, ...Patient data: CT scan, outlinesOptimization of source or beam placementDose calculationLocalization of tumor and critical structuresPreparation of treatment sheet and record and verify dataSimulation
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
Individual patientRadiotherapy treatment unitsBeam data: radiation quality, PDD, profiles, ...Patient data: CT scan, outlinesOptimization of source or beam placementDose calculationLocalization of tumor and critical structuresPreparation of treatment sheet and record and verify dataSimulationFor eachpatientFor allpatientsChoose for eachpatient
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
ii. Patient information requiredRadiotherapy is a localized treatment of cancer - one needs to know not only the dose but also the accurate volume where it has been delivered to.This applies to tumour as well as normal structures - the irradiation of the latter can cause intolerable complications. Again, both volume and dose are important.
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
One needs to knowTarget locationTarget volume and shapeSecondary targets - potential tumour spreadLocation of critical structuresVolume and shape of critical structuresRadiobiology of structures
Part 10, lecture 3: Radiotherapy treatment planning
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It all comes down to the correct dose to the correct volumeDose Volume Histograms are a way to summarize this information
Part 10, lecture 3: Radiotherapy treatment planning
Radiation Protection in Radiotherapy
Dose Volume HistogramsComparison of three differenttreatment techniques (red, blue and green)in terms of dose to the target and a critical structureTarget doseCriticalorgan
Part 10, lecture 3: Radiotherapy treatment planning
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Four Field
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SIMAT
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10010099.958983894348.228551580432.441820076425.6686349427
99.980859150710099.958983894347.707537339431.278221604725.4081278222
99.917967788710099.958983894347.064953108730.618270232724.8871135811
99.898826939410099.917967788746.405001736729.836748871124.6266064606
99.857810833799.958983894399.898826939446.283431747129.315734630123.845085099
99.816794728199.93984304599.898826939446.022924626628.9336575223.4630079889
99.753903366199.835935577499.857810833744.703021882627.752691906922.9419937478
99.671871154799.794919471799.734762516744.442514762126.971170545322.1604723862
99.570698094199.734762516799.712887260444.182007641526.589093435222.0215352553
99.466790626599.652730305499.652730305443.018409169925.929142063221.7610281348
99.406633671599.589838943499.488665882840.534907954225.408127822221.2400138937
99.283585354599.507806732199.466790626539.353942341124.105592219520.1979854116
99.242569248999.261710098299.384758415139.093435220623.324070857919.555401181
99.179677886999.119520931999.283585354538.693990969122.160472386219.0170197985
98.933581252998.955456509399.056629569937.65196248720.979506773218.6349426884
98.851549041698.851549041698.851549041637.530392497419.4164640517.9749913164
98.810532935998.62732766498.769516830336.349426884318.374435567917.7144841959
98.728500724698.381231030198.668343769734.404307051116.029871483216.6724557138
98.668343769798.135134396198.545295452733.622785689513.80687738815.7693643626
98.545295452797.886303355198.31833966832.441820076411.462313303214.2063216395
98.31833966897.498017554998.113259139830.23619312268.735672108413.0253560264
98.072243034197.148013453397.971069973528.01319902746.651615144111.9833275443
97.889037762296.778868502497.867162505827.89162903794.9496352910.8197290726
97.889037762296.245659128897.807005550827.75269190693.386592566910.1597777006
97.826146400295.813622815997.539033660626.84960055572.344564084810.1597777006
97.724973339595.466353121397.437860599926.32858631471.70197985419.7777005905
97.662081977595.034316808497.292937026625.92914206321.16359847178.7356721084
97.519892811294.583139646296.964808181325.14762070160.78152136167.5547064953
97.251920920994.112821634696.472614913523.72351510940.64258423067.0336922543
96.964808181393.658910065495.917530283621.37895102470.12156998965.9916637721
96.822619015193.002652374895.526510076318.63494268840.12156998964.8106981591
96.472614913592.614366574695.157365125413.68530739840.12156998963.9076068079
95.876514177991.936233627794.624155751810.420284821102.4661340743
95.362445653791.320992042994.02805501638.596734977401.5630427232
94.870252385890.664734352493.35265647647.172629385200.659951372
94.112821634689.844412239292.83858795225.349079541500.2605071205
93.251483415889.39323507792.18233026173.907606807900.1215699896
92.778430997288.857291296491.34013289223.126085446300.1215699896
92.081157201188.201033605990.6428590961.823549843700
91.362008148587.544775915389.94558529981.563042723200
91.197943725986.948675179889.18542014161.563042723200
90.724891307386.333433594988.50728719481.441472733600
89.781520877285.551393180487.68696508161.441472733600
89.185420141684.627163599686.82289245581.441472733600
88.548303300483.970905909185.81936507070.65995137200
88.135407836882.961909709984.4029422220.65995137200
87.665089825381.772442645883.2708977058000
87.21391266380.665007793181.9775231741000
86.538514123278.592327253880.4790681141000
85.939678980676.475896201978.6114681031000
85.59240928673.131716387376.2106587187000
84.649038855969.762926909373.8700062891000
84.011922014766.541795411770.8539553198000
83.106833283263.31792950767.8351699434000
81.775177052960.671023488664.0562194088000
79.658746000957.813568127859.640152033000
77.134888299554.592436630154.5924366301000
73.867271882150.367777747447.4064149189000
67.208990730443.466134368836.5289436986000
47.171255913233.280468130519.9201553143000
8.558694047216.01542205572.0535396899000
0.04101610573.67504306690000
00.43203631290000
000000
four field
six field
simat
four field
six field
simat
Dose (%)
Volume (cm3)
PTV1 DVH norm to 95%
ptv1
Zimmerman
ptv1rectum
Dose (%)four fieldsix fieldsimatfour fieldsix fieldsimatd-sixfieldd-simat
010010010010010010000
0.51001001001001001000.52020810510.5140151515
0.991001001001001001001.03001204821.01775
1.491001001001001001001.55022015331.5317651515
1.991001001001001001002.07042825852.045780303
2.491001001001001001002.59063636362.5597954545
2.981001001001001001003.10044030673.063530303
3.481001001001001001003.62064841183.5775454545
3.981001001001001001004.1408565174.0915606061
4.481001001001001001004.66106462214.6055757576
4.971001001001001001005.17086856525.1093106061
5.471001001001001001005.69107667035.6233257576
5.971001001001001001006.21128477556.1373409091
6.471001001001001001006.73149288066.6513560606
6.961001001001001001007.24129682377.1550909091
7.461001001001001001007.76150492887.6691060606
7.961001001001001001008.2817130348.1831212121
8.451001001001001001008.7915169778.6868560606
8.951001001001001001009.31172508219.2008712121
9.451001001001001001009.83193318739.7148863636
9.9510010010010010010010.352141292410.2289015152
10.4410010010010010010010.861945235510.7326363636
10.9410010010010010010011.382153340611.2466515152
11.4410010010010010010011.902361445811.7606666667
11.9410010010010010010012.422569550912.2746818182
12.4310010010010099.861062869110012.93237349412.7784166667
12.9310010010010099.861062869110013.452581599113.2924318182
13.4310010010010099.861062869110013.972789704313.8064469697
13.9310010010010099.861062869199.739492879514.492997809414.3204621212
14.4210010010010099.861062869199.478985758915.002801752514.8241969697
14.9210010010010099.478985758999.079541507515.523009857615.3382121212
15.4210010010010099.34004862898.957971517916.043217962815.8522272727
15.9110010010010099.218478638498.819034386916.553021905816.3559621212
16.4110010010010099.079541507598.436957276817.07323001116.8699772727
16.9110010010010099.079541507598.176450156317.593438116117.3839924242
17.4110010010010098.697464397497.516498784318.113646221217.8980075758
17.910010010010098.558527266496.734977422718.623450164318.4017424242
18.410010010010098.436957276896.352900312619.143658269418.9157575758
18.910010010010098.176450156395.692948940619.663866374619.4297727273
19.410010010010098.176450156394.789857589420.184074479719.9437878788
19.8910010010010098.037513025493.869399096920.693878422820.4475227273
20.3910010010010097.777005904893.209447724921.214086527920.9615378788
20.8910010010010097.516498784392.566863494321.734294633121.4755530303
21.3910010010010097.255991663891.906912122322.254502738221.9895681818
21.8810010010010097.255991663890.743313650622.764306681322.4933030303
22.3810010010010096.734977422790.343869399123.284514786423.0073181818
22.8810010010010096.596040291889.683918027123.804722891623.5213333333
23.3810010010010096.213963181788.902396665524.324930996724.0353484848
23.8710010010010095.953456061188.120875303924.834734939824.5390833333
24.3710010010010095.814518930286.818339701325.354943044925.0530984848
24.8710010010010095.432441820185.776311219225.875151150125.5671136364
25.3610010010010095.293504689184.855852726626.384955093126.0708484848
25.8610010010010095.171934699583.692254254926.905163198226.5848636364
26.3610010010010095.032997568683.171240013927.425371303427.0988787879
26.8610010010010094.39041333882.528655783327.945579408527.6128939394
27.3510010010010094.129906217481.469260159828.455383351628.1166287879
27.8510010010010093.73046196680.427231677728.975591456728.6306439394
28.3510010010010093.469954845479.524140326529.495799561929.1446590909
28.8510010010010093.348384855978.204237582530.01600766729.6586742424
29.3410010010010092.688433483877.040639110830.525811610130.1624090909
29.8410010010010092.306356373776.380687738831.046019715230.6764242424
30.3410010010010091.646405001776.120180618331.566227820431.1904393939
30.8410010010010091.385897881275.217089267132.086435925531.7044545455
31.3310010010010091.125390760774.696075026132.596239868632.2081893939
31.8310010010010090.4828065373.775616533533.116447973732.7222045455
32.3310010010010089.82285515873.393539423433.636656078933.236219697
32.8210010010010088.780826675972.473080930934.146460021933.7399545455
33.3210010010010087.860368183471.569989579734.666668127134.253969697
33.8210010010010085.637374088271.170545328235.186876232234.7679848485
34.3210010010010084.595345606170.006946856535.707084337335.282
34.8110010010010083.292810003569.22542549536.216888280435.7857348485
35.3110010010010082.129211531868.56547412336.737096385536.29975
35.8110010010010081.347690170267.922889892337.257304490736.8137651515
36.3110010010010080.948245918766.880861410237.777512595837.327780303
36.810010010010080.305661688166.099340048638.287316538937.8315151515
37.310010010010079.906217436665.300451545738.80752464438.345530303
37.810010010010079.003126085464.397360194539.327732749238.8595454545
38.310010010010078.60368183462.695380340439.847940854339.3735606061
38.7910010010010077.961097603362.174366099340.357744797439.8772954545
39.2910010010010077.700590482860.993400486340.877952902540.3913106061
39.7910010010010076.919069121260.472386245241.398161007740.9053257576
40.2810010010010075.738103508260.211879124741.907964950741.4090606061
40.7810010010010075.338659256759.430357763142.428173055941.9230757576
41.2810010010010074.696075026159.04828065342.94838116142.4370909091
41.7810010010010074.17506078558.38832928143.468589266242.9511060606
42.2710010010010073.914553664558.127822160543.978393209243.4548409091
42.7710010010010073.51510941357.867315039944.498601314343.9688560606
43.2710010010099.478985758972.872525182457.224730809345.018809419544.4828712121
43.7710010010099.478985758972.073636679456.564779437345.539017524644.9968863636
44.2610010010098.957971517971.431052448855.783258075746.048821467745.5006212121
44.7610010010098.957971517970.649531087255.401180965646.569029572846.0146363636
45.2610010010098.957971517970.510593956254.880166724647.08923767846.5286515152
45.7610010010098.957971517970.250086835754.359152483547.609445783147.0426666667
46.2510010010098.957971517969.989579715253.317124001448.119249726247.5464015152
46.7510010010098.957971517969.607502605152.796109760348.639457831348.0604166667
47.2510010010098.957971517969.468565474151.875651267849.159665936548.5744318182
47.7410010010098.819034386968.825981243551.354637026749.669469879549.0781666667
48.2410010010098.436957276868.304967002450.712052796150.189677984749.5921818182
48.7410010010098.436957276868.044459881949.409517193550.709886089850.1061969697
49.2410010010098.436957276867.523445640849.01007294251.23009419550.6202121212
49.7310010010097.394928794766.863494268848.228551580451.73989813851.1239469697
50.2310010010097.394928794765.960402917747.968044459952.260106243251.6379621212
50.7310010010097.394928794765.300451545746.926015977852.780314348352.1519772727
51.2310010010097.394928794764.918374435645.883987495753.300522453552.6659924242
51.7210010010097.394928794764.518930184145.102466134153.810326396553.1697272727
52.2210010010097.255991663863.876345953544.841959013554.330534501653.6837424242
52.7210010010097.255991663862.955887460944.320944772554.850742606854.1977575758
53.2210010010097.255991663862.174366099344.06043765255.370950711954.7117727273
53.7110010010096.873914553761.792288989243.92150052155.88075465555.2155075758
54.2110010010094.129906217460.871830496743.4004862856.400962760155.7295227273
54.7110010010085.776311219260.611323376243.018409169956.921170865356.2435378788
55.210010010075.217089267159.70823202542.236887808357.430974808356.7472727273
55.710010010071.813129558959.18721778441.698506425857.951182913557.2612878788
56.210010010067.90552275158.527266411941.437999305358.471391018657.7753030303
56.710010010066.203542896857.346300798941.316429315758.991599123858.2893181818
57.1910010010064.901007294257.224730809341.055922195259.501403066858.7930530303
57.6910010010064.119485932656.703716568340.656477943760.02161117259.3070681818
58.1910010010063.355331712455.383813824240.395970823260.541819277159.8210833333
58.6910010010062.712747481854.741229593639.614449461661.062027382360.3350984848
59.1810010010061.792288989253.838138242439.353942341161.571831325360.8388333333
59.6810010010061.271274748253.317124001438.450850989962.092039430461.3528484848
60.1810010010060.350816255652.396665508938.31191385962.612247535661.8668636364
60.6810010010058.648836401551.233067037237.530392497463.132455640762.3808787879
61.1710010010058.509899270649.392150052137.009378256363.642259583862.8846136364
61.6710010010057.346300798948.228551580436.366794025764.162467688963.3986287879
62.1710010010056.825286557846.405001736735.585272664164.682675794163.9126439394
62.6710010010054.741229593645.623480375134.664814171665.202883899264.4266590909
63.1610010010054.081278221645.484543244234.282737061565.712687842364.9303939394
63.6610010010053.560263980545.224036123733.761722820466.232895947465.4444090909
64.1610010010051.997221257444.58145189333.362278568966.753104052665.9584242424
64.6510010010051.476207016343.92150052131.920805835467.262907995666.4621590909
65.1510010010050.955192775343.799930531431.278221604767.783116100866.9761742424
65.6510010010050.955192775343.018409169929.975686002168.303324205967.4901893939
66.1510010010050.955192775341.837443556829.055227509668.823532311168.0042045455
66.6410010010050.694685654741.194859326228.673150399469.333336254168.5079393939
67.1410010010050.052101424140.673845085128.534213268569.853544359369.0219545455
67.6410010010050.052101424139.753386592628.152136158470.373752464469.535969697
68.1410010010050.052101424138.711358110527.752691906970.893960569670.0499848485
68.6310010010049.791594303637.391455366427.370614796871.403764512670.553719697
69.1310010010049.131642931635.828412643326.971170545371.923972617771.0677348485
69.6310010010049.131642931634.664814171626.328586314772.444180722971.58175
70.1310010010048.610628690533.744355679125.807572073672.96438882872.0957651515
70.6210010099.958983894348.228551580432.441820076425.668634942773.474192771172.5995
71.1299.980859150710099.958983894347.707537339431.278221604725.408127822273.994400876273.1135151515
71.6299.917967788710099.958983894347.064953108730.618270232724.887113581174.514608981473.627530303
72.1199.898826939410099.917967788746.405001736729.836748871124.626606460675.024412924474.1312651515
72.6199.857810833799.958983894399.898826939446.283431747129.315734630123.84508509975.544621029674.645280303
73.1199.816794728199.93984304599.898826939446.022924626628.9336575223.463007988976.064829134775.1592954545
73.6199.753903366199.835935577499.857810833744.703021882627.752691906922.941993747876.585037239975.6733106061
74.199.671871154799.794919471799.734762516744.442514762126.971170545322.160472386277.094841182976.1770454545
74.699.570698094199.734762516799.712887260444.182007641526.589093435222.021535255377.615049288176.6910606061
75.199.466790626599.652730305499.652730305443.018409169925.929142063221.761028134878.135257393277.2050757576
75.699.406633671599.589838943499.488665882840.534907954225.408127822221.240013893778.655465498477.7190909091
76.0999.283585354599.507806732199.466790626539.353942341124.105592219520.197985411679.165269441478.2228257576
76.5999.242569248999.261710098299.384758415139.093435220623.324070857919.55540118179.685477546578.7368409091
77.0999.179677886999.119520931999.283585354538.693990969122.160472386219.017019798580.205685651779.2508560606
77.5998.933581252998.955456509399.056629569937.65196248720.979506773218.634942688480.725893756879.7648712121
78.0898.851549041698.851549041698.851549041637.530392497419.4164640517.974991316481.235697699980.2686060606
78.5898.810532935998.62732766498.769516830336.349426884318.374435567917.714484195981.75590580580.7826212121
79.0898.728500724698.381231030198.668343769734.404307051116.029871483216.672455713882.276113910281.2966363636
79.5798.668343769798.135134396198.545295452733.622785689513.80687738815.769364362682.785917853281.8003712121
80.0798.545295452797.886303355198.31833966832.441820076411.462313303214.206321639583.306125958482.3143863636
80.5798.31833966897.498017554998.113259139830.23619312268.735672108413.025356026483.826334063582.8284015152
81.0798.072243034197.148013453397.971069973528.01319902746.651615144111.983327544384.346542168783.3424166667
81.5697.889037762296.778868502497.867162505827.89162903794.9496352910.819729072684.856346111783.8461515152
82.0697.889037762296.245659128897.807005550827.75269190693.386592566910.159777700685.376554216984.3601666667
82.5697.826146400295.813622815997.539033660626.84960055572.344564084810.159777700685.89676232284.8741818182
83.0697.724973339595.466353121397.437860599926.32858631471.70197985419.777700590586.416970427285.3881969697
83.5597.662081977595.034316808497.292937026625.92914206321.16359847178.735672108486.926774370285.8919318182
84.0597.519892811294.583139646296.964808181325.14762070160.78152136167.554706495387.446982475486.4059469697
84.5597.251920920994.112821634696.472614913523.72351510940.64258423067.033692254387.967190580586.9199621212
85.0596.964808181393.658910065495.917530283621.37895102470.12156998965.991663772188.487398685787.4339772727
85.5496.822619015193.002652374895.526510076318.63494268840.12156998964.810698159188.997202628787.9377121212
86.0496.472614913592.614366574695.157365125413.68530739840.12156998963.907606807989.517410733888.4517272727
86.5495.876514177991.936233627794.624155751810.420284821102.466134074390.03761883988.9657424242
87.0395.362445653791.320992042994.02805501638.596734977401.563042723290.54742278289.4694772727
87.5394.870252385890.664734352493.35265647647.172629385200.65995137291.067630887289.9834924242
88.0394.112821634689.844412239292.83858795225.349079541500.260507120591.587838992390.4975075758
88.5393.251483415889.39323507792.18233026173.907606807900.121569989692.108047097591.0115227273
89.0292.778430997288.857291296491.34013289223.126085446300.121569989692.617851040591.5152575758
89.5292.081157201188.201033605990.6428590961.82354984370093.138059145792.0292727273
90.0291.362008148587.544775915389.94558529981.56304272320093.658267250892.5432878788
90.5291.197943725986.948675179889.18542014161.56304272320094.17847535693.0573030303
91.0190.724891307386.333433594988.50728719481.44147273360094.68827929993.5610378788
91.5189.781520877285.551393180487.68696508161.44147273360095.208487404294.0750530303
92.0189.185420141684.627163599686.82289245581.44147273360095.728695509394.5890681818
92.5188.548303300483.970905909185.81936507070.6599513720096.248903614595.1030833333
9388.135407836882.961909709984.4029422220.6599513720096.758707557595.6068181818
93.587.665089825381.772442645883.270897705800097.278915662796.1208333333
9487.21391266380.665007793181.977523174100097.799123767896.6348484848
94.586.538514123278.592327253880.479068114100098.319331872997.1488636364
94.9985.939678980676.475896201978.611468103100098.82913581697.6525984848
95.4985.59240928673.131716387376.210658718700099.349343921198.1666136364
95.9984.649038855969.762926909373.870006289100099.869552026398.6806287879
96.4884.011922014766.541795411770.8539553198000100.379355969399.1843636364
96.9883.106833283263.31792950767.8351699434000100.899564074599.6983787879
97.4881.775177052960.671023488664.0562194088000101.4197721796100.2123939394
97.9879.658746000957.813568127859.640152033000101.9399802848100.7264090909
98.4777.134888299554.592436630154.5924366301000102.4497842278101.2301439394
98.9773.867271882150.367777747447.4064149189000102.969992333101.7441590909
99.4767.208990730443.466134368836.5289436986000103.4902004381102.2581742424
99.9747.171255913233.280468130519.9201553143000104.0104085433102.7721893939
100.468.558694047216.01542205572.0535396899000104.5202124863103.2759242424
100.960.04101610573.67504306690000105.0404205915103.7899393939
101.4600.43203631290000105.5606286966104.3039545455
101.96000000106.0808368018104.817969697
Chart for ptv2
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Four Field
Six Field
SIMAT
four field
six field
simat
Dose (%)
Volume (%)
PTV2 and Rectum DVHs normalised to 95% Dose
ptv2
zimmerman
ptv2rectum
Dose (%)Four FieldSix FieldSIMATfour fieldsix fieldsimatd(six field)d(simat)d(simat)Dose (gy)Dose (gy)Dose (gy)
0100100100100100100000000
0.51001001001001001000.5218657290.51457204770.40136619720.390.40705526870.4013661972
0.991001001001001001001.03329414351.01885265440.79470507040.77220.80596943190.7947050704
1.491001001001001001001.55515987251.53342470211.19607126761.16221.21302470061.1960712676
1.991001001001001001002.07702560162.04799674971.59743746481.55221.62007996921.5974374648
2.491001001001001001002.59889133062.56256879741.9988036621.94222.02713523791.998803662
2.981001001001001001003.11031974513.06684940412.39214253522.32442.42604940122.3921425352
3.481001001001001001003.63218547413.58142145182.79350873242.71442.83310466982.7935087324
3.981001001001001001004.15405120324.09599349953.19487492963.10443.24015993853.1948749296
4.481001001001001001004.67591693224.61056554713.59624112683.49443.64721520713.5962411268
4.971001001001001001005.18734534675.11484615383.989583.87664.04612937043.98958
5.471001001001001001005.70921107575.62941820154.39094619724.26664.45318463914.3909461972
5.971001001001001001006.23107680476.14399024924.79231239444.65664.86023990774.7923123944
6.471001001001001001006.75294253386.65856229695.19367859155.04665.26729517645.1936785915
6.961001001001001001007.26437094827.16284290365.58701746485.42885.66620933965.5870174648
7.461001001001001001007.78623667737.67741495125.9883836625.81886.07326460835.988383662
7.961001001001001001008.30810240638.19198699896.38974985926.20886.48031987696.3897498592
8.451001001001001001008.81953082088.69626760566.78308873246.5916.87923404026.7830887324
8.951001001001001001009.34139654989.21083965337.18445492966.9817.28628930897.1844549296
9.451001001001001001009.86326227899.7254117017.58582112687.3717.69334457757.5858211268
9.9510010010010010010010.385128007910.23998374867.98718732397.7618.10039984627.9871873239
10.4410010010010010010010.896556422410.74426435548.38052619728.14328.49931400948.3805261972
10.9410010010010010010011.418422151411.2588364038.78189239448.53328.90636927818.7818923944
11.4410010010010010010011.940287880511.77340845079.18325859158.92329.31342454689.1832585915
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12.4310010010010099.861062869110012.97358202412.79226110519.9779636629.695410.11939397879.977963662
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13.4310010010010099.861062869110014.01731348213.821405200410.780696056310.475410.93350451610.7806960563
13.9310010010010099.861062869199.739492879514.539179211114.335977248111.182062253510.865411.340559784611.1820622535
14.4210010010010099.861062869199.478985758915.050607625514.840257854811.575401126811.247611.739473947911.5754011268
14.9210010010010099.478985758999.079541507515.572473354615.354829902511.976767323911.637612.146529216611.9767673239
15.4210010010010099.34004862898.957971517916.094339083615.869401950212.378133521112.027612.553584485212.3781335211
15.9110010010010099.218478638498.819034386916.605767498116.373682556912.771472394412.409812.952498648512.7714723944
16.4110010010010099.079541507598.436957276817.127633227116.888254604613.172838591512.799813.359553917213.1728385915
16.9110010010010099.079541507598.176450156317.649498956217.402826652213.574204788713.189813.766609185813.5742047887
17.4110010010010098.697464397497.516498784318.171364685217.917398699913.975570985913.579814.173664454513.9755709859
17.910010010010098.558527266496.734977422718.682793099718.421679306614.368909859213.96214.572578617714.3689098592
18.410010010010098.436957276896.352900312619.204658828718.936251354314.770276056314.35214.979633886414.7702760563
18.910010010010098.176450156395.692948940619.726524557719.45082340215.171642253514.74215.38668915515.1716422535
19.410010010010098.176450156394.789857589420.248390286819.965395449615.573008450715.13215.793744423715.5730084507
19.8910010010010098.037513025493.869399096920.759818701220.469676056315.966347323915.514216.19265858715.9663473239
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87.0398.664133831794.938415344197.37729027518.596734977401.563042723290.835948796889.566410617669.861800281767.883470.852040061569.8618002817
87.5398.250505545794.570745756596.96366198917.172629385200.65995137291.357814525990.080982665270.263166478968.273471.259095330270.2631664789
88.0397.610147680694.11115877296.64195109995.349079541500.260507120591.879680254990.595554712970.664532676168.663471.666150598870.6645326761
88.5397.126049390393.743489184496.11189411123.907606807900.121569989692.40154598491.110126760671.065898873269.053472.073205867571.0658988732
89.0296.595992401593.283902199995.58490103563.126085446300.121569989692.912974398491.614407367371.459237746569.435672.472120030871.4592377465
89.5296.252834119792.940743918195.14676144371.82354984370093.434840127592.12897941571.860603943769.825672.879175299471.8606039437
90.0295.952570623292.61903302994.73313315771.56304272320093.956705856592.643551462672.261970140870.215673.286230568172.2619701408
90.5295.952570623292.343280838394.13567007781.56304272320094.478571585593.158123510372.66333633870.605673.693285836772.663336338
91.0195.514431031391.813223849593.67608309331.44147273360094.9993.66240411773.056675211370.987874.092273.0566752113
91.5194.962926649991.123843372892.98670261661.44147273360095.51186572994.176976164773.458041408571.377874.499255268773.4580414085
92.0194.619768368290.455910288692.29425822661.44147273360096.033731458194.691548212473.859407605671.767874.906310537373.8594076056
92.5194.135670077889.879894601491.55891905140.6599513720096.555597187195.2061202674.260773802872.157875.31336580674.2607738028
9393.881365279788.724799313790.27207549480.6599513720097.067025601695.710400866774.654112676172.5475.712279969274.6541126761
93.593.305349592587.575831852489.120044120400097.588891330696.224972914475.055478873272.9376.119335237975.0554788732
9492.891721306586.518781788188.038482750200098.110757059796.739544962175.456845070473.3276.526390506575.4568450704
94.592.364728230984.564005147486.586187879200098.632622788797.254117009875.858211267673.7176.933445775275.8582112676
94.9991.813223849582.584717200884.815246032200099.144051203297.758397616576.251550140874.092277.332359938576.2515501408
95.4991.51296035379.088792205482.471352411300099.665916932298.272969664176.65291633874.482277.739415207176.652916338
95.9990.823579876275.568355904280.0784361787000100.187782661298.787541711877.054282535274.872278.146470475877.0542825352
96.4890.155646792172.213370917377.0666094736000100.699211075799.291822318577.447621408575.254478.545384639177.4476214085
96.9889.39579631168.876769409974.0057601569000101.221076804799.806394366277.848987605675.644478.952439907777.8489876056
97.4888.314234940966.116183589770.0012255653000101.7429425338100.320966413978.250353802876.034479.359495176478.2503538028
97.9886.151112200563.214657760965.3777805013000102.2648082628100.835538461578.6517276.424479.76655044578.65172
98.4783.782707273759.743244071359.8137140756000102.7762366773101.339819068379.045058873276.806680.165464608379.0450588732
98.9780.651387952755.285250321752.3132544886000103.2981024063101.854391115979.446425070477.196680.572519876979.4464250704
99.4773.923034499747.852196825840.4222072431000103.8199681354102.368963163679.847791267677.586680.979575145679.8477912676
99.9752.209081438836.647466143822.1367730866000104.3418338644102.883535211380.249157464877.976681.386630414280.2491574648
100.469.40621361617.69103498992.3224462283000104.8532622789103.38781581880.64249633878.358881.785544577580.642496338
100.960.02451130584.04742937680000105.3751280079103.902387865781.043862535278.748882.192599846281.0438625352
101.4600.48409829030000105.896993737104.416959913381.445228732479.138882.599655114881.4452287324
101.96000000106.418859466104.93153196181.846594929679.528883.006710383581.8465949296
ptv2
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Four Field
Six Field
SIMAT
four field
six field
simat
Dose (%)
Volume (%)
Sheet3
000000
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Four Field
Six Field
SIMAT
four field
six field
simat
Dose (%)
PTV2 Volume (%)
(a)
000000
000000
000000
000000
000000
000000
000000
000000
000000
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Four Field
Six Field
SIMAT
four field
six field
simat
Dose (%)
Rectum Volume (%)
(b)
001
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
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00
00
00
00
00
00
00
00
00
00
00
00
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00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00