2.0 2dddb6b9-fdbf-4fe1-86c9-76d56d96942c *AOS_Prostate_SV hypofx 60Gy 20 fx v1 Pelvis Prostate AOS_Prostate_SV Hypofx 60Gy 20fx AOS sample template - to be copied, reviewed, modified as deemed appropriate, and approved by site physicist Summary: Low Risk Prostate Hypofractionated Treatment 20 fx to 60 Gy. PTV3 to 60 Gy, PTV2 to 57.6 Gy, PTV1 to 48 Gy. No nodal targets. References: "Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial ", E. Hallet. al, Lancet, 2016; and CHHiP Trial Supplementary Index (including planning guidelines). Version 1.7 Created: 2/4/2025 (BSM, SEG) Last updated: 4/18/2025 (PHH/SGH) - Adjusted influencer P values and sub-P ordering, corrected OAR label (Bone_Pelvic) ********************************************************************************************************************* Rx: PTV3, PTV2, and PTV1 recieve 60, 57.6, and 48 Gy, respectively. Dose Coverage: The isodose line used for the prescription doses for PTV3, PTV2, and PTV1 should cover a minimum of 95%, 91%, and 76% of the PTVs, respectively. 100% of the prostate should receive 60 Gy. "Target isodoses have been designed to achieve the following aims (Table 2 + 3): 1. Minimum (defined as to 99% of the target volume) to PTV1 will be the equivalent of 54Gy in 2Gy fractions prescribed to the isocentre and achieving target coverage by 95% isodose. This will be achieved having a 76% minimum isodose coverage. (To achieve the equivalent of 54Gy in 2Gy fractions for the conventional fractionation group, and assuming an alpha-beta ratio equal to 3, implies treating to 59.2Gy in 1.6Gy fractions. Minimum isodose coverage is therefore 100 x 59.2/74 x 0.95 = 76%). 2. Median dose to the outer shell (PTV1 - PTV2) will be the equivalent of 100% of 54Gy equivalent and equates to the 80% isodose. 3. Minimum dose to PTV2 will be the equivalent of 70Gy in 2Gy fractions prescribed to the isocentre . This will be achieved by having a 91% minimum isodose coverage. Median dose to the inner shell (PTV2 - PTV3) will be the equivalent of 70Gy and equates to the 96% isodose. 4. Median dose to PTV3 will be the equivalent to 74Gy (i.e. 100% ± 1%) with a minimum 95% isodose coverage." CHHiP trial Supplementary Index Contouring and Margins: "Volumes will be defined according to 1993 ICRU report 50 and supplement report ICRN 62: Prescribing, Recording and Reporting Photon Beam Therapy." - CHHiP Trial Supplementary Index GTV is prostate only. CTV1 is prostate and base of seminal vesicles (proximal 2cm) with 5mm margin CTV2 is prostate with 5mm margin CTV3 is prostate only. (i.e. CTV3 = GTV) PTVs 1-3 add a 5mm margin to the corresponding CTVs, excepting PTVs 2&3 have 0mm posterior/inferior margins (i.e. toward the rectum). ** Note that for daily adaptive treatments, the PTV expansion and rectal overlap have been excluded. OAR Constraints: See Table 4 of the CHHiP Trial Supplementary Index (page 6). Also see Wilkins et al - Red Journal 2020. Structures have been named according to TG 263. 14544 FMA 3.2 Rectum 4286595072 Rectum 15900 FMA 3.2 Urinary bladder 4294967040 Bladder 19614 FMA 3.2 Penile bulb 4294937740 PenileBulb 32842 FMA 3.2 Femur head & neck right 4294934528 Femur_R 32843 FMA 3.2 Femur head & neck left 4278190208 Femur_L 19667 FMA 3.2 Urethra 4278255615 Urethra 7199 FMA 3.2 Bowel 4286615140 Bowel 19386_Proximal 99VMS_STRUCTCODE 1.0 Proximal seminal vesicle 4293185534 SeminalVes_Prox 9600 FMA 3.2 Prostate 4286458316 Prostate 15902 FMA 3.2 Bladder wall 4291610665 Bladder wall OAR2 15900 FMA 3.2 Urinary bladder 5 0 ]]> 16580 FMA 3.2 Pelvic bones (bony pelvis) 4291569980 Bone_Pelvic 14626 FMA 3.2 Rectal wall 4291570104 Rectal wall OAR1 14544 FMA 3.2 Rectum 5 0 ]]> R-429EC SRT Planning target volume 4294901760 PTV_60 OAR9 9600 FMA 3.2 Prostate 5 OAR1 14544 FMA 3.2 Rectum ]]> R-429EB SRT Clinical target volume 4280918220 CTV_60 OAR9 9600 FMA 3.2 Prostate ]]> R-429EB SRT Clinical target volume 4279588463 CTV_57.6 OAR9 9600 FMA 3.2 Prostate 5 OAR1 14544 FMA 3.2 Rectum ]]> R-429EB SRT Clinical target volume 4291488244 CTV_48 OAR9 9600 FMA 3.2 Prostate 5 OAR8 19386_Proximal 99VMS_STRUCTCODE 1.0 Proximal seminal vesicle 5 OAR1 14544 FMA 3.2 Rectum ]]> R-429EC SRT Planning target volume 4285464576 PTV_57.6 Target3 R-429EB SRT Clinical target volume 5 OAR1 14544 FMA 3.2 Rectum ]]> R-429EC SRT Planning target volume 4294954188 PTV_48 Target4 R-429EB SRT Clinical target volume 5 OAR1 14544 FMA 3.2 Rectum ]]> Target1 3 VolumeDose ShouldBeMoreOrEqual 95 Relative 60 Absolute 1 1 Target5 2.88 VolumeDose ShouldBeMoreOrEqual 95 Relative 57.6 Absolute 2 1 Target6 2.4 VolumeDose ShouldBeMoreOrEqual 95 Relative 48 Absolute 2 2 OAR4 VolumeDose ShouldBeLessOrEqual 50 Relative 40.8 Absolute 4 1 OAR5 VolumeDose ShouldBeLessOrEqual 50 Relative 40.8 Absolute 4 2 OAR7 VolumeDose ShouldBeLessOrEqual 17 Absolute 40.8 Absolute 3 1 OAR7 VolumeDose ShouldBeLessOrEqual 1 Absolute 50 Absolute 3 2 OAR7 MeanDose OAR3 MeanDose ShouldBeLessOrEqual 40 Absolute 3 3 OAR10 DoseVolume ShouldBeLess 50 Relative 37 Absolute 3 4 OAR10 DoseVolume ShouldBeLess 30 Relative 46 Absolute 3 5 OAR12 DoseVolume ShouldBeLess 50 Relative 37 Absolute 3 6 OAR12 DoseVolume ShouldBeLess 30 Relative 46 Absolute 3 7 OAR2 VolumeDose ShouldBeLessOrEqual 5 Relative 60 Absolute 3 8 OAR2 VolumeDose ShouldBeLessOrEqual 25 Relative 48.6 Absolute 3 9 OAR2 VolumeDose ShouldBeLessOrEqual 50 Relative 40.8 Absolute 3 10 OAR2 MeanDose OAR6 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 63 Absolute 4 OAR1 VolumeDose ShouldBeLessOrEqual 3 Relative 60 Absolute 3 OAR1 VolumeDose ShouldBeLessOrEqual 15 Relative 57 Absolute 3 OAR1 VolumeDose ShouldBeLessOrEqual 30 Relative 52.8 Absolute 3 OAR1 VolumeDose ShouldBeLessOrEqual 50 Relative 48.6 Absolute 3 OAR1 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 63 Absolute 3 OAR1 MeanDose NoNormalization 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None