2.0 d2397dc0-3c8f-4edc-b91a-7bc285c62800 *AOS_Lung_R peripheral SBRT 34Gy 1fx v1 Thorax Lung Right *AOS_Lung_R_peripheral SBRT 34Gy 1fx AOS sample template - to be copied, reviewed, modified as deemed appropriate, and approved by site physicist Summary: 1 fx right peripheral lung SBRT to 34 Gy Reference: RTOG 0915, "A Randomized Phase II Study Comparing 2 Stereotactic Body Radiation Therapy (SBRT) Schedules for Medically Inoperable Patients with State I Peripheral Non-Small Cell Lung Cancer" Version 1.0 Created: 6/13/15 PHH ********************************************************************* Rx: "Patients will receive 34 Gy in 1 fraction to the prescription line at the edge of the PTV.." - RTOG 0915 "The prescription isodose surface will be chosen such that 95% of the target volume (PTV) is conformally covered by the prescription isodose surface (PTV V95%RX = 100%) and 99% of the target volume (PTV) receives a minimum of 90% of the prescription dose (PTV V90%RX > 99%)." - RTOG 0915 "Maximum dose: The treatment plan should be created such that 100% corresponds to the maximum dose delivered to the patient. This point must exist within the PTV. Prescription isodose: The prescription isodose surface must be ≥ 60% and < 90% of the maximum dose." - RTOG 0915 PTV Margins: "There are 2 acceptable methods to define the PTV depending on the method of CT simulation: a. Conventional (helical) CT-simulation (non-4DCT): The PTV will include the GTV plus an additional 0.5 cm margin in the axial plane and 1.0 cm margin in the longitudinal plane (craniocaudal). b. 4D CT-simulation: An internal target volume (ITV) around the GTV, accounting for tumor motion may be defined from the 4D CT dataset. The PTV will include the ITV plus an additional 0.5 cm margin uniformly applied to the ITV." - RTOG 0915 Conformality: "High Dose Spillage: The cumulative volume of all tissue outside the PTV receiving a dose > 105% of prescription dose should be no more than 15% of the PTV volume. Conformality of PTV coverage will be judged such that the ratio of the volume of the prescription isodose meeting criteria 1 through 4 to the volume of the PTV is ideally < 1.2 (see table below). These criteria will not be required to be met in treating very small tumors (< 2.5 cm axial GTV dimension or < 1.5 cm craniocaudal GTV dimension) in which the required minimum field size of 3.5 cm (see Section 6.2) results in the inability to meet a conformality ratio of 1.2. The “None” and “Minor” entries in this table define the Per Protocol, Variation Acceptable and Deviation Unacceptable Compliance Criteria (see Section 6.7)." - RTOG 0915 Intermediate Dose Spillage: "The falloff gradient beyond the PTV extending into normal tissue structures must be rapid in all directions and meet the following criteria: Location: The maximum total dose over all fractions in Gy to any point 2 cm or greater away from the PTV in any direction must be no greater than D2cm. Volume: The ratio of the volume of the 12 Gy isodose volume to the volume of the PTV must be no greater than R50%."- RTOG 0915 OAR Constraints: See RTOG 0915 Section 6.5.1 p.18. OAR Contouring: See RTOG 0915 Section 6.5.2 p. 19. Structures have been named according to TG 263. 5018 FMA 3.2 Bones 4289396157 Bones 7088 FMA 3.2 Heart 4294957055 Heart 7131 FMA 3.2 Esophagus 4289068874 Esophagus 7309 FMA 3.2 Lung right 4278190284 Lung_R 7310 FMA 3.2 Lung left 4294967040 Lung_L 45245 FMA 3.2 Brachial plexus left 4294934720 BrachialPlex_L 45244 FMA 3.2 Brachial plexus right 4286578943 BrachialPlex_R T-D3219 SRT Great vessels of the heart 4291454208 GreatVes 7394 FMA 3.2 Trachea 4278190335 Trachea 264793 FMA 3.2 Set of left ribs 4278223103 Ribs_L 264792 FMA 3.2 Set of right ribs 4291624908 Ribs_R 7163 FMA 3.2 Skin 4286644096 Skin Body BODY 99VMS_STRUCTCODE 1.0 Body plus other external items 5 0 ]]> 7148 FMA 3.2 Stomach 4294934720 Stomach 9869 FMA 3.2 Pericardium 4294901888 Pericardium 7197 FMA 3.2 Liver 4278206464 Liver 7405 FMA 3.2 Main bronchus 4289986559 Bronchus_Main 68877 FMA 3.2 Both lungs 4294934528 Lungs 7647 FMA 3.2 Spinal cord 4278255615 SpinalCord GTVp 99VMS_STRUCTCODE 1.0 Primary gross tumor volume 4285868492 GTV primary ITV 99VMS_STRUCTCODE 1.0 Internal target volume 4294934528 ITV R-429EC SRT Planning target volume 4294901760 PTV Target2 ITV 99VMS_STRUCTCODE 1.0 Internal target volume 5 5 10 5 5 10 Body BODY 99VMS_STRUCTCODE 1.0 Body plus other external items -2 ]]> HealthyTissue 99VMS_STRUCTCODE 1.0 Generic healthy tissue 4278190208 Lungs-ITV OAR5 7310 FMA 3.2 Lung left OAR4 7309 FMA 3.2 Lung right Target1 GTVp 99VMS_STRUCTCODE 1.0 Primary gross tumor volume Target2 ITV 99VMS_STRUCTCODE 1.0 Internal target volume OAR16 7405 FMA 3.2 Main bronchus ]]> Target3 34 DoseVolume ShouldBeMoreOrEqual 95 Relative 34 Absolute 1 1 DoseVolume ShouldBeMoreOrEqual 99 Relative 30.599999999999998 Absolute 2 1 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 140 Relative DoseVolume ShouldBeLessOrEqual 0.03 Absolute 166.7 Relative 3 8 OAR3 DoseVolume ShouldBeLessOrEqual 5 Absolute 11.9 Absolute 2 5 OAR3 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 15.4 Absolute 3 2 OAR3 MeanDose OAR6 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 17.5 Absolute 2 OAR6 DoseVolume ShouldBeLessOrEqual 3 Absolute 14 Absolute 3 OAR7 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 17.5 Absolute 2 6 OAR7 DoseVolume ShouldBeLessOrEqual 3 Absolute 14 Absolute 3 OAR2 DoseVolume ShouldBeLessOrEqual 15 Absolute 16 Absolute 3 1 OAR2 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 22 Absolute 3 11 OAR2 MeanDose OAR8 DoseVolume ShouldBeLessOrEqual 10 Absolute 31 Absolute 2 7 OAR8 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 37 Absolute 3 3 OAR9 DoseVolume ShouldBeLessOrEqual 4 Absolute 10.5 Absolute 3 4 OAR9 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 20.2 Absolute 3 5 OAR11 DoseVolume ShouldBeLessOrEqual 1 Absolute 22 Absolute 4 1 OAR11 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 30 Absolute 4 2 OAR10 DoseVolume ShouldBeLessOrEqual 1 Absolute 22 Absolute 4 3 OAR10 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 30 Absolute 4 4 OAR12 DoseVolume ShouldBeLess 10 Absolute 23 Absolute 4 5 OAR12 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 26 Absolute 4 6 OAR14 DoseVolume ShouldBeLessOrEqual 15 Absolute 16 Absolute 3 7 OAR14 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 22 Absolute 3 12 OAR14 MeanDose OAR13 DoseVolume ShouldBeLessOrEqual 10 Absolute 11.2 Absolute DoseVolume ShouldBeLessOrEqual 10 Absolute 12 Absolute 3 13 OAR13 MeanDose OAR13 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 12.4 Absolute 3 OAR15 DoseVolume ShouldBeLessOrEqual 700 Absolute 10 Absolute 3 6 OAR15 MeanDose OAR16 DoseVolume ShouldBeLessOrEqual 4 Absolute 10.5 Absolute 3 9 OAR16 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 20.2 Absolute 3 14 OAR18 DoseVolume ShouldBeLess 0.35000000000000003 Absolute 10 Absolute 2 2 OAR18 DoseVolume ShouldBeLess 1.2 Absolute 7 Absolute 2 8 OAR18 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 14 Absolute 1 ControlRegion1 DoseVolume ShouldBeLess 1500 Absolute 7 Absolute 2 3 ControlRegion1 DoseVolume ShouldBeLess 1000 Absolute 7.4 Absolute 2 4 ControlRegion1 MeanDose OAR5 MeanDose OAR4 MeanDose NoNormalization 1 None