Course book Advanced Treatment Planning 2018

Treatment plan robustness

Robustness of a treatment plan is one of the most important criteria in the plan assessment – complex treatment plans are susceptible to errors Major uncertainties: – Ion range – RBE (fragementation tail of carbon ions) Possibilities to achieve a good robustness – Beam through most homogenous tissue (avoid areas with larger movement) – Avoiding beam angles perpendicular to organ motion Assessing robustness against set-up errors and patient or organ motion by simulating these variation and their influence on dose distribution Opposing field arrangement is very robust with regard to range uncertainties PTV margins can be optimised in order to maximise the robustness