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Treatment Planning Goals
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Conformal therapy is optimal
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Della-Bianca et al. compared AP/PA vs. 3D-CRT vs. IMRT
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Advantage to conformal therapy when PTV was in close proximity or overlapped with kidney
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IMRT led to further decrease in left kidney and liver dose
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Potential advantages in some cases to IMRT over 3D-CRT
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Goal of homogeneous dose delivery (D95 >95%)
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Doses to normal structures as low as reasonably achievable (ALARA)
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Sparing of kidney and liver
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Kidney dose: limited to <20 Gy to 2/3 of kidney
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Liver dose: Mean dose < 30 Gy