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Radiotherapy
Adaptive RT
Coen Rasch
Radiotherapy
No disclosures
Radiotherapy
A reminder:
GTV
Imaging, Clinical investigation
CTV
Statistics, Experience
PTV / ITV
Possible positions of the CTV
Treated Volume / irradiated Volume
Collateral damage
•IMRT
•IGRT
•ART
Radiotherapy
What is adaptive RT
Adaptive radiotherapy (ART) is an approach
to correct for variations in geometry of tumor
and bystander anatomy with repeated
(imaging-based (?)) modification of treatment
delivery
Schwartz et al Curr Oncol Rep 2012
Radiotherapy
How does adaptive RT translate
(4D) adaptive RT is RT with time weighted
adaptation
I.e.
Measuring and correcting for day to day variation
Adaptation of RT based upon (anatomical,
functional, biological) changes during RT either
expected (weight loss, shrinkage) or unexpected
like atelectasis
Basics: it is per patient, not per group
Radiotherapy
Ask yourself:
Do I want adaptation for:
1) Day to day, random changes
Bladder, cervix
2) Expected changes
Head and Neck
3) Random occurring systematic changes?
(base line shift, suddenly changed anatomy in
e.g. Lung)