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Robust control
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A prerequisite of high precision dose delivery is high precision of targeting.
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If (all) involved uncertainties are not taken into account
→
reduced benefit
of highly conformal techniques.
•
Margins are a robust strategy for target coverage with a clear price (healthy
tissues irradiation) … but in some cases are not enough.
•
To fully exploit the potential of IMRT/PT in complex cases with
considerable organ motion, real time image guidance is necessary.
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In the absence of accurate prognostic factors an adaptive approach (repeat
imaging – calculation – planning) is recommended in PT.
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A plan is robust if treatment goals are met despite uncertainties in the
patient model and the plan remains acceptable over a range of likely
variations.
•
Optimal dose distribution
→
dose conformity, healthy tissue sparing and
robustness towards uncertainties.