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• DVH parameters for EMBRACE II were initially based on ICRU guidelines and literature evidence
• Hard and soft constraints were based on current evidence for dosimetric gain and clinical
outcome improvement
• First planning experience using these parameters revealed that
• DVH constraints not sufficient for conformal dose planning
• For spatial dose distributions still room for improvement
• More parameters to be defined, especially for patients with lymph node metastases
• Commercially available treatment planning systems need quite specific information when
conformal dose distributions are intended
• Example: 45 Gy elective, nodal boost up 55 Gy obturator region, 55.7 Gy common iliac region
Why such a difference?