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• Treatment plan evaluation is based on DVH parameters and assessment of spatial dose distribution
• Cooperation of radiation oncologist, clinical physicist and RTT essential
• Important to realize that treatment planning reflects anatomical situation at one moment in time
• Current CTV-ITV-PTV margins take into account anatomical changes of targets but not OAR
• Daily CBCT position verification allows to detect anatomical changes for targets and OAR
• Plan adaption during the course of EBRT can be necessary in case of major anatomical chances
• Adaptive IGRT accounts for these changes in a structured way and will help to improve balance
between tumor and OAR dose
• Our knowledge on dose constraints and DVH parameters is constantly improving
To consider beyond dose constraints and DVH parameters