Gynae BT 2017

Why such a difference?

• 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