13 Ken Javedan-IMRT with decimal solid modulators - small.pdf

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13 Ken Javedan-IMRT with decimal solid modulators - small.pdf

Treatment planning• In General:• Large 6000-9000 cc, irregular convex and concave shaped PTV nearareas of electronic disequilibrium pose treatment planning anddosimetry challenges for MPM.• Planning Right sided mesothelioma is more challenging than the leftdue to liver dose constraintsNo more than 30% to get 30.0 Gy.• Maintain CTV 50 Gy.• Split beams typically 25x20 cm 2 .• 3 inch brass compensators.• Long calculation times for large volumes.• 3mm to 4mm calculation grid size.• 5-7 gantry angles.79

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