Karen Krueger

Parotid Lab
August 5, 2015
Plan 3 VMAT- The patient was supine, with a large mask (that covered the patients shoulders),
on head rest A. A knee sponge was placed under the knees and the patients arms were by her
side.

GTV 100% > 6000cGy

100%=6018.9cGy

Met

PTV > 95% > 6000cGy

95%= 6000cGy

Met

Max= 2550.1cGy
V48= 0

Met

Max= 3412.5cGy
V50= 0

Met

Mean= 546.7cGy

Met

Max= 6471.2cGy
V70= 0
V60= 9.56cGy

Met

Max= 213.4cGy
Mean= 108.9cGy
V50= 0

Met

Max= 3825.6cGy
Mean= 2032.1cGy

Met

Max= 2590.3cGy
Mean= 868.3cGy
V52= 0

Met

R Lens= 120.7cGy
L Lens= 103.4cGy

Met

Mean= 1757.1

Met

Spinal Cord
Max < 4500cGy
V48<0.03cc
Spinal Cord +5mm
Max < 5000cGy
V50 <0.01cc
Contralateral Parotid
Mean < 2000cGy
Mandible
Max < 7500cGy
V70 <1%
V60<15%
Larynx
Max < 6600cGy
Mean 4400cGy
V50 <27%
Oral Cavity
Max < 6000cGy
Mean <3000cGy
Brainstem
Max < 5400cGy
Mean <3600cGy
V52 <0.03cc
Lens 0%= 300cGy
Cochlea
Mean<4500cGy

Plan 3 VMAT
1) a) I decided to use two partial arcs for this plan. I chose to use a clockwise arc from 359 to
150 and a counter clockwise arc from 150 to 359. b) I used the first arc angles (359 to
150 and 150 to 359) that I tried because my first plan came out acceptable after
optimization.
This was the easiest of the three techniques for me to plan. I placed the isocenter toward the
medial aspect of the planning target volume (PTV). I chose the angle of 150 to go slightly past
the PTV for optimum coverage. I then added 209 for the stopping point to become 359 I used
the play function within Eclipse to verify the field size was adequate for coverage of the PTV. It
was; I did not have to make any adjustments. I then went to VMAT optimization and set my
priorities. I had optimization structures to reduce dose to the mandible, cochlea, oral cavity, and
spinal cord. I entered my priorities and ran the plan. I watched as the plan optimized and made
adjustments as necessary. After the optimization, the plan was acceptable.

Figure 1. Isodose distribution with Volume Modulated Arc Therapy (VMAT) plan with
maximum dose shown.

Figure 2. Dose volume histogram (DVH) of the VMAT plan.

Figure 3. Plan for the VMAT technique.