Table 1.
Planning and treatment parameters
| A | B | C | D | |
|---|---|---|---|---|
| TPS |
XiO |
iPlan |
iPlan |
Pinnacle |
| Calculation algorithm |
SuperPosition |
Pencil Beam |
XVMC |
CCCS |
| Prescription dose |
ChildA: 40Gy/5fr |
44Gy/4fr |
Peripheral: 48Gy/4fr |
Peripheral: 48Gy/4fr |
| |
ChildB: 35Gy/5fr |
|
PeriGI:60Gy/8fr |
Cenrtral:60Gy/8fr |
| Prescription point |
70% isodose |
Isocenter |
Isocenter |
Isocenter |
| Beam arrangement |
Dynamic conformal arc |
Dynamic conformal arc |
Static |
Static |
| |
Non-coplanar, 8 arcs |
Coplanar, 2 arcs |
Non-coplanar, 6–8 beams |
Non-coplanar, 6-8 arcs |
| Respiratory movement |
Confined free-breathing(<1cm) |
Confined free-breathing |
Confined free-breathing |
Gated by Abches® or RPM |
| |
Under abdominal compression |
Under abdominal compression |
Under abdominal compression |
|
| Target definition CT |
Fusion of LSTCT + dynamic CT |
Fusion of 4 times breathing CT |
Fusion of 4DCT + breath-hold CT |
Breath-hold CT |
| Planning CT |
LSTCT |
LSTCT |
AveIP from 4DCT |
Breath-hold CT |
| ITV |
GTV + 2-6mm |
Fusion of 4 times breathing CT |
Directly visualized by LSTCT |
ITV = GTV |
| PTV |
ITV + 2mm |
ITV + CC10mm, AP, LR8mm |
ITV + 5mm |
ITV + CC8mm, AP, LR5mm |
| Dose constraints | ||||
| Liver |
V20(include PTV) < 20% |
V<16 > 700 cc |
V20 < 25% V<15 > 700 cc |
V20≦25% |
| Spinal cord |
Dmax < 25Gy, D1cc < 20Gy |
Dmax < 25Gy/4fr |
Dmax < 25Gy/4fr |
Dmax < 25Gy/4fr |
| GI tract |
Dmax < 25Gy, D1cc < 20Gy |
D10cc < 35Gy/4fr |
D1cc < 40Gy/4fr, D10cc < 35Gy/4fr |
D1cc < 30Gy/4fr, D10cc < 24Gy/4fr |
| Kidney |
- |
V20 < 30% |
V20 < 30% |
D1/3 < 20Gy/4fr |
| Heart |
- |
- |
- |
D1/3 < 28Gy/4fr |
| Gallbladder | - | - | - | D1/3 < 40Gy/4fr |
Abbreviations: TPS, treatment planning system; XVMC, X-ray voxel Monte Carlo algorithm; CCCS, collapsed cone convolution superposition; periGI, perigastrointestinal; RPM, The Varian® Real-time Position Management™ system; GI, gastrointestinal; LSTCT, long scan time computed tomography; 4DCT, 4-dimensional computed tomography; AveIP, average intensity projection; GTV, gross tumor volume; PTV, planning target volume; ITV, internal target volume; CC, cranial and caudal; LRA, left, right and anterior; P, posterior; LR, left and right; AP, anterior and posterior.