Fig 1.
Workflow chart for the tests implemented.
Table 1.
Dosimetric objectives on treatment volume and OARs for the whole treatment.
The following conventions were used: Dv%>[d]Gy means that the dose that covered v% of the volume must be bigger than dGy; V[d]Gy<[v]% means that the volume fraction that received at most dGy must be smaller than v% of the volume.
Fig 2.
The DVHs for the plans generated for the phantom case.
Top: PTV planning method with NO intra-fraction motion (continuous line); PTV planning method with intra-fraction motion (dashed line). Bottom: adaptive planning method (continuous line) and PTV planning method with intra-fraction motion (dashed line). The prostate shift at the end of the fraction is 1.25 cm. The arrows indicate the DVHs for the prostate (CTV). The DVHs are shown for all the organs involved: the diamonds correspond to the objectives imposed on each of the organs. The doses refer to the total treatment prescriptions.
Table 2.
Target and OAR doses for the volume fractions for which the requirements reported in Table 1 were imposed, for the standard IMRT treatment.
Note: the dose values for the objective on the prostate (D3) and those for the femurs are not reported as the dosimetric objectives were always satisfied in our analysis.
Fig 3.
Isodose lines for two pelvic slices.
In the top and the bottom figure a, b, c and d correspond respectively to the PTV planning method without/with intra-fraction motion and the adaptive planning method with/without MU rescaling (both with intra-fraction motion). In the top figure in a and b the PTV is shown as a grey shaded area surrounding the prostate. The prostate is visible only in the slice shown in the top figure.
Table 3.
Target and OAR doses for the volume fractions for which the requirements reported in Table 1 were imposed, for the IMRT extreme hypofractionation treatment.
Note: the dose values for the objective on the prostate (D3) and those for the femurs are not reported as the dosimetric objectives were always satisfied in our analysis.
Fig 4.
The DVHs for the plans optimized using pure fluence (top figure) and DMPO (bottom figure).
PTV planning method (dashed line); PTV planning method with rigid isocenter shifts (dashed dot line); adaptive planning method (continuous line). The prostate shift at the end of the fraction is about 0.5 cm. The arrows indicate the DVHs for the prostate (CTV), bladder and rectum. The DVHs are shown for all the organs involved: the diamonds correspond to the objectives imposed on each of the organs and the stars correspond to the objectives not satisfied by the PTV planning method. The doses refer to the total treatment prescriptions.