Basic Clinical Radiobiology 2017

35x 2.2 Gy

How to manage uncertainties?

Adapt plan in real-time to occurring events

Incorporate uncertainties into treatment planning

Geometrical margins derived from population based statistics Van Herk et al., (2000), IJROBP Optimize worst case scenario by simulating uncertainties as dosimetric perturbations Inherent plan robustness

Real-time organ motion monitoring

Real-time adaptation of treatment plan to actual position

Real-time adaptation

Optimum?

‘Anticipate to what you expect’

‘Act to what you see’

‘Act when necessary, anticipate as far as necessary’

5x 7 Gy