Physics Athens 2016

Complex treatments and the need for patient specific QA

Conventional RT : 10 1 parameters/plan

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IMRT :

10 3 parameters/plan

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Impossible to verify all combinations with machine oriented QA experiments

TomoTherapy :

10 4 parameters/plan

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In IMRT/VMAT/Tomotherapy the classic entrance dose in vivo, which was a proved technique to detect large errors, became difficult, and yet it are these complex techniques which really require patient specific QA Even advanced TPS contains only limited model of the beam and machine …” Is it possible to cover all operation parameter combinations in machine related QA for advanced IMRT delivery techniques? Maybe we should focus on the end result the delivered dose to the patient and relate any dosimetric discrepancies between intended and

delivered dose to the impact on treatment effectiveness ?! Prove the plan works with an experimental verification

1) Dose, MU calc 2) Information transfer TPS->R&V 3) Dose delivery

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