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Mono-Isocentric Breast and Supraclavicular Nodal Auto-Planning with TORUS

K Bush*, C Locke, Stanford University, Stanford, CA


(Sunday, 7/29/2018) 3:00 PM - 6:00 PM

Room: Exhibit Hall

Purpose: In radiation therapy, breast tangents remain a standard of care and implementation of standard IMRT techniques have brought unwarranted dose inhomogeneity, hotspots and scattered dose to the lungs and heart. In this work, we present an intelligent auto-planning algorithm capable of producing quality breast plans in less time than manual dosimetry planning efforts.

Methods: This work builds off of the TORUS algorithm (Trajectory Optimization in Radiotherapy Using Sectioning) by offering a fixed gantry mode allowing a forward planned tangential approach for determining beam geometries for use in breast cancer treatments. The beam optimization is performed without the need to do inverse optimization by using the concept of PTV angular flux introduced in TORUS, and calculating a beam configuration that maximizes the PTV angular flux novelty score. An algorithm is also introduced that computes a supraclavicular node field using 3D geometrical considerations.

Results: This approach is applied to a previously treated left and right breast case. It is found that the auto-planned approach is able to achieve clinically acceptable plans for the left and right breast cases using coplanar beams. Plan quality is further improved by allowing the algorithm to use non-coplanar beams.

Conclusion: The extended TORUS algorithm offers a promising clinical tool to automate conventional tangential breast planning with supraclavicular nodal coverage as well as introducing more complex dynamic trajectories for complex breast cases.

Funding Support, Disclosures, and Conflict of Interest: This work was supported in part by Varian Medical Systems.


Not Applicable / None Entered.


TH- External beam- photons: treatment planning/virtual clinical studies

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