Session Item

In photon treatment planning target volumes (PTVs) are used to make sure that the clinical target volume (CTV) receives adequate dose despite treatment uncertainties. The underlying static dose cloud approximation (the assumption that the dose distribution is invariant to errors) is problematic in intensity modulated proton treatments where range errors should be taken into account as well. A solution is robust planning, i.e., explicitly taking into account uncertainties in the robust optimization and robustness evaluation of treatment plans, in so called treatment scenarios. Although robust planning is conceptually straightforward, it introduces difficulties, e.g. in the scenario selection and evaluation of corresponding scenario dose distributions.

The purpose of this talk is to give background information and provide practical choices to help the transition from PTV based planning to robust treatment planning. Important aspects are limitations of the method, assessment of criteria by benchmarking against a PTV method, and to include the whole radiation oncology team in the process. Furthermore, pitfalls and common misconceptions are discussed.