A One Step Model for Online A One Step Model for Online Planning and Treatment for Planning and Treatment for Palliative Radiotherapy using Palliative Radiotherapy using Cone Beam CT Cone Beam CT David Fitzpatrick, Anita David Fitzpatrick, Anita Vloet Vloet , Daniel Letourneau, , Daniel Letourneau, Rebecca Wong, Mary Rebecca Wong, Mary Gospodarowicz Gospodarowicz , David A , David A Jaffray Jaffray 5 th Annual Toronto Radiation Medicine Conference Kingbridge Sunday 27 April 2008
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A One Step Model for Online A One Step Model for Online Planning and Treatment for Planning and Treatment for
Palliative Radiotherapy using Palliative Radiotherapy using Cone Beam CTCone Beam CT
David Fitzpatrick, Anita David Fitzpatrick, Anita VloetVloet, Daniel Letourneau, , Daniel Letourneau, Rebecca Wong, Mary Rebecca Wong, Mary GospodarowiczGospodarowicz, David A , David A JaffrayJaffray
5th Annual Toronto Radiation Medicine Conference
Kingbridge Sunday 27 April 2008
BackgroundBackground
• Palliative radiation should be effective yet fast • Uses simple Techniques
– Ant/Post opposed fields – A Direct field
• Conventional CT planning – a multistep process– can take a few hours to 1-2 days
• 2D planning – Quicker than CT planning– But lacks dosimetric information
Cone Beam CT (CBCT)Cone Beam CT (CBCT)
• CBCT scan images can be rapidly acquired on an RT treatment unit
• CBCT established for Image Guided RT Jaffray, Kupelian at al Expert Rev Anticancer Therapy 2007
• CBCT recently developed to permit image quality sufficient for treatment planning Letourneau, Wong et al IJROBP 2007. Sharpe, Moseley et al Med Physics 2006.
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Conventional CT Simulation (PCT) Conventional CT Simulation (PCT) Planning and RT Planning and RT
Planning and treatment process uncomfortable 4 (3-5)
Inconvenient 4 (2-5)Process difficult 4 (4-5)
Difficulty lying in position 3.5 (1-5)Took a long time 3.5 (2-5)
Efficient 2 (1-5)Satisfied with care 1 (1-2)
Clinical Advantages of 1 Step Online Clinical Advantages of 1 Step Online Planning and TreatmentPlanning and Treatment
• 1 step (less handoffs)• Time efficiency from Institutional perspective• Weekend on call
– Minimize pt transfer between units when staff minimal– Do not require staff trained to operate both CT Simulator
and RT treatment unit• Same day Sim + Treatment start• Minimize delays due to sequencing between systems• Could potentially be used in developing countries
for 3D simulation and Planning
Thank You forThank You for Your AttentionYour Attention