DR KANHU CHARAN PATRO
PROSTATE SBRT PLAN EVALUATION CHECK LIST
I. NAME UMR
II. DIAGNOSIS AGE
III. RISK
IV. GLEASON SCORE
V. PSA AT DIAGNOSIS POST HT3M/6M
VI. IPSS SCORE AT DIAGNOSIS POST HT3M/6M
VII. IMAGING AT DIAGNOSIS MRI PSMA
PROSTATE
SEMINAL VESICLES
NODES
VIII. IMAGING AT POST HT 3M/6M
PROSTATE
SEMINAL VESICLES
NODES
IX. DOSE PRESCRIBED PTV PROSTATE
PTV NODE
X. COVERAGE INDEX
PRIME STUDY
TARGET PARAMETER DESIRED ACHIEVED
CTV PROSTATE D
98
98%
CTV NODE IF D
98
98%
PTV PROSTATE D
98
95%
PTV NODE IF D
98
95%
XI. OAR PRIME PACE
PARAMETER DESIRED ACHIEVED PARAMETER DESIRED ACHIEVED
N+ N-
1. RECTUM V
14
<50% <40% D
50%
18.1Gy
V
17.5
<40% <30% D
20%
29Gy
V
28
<15% <15% D
1cc
36Gy
V
31.5
<8% <8% -- --
V
35
<3% <3% -- --
2. BLADDER V
14
<40% <35% D
40%
18.1Gy
V
17.5
<27% <20% V
37Gy
10cc
V
28
<20% <10% -- --
V
35
<3% <3% -- --
3. BOWEL V28 80CC D5cc 18.1Gy
V28 80CC -- -- D1cc 30Gy
4. FEMORAL RT V14 <5% D5% 14.5Gy
5. FEMORAL LT V14 <5% D5% 14.5Gy
6. BULB -- -- -- -- D50% 29.5Gy
7. URETHRA
PROSTATIC
-- -- -- -- D50% 42Gy

PROSTATE SBRT PLAN EVALUATION SHEET.docx

  • 1.
    DR KANHU CHARANPATRO PROSTATE SBRT PLAN EVALUATION CHECK LIST I. NAME UMR II. DIAGNOSIS AGE III. RISK IV. GLEASON SCORE V. PSA AT DIAGNOSIS POST HT3M/6M VI. IPSS SCORE AT DIAGNOSIS POST HT3M/6M VII. IMAGING AT DIAGNOSIS MRI PSMA PROSTATE SEMINAL VESICLES NODES VIII. IMAGING AT POST HT 3M/6M PROSTATE SEMINAL VESICLES NODES IX. DOSE PRESCRIBED PTV PROSTATE PTV NODE X. COVERAGE INDEX PRIME STUDY TARGET PARAMETER DESIRED ACHIEVED CTV PROSTATE D 98 98% CTV NODE IF D 98 98% PTV PROSTATE D 98 95% PTV NODE IF D 98 95% XI. OAR PRIME PACE PARAMETER DESIRED ACHIEVED PARAMETER DESIRED ACHIEVED N+ N- 1. RECTUM V 14 <50% <40% D 50% 18.1Gy V 17.5 <40% <30% D 20% 29Gy V 28 <15% <15% D 1cc 36Gy V 31.5 <8% <8% -- -- V 35 <3% <3% -- -- 2. BLADDER V 14 <40% <35% D 40% 18.1Gy V 17.5 <27% <20% V 37Gy 10cc V 28 <20% <10% -- -- V 35 <3% <3% -- -- 3. BOWEL V28 80CC D5cc 18.1Gy V28 80CC -- -- D1cc 30Gy 4. FEMORAL RT V14 <5% D5% 14.5Gy 5. FEMORAL LT V14 <5% D5% 14.5Gy 6. BULB -- -- -- -- D50% 29.5Gy 7. URETHRA PROSTATIC -- -- -- -- D50% 42Gy