Dose constraints for target and normal tissues and dosimetric parameters for the 16 plans
| Variables . | Objectives . | Planning approaches (Mean ± SD) . | P value . | |||
|---|---|---|---|---|---|---|
| SO . | VB04 . | VB10 . | RO . | |||
| CTV | ||||||
| V95% (%) | ≧95% | 99.3 ± 0.7 | 98.6 ± 0.9 | 96.6 ± 2.3 | 99.5 ± 0.5 | b,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.5 | 0.2 ± 0.3 | b,d |
| D50% (cGy) | ≧3000 cGy | 3006.4 ± 5.0 | 3005.6 ± 4.2 | 3025.8 ± 14.3 | 3014.6 ± 5.4 | b,c,d,e,f |
| PTV_Eval | ||||||
| V95% (%) | ≧95% | 98.1 ± 1.3 | 97.7 ± 0.8 | 95.7 ± 2.0 | 92.4 ± 2.0 | b,c,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.3 | 0.2 ± 0.2 | b,d |
| D50% (cGy) | ≧3000 cGy | 3003.9 ± 3.9 | 3002.3 ± 3.8 | 3020.2 ± 13.9 | 3002.2 ± 3.2 | b,d,f |
| Dmax (cGy) | ≦3300 cGy | 3158.6 ± 19.4 | 3154.8 ± 20.1 | 3180.5 ± 25.3 | 3156.2 ± 28.5 | b,d |
| Heart (right) | ||||||
| DMean (cGy) | <70 cGy | 30.8 ± 8.9 | 41.7 ± 9.9 | 40.5 ± 13.8 | 31.4 ± 9.6 | |
| V1.5 Gy (%) | ≦5% | 0.7 ± 1.5 | 1.8 ± 2.4 | 1.6 ± 2.5 | 0.7 ± 1.4 | |
| Heart (left) | ||||||
| DMean (cGy) | <150 cGy | 43.2 ± 28.9 | 47.9 ± 22.1 | 45.0 ± 23.6 | 41.7 ± 23.4 | a,b,e,f |
| V4.5 Gy (%) | ≦5% | 0.5 ± 1.1 | 0.5 ± 0.9 | 0.5 ± 1.1 | 0.5 ± 0.9 | |
| Contralateral breast | ||||||
| Dmax (cGy) | ≦90 cGy | 106.4 ± 57.0 | 118.8 ± 70.7 | 109.2 ± 61.6 | 101.6 ± 53.3 | a,c,e |
| Ipsilateral breast | ||||||
| V50% (%) | ≦50% | 34.9 ± 9.5 | 34.4 ± 9.5 | 35.3 ± 10.4 | 33.2 ± 9.1 | c,e,f |
| V95% (%) | ≦25% | 17.6 ± 4.9 | 17.4 ± 5.0 | 16.8 ± 4.5 | 16.0 ± 4.5 | b,c,d,e,f |
| Contralateral lung | ||||||
| V10% (%) | ≦5% | 0.0 ± 0.0 | 0.0 ± 0.1 | 0.0 ± 0.1 | 0.0 ± 0.0 | |
| Ipsilateral lung | ||||||
| V10% (%) | ≦30% | 21.6 ± 5.1 | 24.9 ± 5.2 | 23.9 ± 5.2 | 21.9 ± 4.8 | a,b,e,f |
| V30% (%) | ≦10% | 5.3 ± 2.3 | 5.8 ± 2.3 | 5.8 ± 2.3 | 5.0 ± 2.1 | a,b,c,e,f |
| V50% (%) | ≦3% | 1.6 ± 1.1 | 1.7 ± 1.2 | 1.7 ± 1.2 | 1.4 ± 1.0 | c,e,f |
| Thyroid | ||||||
| Dmax (cGy) | ≦90 cGy | 8.5 ± 18.3 | 9.7 ± 20.7 | 9.5 ± 20.2 | 8.4 ± 17.7 | a,b,e,f |
| Body outside PTV | ||||||
| V107% (cc) | ≦2 cc | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | |
| Dmax (cGy) | ≦3300 cGy | 3099.9 ± 29.6 | 3075.7 ± 19.9 | 3085.5 ± 22.2 | 3058.2 ± 55.5 | a,c |
| Variables . | Objectives . | Planning approaches (Mean ± SD) . | P value . | |||
|---|---|---|---|---|---|---|
| SO . | VB04 . | VB10 . | RO . | |||
| CTV | ||||||
| V95% (%) | ≧95% | 99.3 ± 0.7 | 98.6 ± 0.9 | 96.6 ± 2.3 | 99.5 ± 0.5 | b,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.5 | 0.2 ± 0.3 | b,d |
| D50% (cGy) | ≧3000 cGy | 3006.4 ± 5.0 | 3005.6 ± 4.2 | 3025.8 ± 14.3 | 3014.6 ± 5.4 | b,c,d,e,f |
| PTV_Eval | ||||||
| V95% (%) | ≧95% | 98.1 ± 1.3 | 97.7 ± 0.8 | 95.7 ± 2.0 | 92.4 ± 2.0 | b,c,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.3 | 0.2 ± 0.2 | b,d |
| D50% (cGy) | ≧3000 cGy | 3003.9 ± 3.9 | 3002.3 ± 3.8 | 3020.2 ± 13.9 | 3002.2 ± 3.2 | b,d,f |
| Dmax (cGy) | ≦3300 cGy | 3158.6 ± 19.4 | 3154.8 ± 20.1 | 3180.5 ± 25.3 | 3156.2 ± 28.5 | b,d |
| Heart (right) | ||||||
| DMean (cGy) | <70 cGy | 30.8 ± 8.9 | 41.7 ± 9.9 | 40.5 ± 13.8 | 31.4 ± 9.6 | |
| V1.5 Gy (%) | ≦5% | 0.7 ± 1.5 | 1.8 ± 2.4 | 1.6 ± 2.5 | 0.7 ± 1.4 | |
| Heart (left) | ||||||
| DMean (cGy) | <150 cGy | 43.2 ± 28.9 | 47.9 ± 22.1 | 45.0 ± 23.6 | 41.7 ± 23.4 | a,b,e,f |
| V4.5 Gy (%) | ≦5% | 0.5 ± 1.1 | 0.5 ± 0.9 | 0.5 ± 1.1 | 0.5 ± 0.9 | |
| Contralateral breast | ||||||
| Dmax (cGy) | ≦90 cGy | 106.4 ± 57.0 | 118.8 ± 70.7 | 109.2 ± 61.6 | 101.6 ± 53.3 | a,c,e |
| Ipsilateral breast | ||||||
| V50% (%) | ≦50% | 34.9 ± 9.5 | 34.4 ± 9.5 | 35.3 ± 10.4 | 33.2 ± 9.1 | c,e,f |
| V95% (%) | ≦25% | 17.6 ± 4.9 | 17.4 ± 5.0 | 16.8 ± 4.5 | 16.0 ± 4.5 | b,c,d,e,f |
| Contralateral lung | ||||||
| V10% (%) | ≦5% | 0.0 ± 0.0 | 0.0 ± 0.1 | 0.0 ± 0.1 | 0.0 ± 0.0 | |
| Ipsilateral lung | ||||||
| V10% (%) | ≦30% | 21.6 ± 5.1 | 24.9 ± 5.2 | 23.9 ± 5.2 | 21.9 ± 4.8 | a,b,e,f |
| V30% (%) | ≦10% | 5.3 ± 2.3 | 5.8 ± 2.3 | 5.8 ± 2.3 | 5.0 ± 2.1 | a,b,c,e,f |
| V50% (%) | ≦3% | 1.6 ± 1.1 | 1.7 ± 1.2 | 1.7 ± 1.2 | 1.4 ± 1.0 | c,e,f |
| Thyroid | ||||||
| Dmax (cGy) | ≦90 cGy | 8.5 ± 18.3 | 9.7 ± 20.7 | 9.5 ± 20.2 | 8.4 ± 17.7 | a,b,e,f |
| Body outside PTV | ||||||
| V107% (cc) | ≦2 cc | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | |
| Dmax (cGy) | ≦3300 cGy | 3099.9 ± 29.6 | 3075.7 ± 19.9 | 3085.5 ± 22.2 | 3058.2 ± 55.5 | a,c |
Abbreviations: CTV, clinical target volume; PTV, planning target volume; SD, standard deviation; SO, standard optimization plan; VB04, virtual bolus plan (d = 0.4 g/cm3); VB10, virtual bolus plan (d = 1.0 g/cm3); RO, robust optimization plan.
Notes: A Friedman test with Bonferroni’s correction was performed, and statistically significant pairs (P < 0.05) were indicated by symbols as follows: aSO vs. VB04; bSO vs. VB10; cSO vs. RO; dVB04 vs. VB10; eVB04 vs. RO; fVB10 vs. RO.
Dose constraints for target and normal tissues and dosimetric parameters for the 16 plans
| Variables . | Objectives . | Planning approaches (Mean ± SD) . | P value . | |||
|---|---|---|---|---|---|---|
| SO . | VB04 . | VB10 . | RO . | |||
| CTV | ||||||
| V95% (%) | ≧95% | 99.3 ± 0.7 | 98.6 ± 0.9 | 96.6 ± 2.3 | 99.5 ± 0.5 | b,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.5 | 0.2 ± 0.3 | b,d |
| D50% (cGy) | ≧3000 cGy | 3006.4 ± 5.0 | 3005.6 ± 4.2 | 3025.8 ± 14.3 | 3014.6 ± 5.4 | b,c,d,e,f |
| PTV_Eval | ||||||
| V95% (%) | ≧95% | 98.1 ± 1.3 | 97.7 ± 0.8 | 95.7 ± 2.0 | 92.4 ± 2.0 | b,c,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.3 | 0.2 ± 0.2 | b,d |
| D50% (cGy) | ≧3000 cGy | 3003.9 ± 3.9 | 3002.3 ± 3.8 | 3020.2 ± 13.9 | 3002.2 ± 3.2 | b,d,f |
| Dmax (cGy) | ≦3300 cGy | 3158.6 ± 19.4 | 3154.8 ± 20.1 | 3180.5 ± 25.3 | 3156.2 ± 28.5 | b,d |
| Heart (right) | ||||||
| DMean (cGy) | <70 cGy | 30.8 ± 8.9 | 41.7 ± 9.9 | 40.5 ± 13.8 | 31.4 ± 9.6 | |
| V1.5 Gy (%) | ≦5% | 0.7 ± 1.5 | 1.8 ± 2.4 | 1.6 ± 2.5 | 0.7 ± 1.4 | |
| Heart (left) | ||||||
| DMean (cGy) | <150 cGy | 43.2 ± 28.9 | 47.9 ± 22.1 | 45.0 ± 23.6 | 41.7 ± 23.4 | a,b,e,f |
| V4.5 Gy (%) | ≦5% | 0.5 ± 1.1 | 0.5 ± 0.9 | 0.5 ± 1.1 | 0.5 ± 0.9 | |
| Contralateral breast | ||||||
| Dmax (cGy) | ≦90 cGy | 106.4 ± 57.0 | 118.8 ± 70.7 | 109.2 ± 61.6 | 101.6 ± 53.3 | a,c,e |
| Ipsilateral breast | ||||||
| V50% (%) | ≦50% | 34.9 ± 9.5 | 34.4 ± 9.5 | 35.3 ± 10.4 | 33.2 ± 9.1 | c,e,f |
| V95% (%) | ≦25% | 17.6 ± 4.9 | 17.4 ± 5.0 | 16.8 ± 4.5 | 16.0 ± 4.5 | b,c,d,e,f |
| Contralateral lung | ||||||
| V10% (%) | ≦5% | 0.0 ± 0.0 | 0.0 ± 0.1 | 0.0 ± 0.1 | 0.0 ± 0.0 | |
| Ipsilateral lung | ||||||
| V10% (%) | ≦30% | 21.6 ± 5.1 | 24.9 ± 5.2 | 23.9 ± 5.2 | 21.9 ± 4.8 | a,b,e,f |
| V30% (%) | ≦10% | 5.3 ± 2.3 | 5.8 ± 2.3 | 5.8 ± 2.3 | 5.0 ± 2.1 | a,b,c,e,f |
| V50% (%) | ≦3% | 1.6 ± 1.1 | 1.7 ± 1.2 | 1.7 ± 1.2 | 1.4 ± 1.0 | c,e,f |
| Thyroid | ||||||
| Dmax (cGy) | ≦90 cGy | 8.5 ± 18.3 | 9.7 ± 20.7 | 9.5 ± 20.2 | 8.4 ± 17.7 | a,b,e,f |
| Body outside PTV | ||||||
| V107% (cc) | ≦2 cc | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | |
| Dmax (cGy) | ≦3300 cGy | 3099.9 ± 29.6 | 3075.7 ± 19.9 | 3085.5 ± 22.2 | 3058.2 ± 55.5 | a,c |
| Variables . | Objectives . | Planning approaches (Mean ± SD) . | P value . | |||
|---|---|---|---|---|---|---|
| SO . | VB04 . | VB10 . | RO . | |||
| CTV | ||||||
| V95% (%) | ≧95% | 99.3 ± 0.7 | 98.6 ± 0.9 | 96.6 ± 2.3 | 99.5 ± 0.5 | b,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.5 | 0.2 ± 0.3 | b,d |
| D50% (cGy) | ≧3000 cGy | 3006.4 ± 5.0 | 3005.6 ± 4.2 | 3025.8 ± 14.3 | 3014.6 ± 5.4 | b,c,d,e,f |
| PTV_Eval | ||||||
| V95% (%) | ≧95% | 98.1 ± 1.3 | 97.7 ± 0.8 | 95.7 ± 2.0 | 92.4 ± 2.0 | b,c,d,e,f |
| V105% (%) | ≦5% | 0.1 ± 0.2 | 0.1 ± 0.1 | 1.1 ± 1.3 | 0.2 ± 0.2 | b,d |
| D50% (cGy) | ≧3000 cGy | 3003.9 ± 3.9 | 3002.3 ± 3.8 | 3020.2 ± 13.9 | 3002.2 ± 3.2 | b,d,f |
| Dmax (cGy) | ≦3300 cGy | 3158.6 ± 19.4 | 3154.8 ± 20.1 | 3180.5 ± 25.3 | 3156.2 ± 28.5 | b,d |
| Heart (right) | ||||||
| DMean (cGy) | <70 cGy | 30.8 ± 8.9 | 41.7 ± 9.9 | 40.5 ± 13.8 | 31.4 ± 9.6 | |
| V1.5 Gy (%) | ≦5% | 0.7 ± 1.5 | 1.8 ± 2.4 | 1.6 ± 2.5 | 0.7 ± 1.4 | |
| Heart (left) | ||||||
| DMean (cGy) | <150 cGy | 43.2 ± 28.9 | 47.9 ± 22.1 | 45.0 ± 23.6 | 41.7 ± 23.4 | a,b,e,f |
| V4.5 Gy (%) | ≦5% | 0.5 ± 1.1 | 0.5 ± 0.9 | 0.5 ± 1.1 | 0.5 ± 0.9 | |
| Contralateral breast | ||||||
| Dmax (cGy) | ≦90 cGy | 106.4 ± 57.0 | 118.8 ± 70.7 | 109.2 ± 61.6 | 101.6 ± 53.3 | a,c,e |
| Ipsilateral breast | ||||||
| V50% (%) | ≦50% | 34.9 ± 9.5 | 34.4 ± 9.5 | 35.3 ± 10.4 | 33.2 ± 9.1 | c,e,f |
| V95% (%) | ≦25% | 17.6 ± 4.9 | 17.4 ± 5.0 | 16.8 ± 4.5 | 16.0 ± 4.5 | b,c,d,e,f |
| Contralateral lung | ||||||
| V10% (%) | ≦5% | 0.0 ± 0.0 | 0.0 ± 0.1 | 0.0 ± 0.1 | 0.0 ± 0.0 | |
| Ipsilateral lung | ||||||
| V10% (%) | ≦30% | 21.6 ± 5.1 | 24.9 ± 5.2 | 23.9 ± 5.2 | 21.9 ± 4.8 | a,b,e,f |
| V30% (%) | ≦10% | 5.3 ± 2.3 | 5.8 ± 2.3 | 5.8 ± 2.3 | 5.0 ± 2.1 | a,b,c,e,f |
| V50% (%) | ≦3% | 1.6 ± 1.1 | 1.7 ± 1.2 | 1.7 ± 1.2 | 1.4 ± 1.0 | c,e,f |
| Thyroid | ||||||
| Dmax (cGy) | ≦90 cGy | 8.5 ± 18.3 | 9.7 ± 20.7 | 9.5 ± 20.2 | 8.4 ± 17.7 | a,b,e,f |
| Body outside PTV | ||||||
| V107% (cc) | ≦2 cc | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | |
| Dmax (cGy) | ≦3300 cGy | 3099.9 ± 29.6 | 3075.7 ± 19.9 | 3085.5 ± 22.2 | 3058.2 ± 55.5 | a,c |
Abbreviations: CTV, clinical target volume; PTV, planning target volume; SD, standard deviation; SO, standard optimization plan; VB04, virtual bolus plan (d = 0.4 g/cm3); VB10, virtual bolus plan (d = 1.0 g/cm3); RO, robust optimization plan.
Notes: A Friedman test with Bonferroni’s correction was performed, and statistically significant pairs (P < 0.05) were indicated by symbols as follows: aSO vs. VB04; bSO vs. VB10; cSO vs. RO; dVB04 vs. VB10; eVB04 vs. RO; fVB10 vs. RO.
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