General Concepts

This chapter provides a comprehensive guide to reviewing radiotherapy treatment plans to ensure that they achieve high-quality standards rather than merely meeting minimum acceptability. The focus of the chapter is on general concepts, applicable to any radiotherapy plan, whereas subsequent chapters will expand on these concepts with anatomical site-specific details. The plan quality review covers all aspects of the planning process, from patient assessment and intent through simulation to the construction of the treatment plan itself. Key areas of emphasis include the review of image registrations, segmentation, beam settings, optimization objects, dose distributions, and dose–volume histograms. This chapter also presents examples of poor versus high-quality plans and addresses complex topics such as the presence of cardiac implantable electronic devices and planning in the context of previously delivered radiation.