TDF Plan (1.9.0): User Guide

As a quick example, in the Integrated Multicourse Regimen (IMR) group, assign to course #1 a conventional treatment regimen of 30 fractions of 200 cGy given one fraction per day, 5 days per week, for an overall treatment time of 6 weeks. Clicking the New Patient button in the lower right corner enters those default values into course #1 and excludes all the other courses. In the Course Calendar window you may optionally select course #1 and click on the starting date of course to set a specific treatment schedule. In this simple example the biologically effective dose (BED or E/α) for early effects is 72 Gy_(10.0) and 100 Gy_(3.0) for late effects. The (α/β) subscripts to the Gy are reminders that E/α does not actually represent true "Gy" in the physics sense, and of the particular values of α/β used in the calculation. BED_(α/β) values can only be summed with other BED_(α/β) values.

For SBRT and other high dose per fraction calculations TDF Plan also implements a linear-quadratic-linear LQ_α/β-L_DT model to calculate BED. You can download a description of LQ-L here.

TDF Plan supports treatment regimens of up to 8 sequential, overlapping or concomitant events. A 4 month calendar allows one to quickly predict when course changes will occur and to work around scheduled and optional holidays. In the example on the right the patient will be simulated on August 20th (entered as course #8) and begin his 3D conformal primary treatment (entered as course #1) on August 22nd. The treatments will be delivered in 5 fractions per week (the treatment week is a user defineable preference setting) The radiotherapy department will be closed on September 3rd (Labor day holiday) so no treatment will be delivered that day. The last primary course treatment will therefore be on September 19th. A field cone-down (course #2) is scheduled to begin September 20th, followed by an IMRT boost (course #3) beginning September 27th. The patient will be out of town on October 5th so that day has been marked as a "skip" day and treatment will resume on October 8th which is a bank holiday, but the department will be open for patient treatments. The start dates for the various courses can be set manually by clicking on the calendar or automatically using the "Auto Sequence Courses" button which assumes the courses are to be delivered sequentially, working around holidays and skip days.

TDF Plan implements an SQL database to track current and pending patients' treatment schedules. The database can be hosted on the same computer as the TDF program (free) for a single stand-alone user, or hosted on a networked computer (a remote database license must be purchased separately from the database vendor REAL Software). Using a remote database enables doctors and staff to share a common scheduling database. TDF Plan will query the database daily and generate a list of all patients with course changes (e.g. boosts, cone downs, etc..) tabulated by calendar day for the upcoming two weeks. TDF Plan can be scheduled to automatically send email to the doctors and dosimetrists associated with each patient alerting them to upcoming course changes. For example, in screen capture on the right Doctor Who will receive an email reminding him of that patient "John Dough" will be starting his field cone down on September 20th. The database can also be queried manually. For example, a manual query might consist of something like: "List patients for doctor "Who" and resident "Evil" and planner "MA" with courses that begin today until 14 days from today". The search terms are selected from the popup menus (or may be entered manually if desired).