S462
Clinical - Gynaecological
ESTRO 2026
cases.Dose-volume parameters (D2%, Dmean, D98%, Vx Gy) were extracted from TPS RayStation (RaySearch AB, Sweden) via a Python API. Protocol compliance with EMBRACE II dose objectives was evaluated for pelvic and paraaortic subgroups with and without boost. For each OOI, the upper quartile of the dose-volume distribution served as a data-driven benchmark representing realistic limits achievable in current VMAT planning with a state-of-the-art TPS. Results: Compliance analysis demonstrated that 85% of plans met all EMBRACE II dose-volume objectives (bladder 80%, rectum 93%, bowel 80%).Based on the dose-volume distribution (Figure 1-2), stricter dose objectives were identified: bladder V30 Gy < 75%, V40 Gy < 55%; rectum V30 Gy < 85%, V40 Gy < 60%; bowel V30 Gy < 500 cm ³ , V40 Gy < 250 cm ³ .
These objectives were 5-15% lower for the bladder, rectum, and 100-150 cm ³ lower for the bowel compared with the EMBRACE II protocol, suggesting that improved OOI sparing can be achieved for EBRT in CC-RT. Compliance with new dose objectives was 73% (bladder 70%, rectum 76%, bowel 72%). Conclusion: Real-world data demonstrated that the EMBRACE II OOI dose objectives can be reliably achieved with modern TPS and image-guided VMAT techniques, confirming the protocol's continued applicability and effectiveness in clinical practice. Establishing institutional benchmarks from clinical dose- volume data provides an objective, data- driven framework for plan evaluation, quality assurance, and future automated optimization in cervical cancer EBRT. References: [1] EMBRACE www.embracestudy.dk. Keywords: cervical cancer, organs of interest, EMBRACE II
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