Appendix 6: Video 16.2 Transcript
[Ngoc, Ang, and Ethan discuss the plan and their planning experiences.]
Facilitator: Ang and Ethan, have you got anything to offer Ngoc to help with their plan?
Ang: Ngoc, just, if you keep that screen up, I was just having a look at your objectives. I was thinking maybe with the PTV 56, you’re saying that you’re getting a bit of splay.
Ngoc: Yeah, yeah, a lot. Yeah.
Ang: That’s because the upper is set to 59 and the lower is set to 57.5. Try still to aim for 57, at least 57.5 to get into that PTV volume. So maybe something that could be tried, which I found helped when I was doing this plan, was put in the lower a bit lower, perhaps, maybe 56? To try to aim to push in more than 57.5?
Ngoc: Yeah, okay. I did start out with the, you know, with the 95 per cent exactly. And then, I think, I fell into the trap of thinking if I pushed it further, it’s going to work harder. I just got to a point where, I think, I was maybe changing too many things at once, and I lost track of, you know, perhaps I should have just changed that and then went back out and checked it. But, I think, when I went to do that, I remember, I sort of tweaked a few of the PTVs at the one time. Yeah, yeah, so, I think that’s a great idea, is to just take it slow and just do one thing at a time.
Ang: Yeah, that, that might be a suggestion, like, if you did do that to 56, and then if you’re fine, maybe play with the priorities first more than the dose to begin with, maybe a few, because at the moment they look like they’re quite close together, about 10 from each other, so that there might not be working hard enough to, it might begin a little bit confused. So, I’m not sure whether that would be something that might give you more ideas.
Ngoc: Yeah, I think, that to me is a really hard concept to grip, because I sort of feel like it’s contradicting. You know, you want it to work hard, so then you’re trying to make that gap smaller. But I think, in doing that, it just doesn’t work out, so that it makes sense. So, yeah.
Ang: And sometimes I found you make one little change and then everything goes kaput. Like, it just all changes the plan. You try and just do the most, the smallest thing, and all of a sudden, your plan’s just gone backwards, big time. So, it’s hard. That’s why I sometimes copy plans when I’m making bigger changes. It’s a tricky plan, though.
Facilitator: Ethan, have you got any thoughts how to help Ngoc with their plan?
Ethan: Yeah, um, well, firstly, Ngoc, great presentation. You were able to really well describe what the problems were with the plan and really made it easy for us to assess it. I guess the first thing that’s staring me right at the face is the NTO priority. That might be a little bit low, I think. In my experience, the rule of thumb is always to have it roughly 10 below, I think, one of the PTV priorities. And so, maybe you’re not letting the NTO maybe work hard enough there. That might be something worth a go, especially since we’re playing around with it. It might be worth to see if that improves maybe some of the dose drop-off, maybe minimise some of that 95 per cent splay in your high-dose regions.
Ngoc: Yeah, so, it’s funny you mentioned that, because I did start out with 125, just to match my lowest PTV priority, because I thought, you know, that’s where you wanted to start working. And so, I had it at 25, and I felt, and I found that the coverage, my PTV coverage for the PTV 56 was, it was quite skimpy, like, it was eating into the PTV. So, then I went and relaxed it, thinking that if I relaxed it, it would then let dose, you know, like, let a bit more in, a bit more in to work, but I think it worked too well, in the sense that now it is splaying way too much out. So, I probably, could probably, maybe, bring it back up a little bit. I sort of went from 25 down to 15, like, I didn’t, I didn’t do it gradually. So, definitely, I see, yeah, definitely what you said. And, yeah, and I was having trouble calculating a lot the last few times I went in, so I sort of, just, you know, doing what I can, but, okay, so definitely that is something I will try, and when I get back into it, but, yeah, I could totally see, you know, your point.
Facilitator: Well, great work, Ngoc. Did you have any other queries, or do you feel like you’ve got a good position to move forward with your plan?
Ngoc: Yeah, no, definitely lots of things to try out that I’ve either thought about but ran out of time or, you know, ideas I’ve not even thought about. So, yeah, definitely lots, lots to try and see what happens. But yeah, I think, you know, like I said, this plan, it has, it has a long way to go, so any, anything extra is going to help it. Yeah.
Facilitator: Excellent. Well, thanks so much for sharing.
