************************************* A terrifying parable of the failure of the modern planning system could be found this week in Gorleston, Norfolk, where Great Yarmouth Borough Council approved an application to build 15 terraced houses on the site of a recently demolished pub.
It also has a reasonably up to date review of the various radiation distribution algorithms employed by modern treatment planning systems, but it does not discuss the advantages and disadvantages of the various approaches.
Currently, despite the ability of modern radiotherapy planning systems to quantify individuals' normal tissue doses in detail, there is almost no capacity to utilise this information to either optimise treatment plans to minimise SMN risks without compromising initial cure, or to provide individual-level counselling about risks.
In modern clinical treatment planning systems, fluence based optimization is done (at most) as an initial step.
Although strict definitions might have been usable with the older 'square' style of planning, in the era before modern imaging or radiotherapy planning systems the uncertainties in target localisation and dose were so large that such definitions would have offered little advantage.
Modern CT-based treatment planning systems also allow for graphical optimization, whereby a radiation oncologist can drag and drop the isodose lines on the CT dataset to the desired location and immediately observe the composite dose distribution and its relationship to the target volume and adjacent normal structures.
To compensate for this problem, the tumor was contoured with a modern radiation treatment planning system (CorePLAN, Seoul C&J Inc., Korea) to calculate the tumor volume.
In this essay, we identify the key paradox of modern planning which seeks to intervene in systems that have enormous complexity, growing and evolving rather than being designed in any top-down fashion.
Three-dimensional (3D) treatment planning systems have evolved and become crucial components of modern radiation therapy.
In broad historical perspective, Chinese city planning can be divided into millennia-old imperial planning and twentieth century modern planning.
