A dosimetric retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC)

Purpose A retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC). Methods and materials Five randomly selected early stage lung cancer patients were included in the study. For each patient, four plans were created: the SBRT plan and three VMAT plans using different optimisation methodologies. A total of 20 different plans were evaluated. The dose parameters of dose conformity results and the target dose constraints results were compared for these plans. Results The mean planning target volume (PTV) for all the plans (SBRT and VMAT) was 18·3 cm3, with a range from 15·6 to 20·1 cm3. The maximum dose tolerance to 1 cc of all the plans was within 140% (84 Gy) of the prescribed dose, and 95% of the PTV of all the plans received 100% of the prescribed dose (60 Gy). In all the plans, 99% of the PTV received a dose >90% of the prescribed dose, and the mean dose in all the plans ranged from 67 to 72 Gy. The planning target dose conformity for the SBRT and the VMAT (0°, 15° collimator single arc plans and dual arc) plans showed the tightness of the prescription isodose conformity to the target. Conclusions SBRT and VMAT are radiotherapy approaches that increase doses to small tumour targets without increasing doses to the organs at risk. Although VMAT offers an alternative to SBRT for NSCLC and the potential advantage of VMAT is the reduced treatment times over SBRT, the statistical results show that there was no significant difference between the SBRT and VMAT optimised plans in terms of dose conformity and organ-at-risk sparing.

Supporting mindful planners in a mindless system: Limitations to the emotional turn in planning practice

Despite widespread acknowledgment within planning scholarship that emotion – both present in knowledge and a form of knowledge – is integral to lived experience and the judgement of planners, it is often sidelined within planning practice. The extent to which mainstream planning has been able or willing to accommodate emotions remains constrained and the emotions of planners and the public remain an unacknowledged but pervasive presence. Antonio Ferreira recently highlighted in this journal the importance of attending to emotions at the level of the individual planner through the concept of mindfulness. We argue this approach must be complemented by an acknowledgement of the structural and institutional limitations of including emotions in planning practice. Drawing from the emotional geographies literature to describe a social-spatial conceptualisation of emotion, we highlight ontological and practical tensions associated with the achievement of the ‘emotional turn’ and advance a more purposeful engagement with emotion in mainstream planning practice.

Planning the unplanned City: The story of the gold coast

One of the distinctive features of Gold Coast urbanisation is its historically ad hoc approach to development with little or no strategic planning to guide it. Many have commented on the lack of planning on the Gold Coast calling it ‘an experiment in freedom’ or ‘free enterprise city’. Following a major restructuring of the Queensland’s local councils, the 1990s witnessed a shift from ad hoc decision making to more systematic planning on the Gold Coast. Understanding the past is important for shaping the future. This paper reviews the history of regulatory planning on the Gold Coast, encompassing decisions affecting the form and development of its earliest settlements through to its periods of greatest construction and most streamlined decision–making. It focuses mainly on past planning processes, the problems identified in each planning exercise and the interventions introduced, asking whether these were implemented or not and why. The paper positions the Gold Coast as a physical embodiment of this history of decision making, assessing the effects on the city as a whole of specific measures either affording freedoms or insisting on accountability to various levels of regulation. It examines how the absence of some planning measures influenced the form of the city and its internal arrangements and considers how the shift from ad hoc decision making towards more systematic planning efforts affected the city’s urbanisation. The lessons that the Gold Coast example provides will resonate with places elsewhere in Australia and the world, if not always in scale definitely in substance.