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The max dose for the lung plan was 136%, 135.3%, and 128%, for the 20 Gy, 15 Gy, and 10 Gy plans, respectively. All neck and lung plans were able to achieve negligible dose to the spinal cord, esophagus, untreated lung, and heart. The treated lung had V8 Gy of 1.9%, 0.8%, and 0.1% for 20 Gy, 15 Gy, and 10 Gy doses, respectively.The lung plans required a higher number of MUs (3512-12,327) than the neck plans (2280-9764). Conclusion: This study demonstrates that it is feasible to create LRT plans for neck and lung tumors using VMAT. These plans are currently under quality assurance testing. We plan to use this planning process in an upcoming institutional trial to examine the safety, efficacy, and immunogenicity of ablative LRT for oligometastatic conventional chondrosarcoma, a radioresistant, "cold" tumor with few promising treatment options.

electronic medical records for each case and the time logs from both nursing and anesthesia. The patient's length of stay (registration to discharge from hospital), procedure time (time under anesthesia) and recovery time were analyzed for both groups. The presence of hematuria and need for a urinary catheter at time of discharge was also reviewed for both techniques. Results: A total of 50 consecutive cases for each technique were analyzed. The median ages for the two cohorts were similar, with 67 years (CT) and 64 years (US). Average total length of stay for patients undergoing CT based planning was 8.4 hours compared to US based planning of 6.6 hours. Procedures time for CT and US based planning was on average of 4.7AE1.1h vs. 2.9AE0.4h respectively. Recovery time was longer for CT based planning when compared to US based; 2.9AE1.9h vs 2.3AE.9h respectively. The percentage of patients with hematuria at discharge was 44% (22/50) for CT based planning and 14 % (7/50) for US based planning. The patients that required a urinary catheter at discharge was 26 % (13/50) using CT based planning and 4% (2/50) with US based planning. Conclusion: Procedure time and recovery time were both longer for CT based planning, directly influencing patients' lengths of stay. Contributing factors to the increased procedure time include patient transportation to CT scanner, administrating bladder contrast, scanning and reposition of needles due to transfer movement from table to stretcher to scanner. Longer periods of anesthesia can lead to multiple side effects and longer recovery time. With stepper-based template planning we found dramatic decreases in both incidence of hematuria and urinary catheter utilization. This overall increase in length of stay not only affects the efficiency in which hospital resources are used but also negatively impacts patients experience and overall satisfaction. More efficient and less traumatic treatment planning processes are crucial to the continuing success of HDR brachytherapy for prostate cancer.