I have had enough PMs that I am just going to start a public thread. I don't know of any formal templates for planning notes. What I like to do is a combination of things I picked up along the way. I feel like there are 3 key elements that I want physics/dose to consider when planning my cases:
1) Define your target volumes - its nice to remember exactly what you did and occasionally physics or dose catch where I expanded incorrectly or grabbed the wrong structure for expansion. For residents, it is also very good to be able to describe it words and details what you did and be able to go back and review at a later date. When I was a resident, I I can't count the number of times I would be contouring a complicated case late in the evening and trying to remember what we did for a similar case before.
2) Prescription - needs to include total dose, dose per fraction, and number of fractions as well as whether you want an SIB or sequential boost. There are a lot of ways of getting to 50 or 60 Gy right? I know of cases where attendings approved plans only to get a call from billing after the patient started wanting to know why they requested approval for 16 fractions but are now delivering 25 (you can guess what disease site that is...)
3) Dose limits - again, prioritize
I'll share an example from this week. This is a good one because even though I treat a lot of esophageal cancers, this is not a typical case. Young lady with a metastatic esophageal cancer to non-regional lymph nodes. She had a pretty good response to palliative chemo + herceptin but still has pretty bulky gastrohepatic nodes abutting the stomach and a number of aortocaval nodes. She is starting to get platinum toxicity so we are transitioning to "definitive" chemorads. Realistically our goal is durable local control but there is a small chance of cure (think Lloyd Christmas from Dumb and Dumber kind of small). These can be tough because you want to give her the best shot but also not cause undo toxicity. I ended up doing a weird dose/fractionation. In non-surgical cases I would normally want to give 45/25 to the nodal CTV and 54/30 to the gross disease if possible but there would be no way of getting that much dose without a very high risk of gastric ulceration in her case. So I opted to go to 52 Gy. What is the easiest way to get to 52 Gy? 2 x 26. But wait, do you really want to do a single fraction sequential boost (if the nodes go to 45/25)? No, thats a lot of work and silly. I opted to just do an SIB in 26 fractions to both volumes (1.8 and 2.0 x 26). I've never done this dose/fractionation before and I am pretty sure dosimetry has never seen it before either. Without writing it down I am almost assured to either get at least 1 phone call or have to ask for a re-plan.
Target Volumes
GTV = nodal and primary GTV on BH and Insp scans
ITV Primary = union of GTVs
CTV Primary = ITV Primary + 3 mm
Nodal CTV = regional and involved nodes contoured on BH (minimal motion so not contoured on Insp)
PTV 4680 = Nodal CTV + CTV primary + 5 mm
PTV 5200 = CTV Primary + 5 mm
Prescription
Single plan, SIB
180 cGy x 26 = 4680 cGy prescribed to PTV 4680
200 cGy x 26 = 5200 cGy prescribed to PTV 5200
Dose Limits
Liver V30 < 30%, Mean < 20 Gy
Kidneys Mean < 18 EACH
Duodenum/stomach V54 < 1 cc, Keep plan max < 105%
In 4 hours, I had an amazing plan that met all of my goals with a plan max 5378. I love pleasant surprises
And before anyone asks, how long these are depends on specifics of the case. I basically don't do much of a note for a standard 3 field rectal plan (I rarely contour any target volumes for these, the doses are standard and there is rarely anything to add to the score card). Prostate notes tend to be short unless the rectum is likely to cause problems.