SU-E-J-81: Adaptive Radiotherapy for IMRT Head & Neck Patient in AKUH

Abstract

Purpose: In this study we proposed Adaptive radiotherapy for IMRT patients which will brought an additional dimension to the management of patients with H&N cancer in Aga Khan University Hospital. Methods: In this study 5 Head and Neck (H&N) patients plan where selected, who's Re‐CT were done during the course of their treatment, they were simulated with IMRT technique to learn the consequence of anatomical changes that may occur during the treatment, as they are more dramatic changes can occur as compare to conventional treatment. All the organ at risk were drawn according RTOG guidelines and doses were checked as per NCCN guidelines. Results: The reduction in size of Planning target volume (PTV) is more than 20% in all the cases which leads to 3 to 5 % overdose to normal tissues and Organ at Risk. Conclusion: Through this study we would like to emphasis the importance of Adaptive Radiotherapy practice in all IMRT (H&N) patients, although prospective studies are required with larger sample sizes to address the safety and the clinical effect of such approaches on patient outcome, also one need to develop protocols before implementation of this technique in practice.

Assessing the need for adaptive radiotherapy in head and neck cancer patients using an automatic planning tool

“…These factors include daily setup variations, primary tumour or nodal volume regression or progression, alteration in muscle mass and/or fat distribution, fluid shift within the body and weight loss [3,4]. If unnoticed or unattended, these changes might lead to discrepancies in dose delivery, namely underdosage of the target volume, with loss of tumour control, and/or to overdosage of the normal structures, potentially producing unexpected side effects [5,6]. In order to correct for day-to-day positioning errors relative to the p-CT, most centres perform Image Guided Radiotherapy (IGRT) where most of those mismatches are corrected through couch shifts.…”