Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volumetric-modulated arc therapy (VMAT).

ABSTRACT: VMAT is an important tool in the treatment of head and neck cancers, many of which also require treatment to the supraclavicular lymph nodes. However, full VMAT arcs treating this nodal region necessarily cause entrance beam to pass through patients' shoulders. Thus, interfractional variations in shoulder position may cause unwanted dose perturbations. To assess this possibility, six patients undergoing treatment at our institution for head and neck cancers with associated supraclavicular lymph node treatment were imaged with in-room CT-on-rails during the course of their treatments. This allowed for the establishment of a true record of the actual shoulder position during selected treatment fractions. Then, a full VMAT plan and a plan with VMAT arcs superior to the shoulder and a static a

SUBMITTER: Casey KE 

PROVIDER: S-EPMC5690006 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature