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Take Home Message

“Complex and multifactorial dosimetric variations occur

during head and neck IMRT.”

(Graff et al., 2012)

Take caution due to tight margins, conformal techniques and

proximity of radiosensitive structures

Have an understanding of dosimetric impact of weight loss and

shoulder motion

Appropriate immobilisation is key. IGRT may help in

assessment of this, but can not always correct for this.

Recommend clear protocols to mandate imaging frequency and

match structures