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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