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5
Radiotherapy
Planning
No adaptation
With adaptation
Castelli 2015
This is what
you
think
you get
This is what
you
get
This is what
you
can
make of it
Radiotherapy
Adaptive RT in Head and Neck
15 patients with advanced HN cancer
70 Gy 7 weeks
Weekly repeat CT
Results:
4 Gy more mean dose to the parotid than
planned without adaptation
5 Gy less mean dose to the parotid gland with
weekly replanning compared to no adaptation
Castelli 2015
Radiotherapy
Summary: ART for head and neck
Careful when adapting for tumor shrinkage
You can overcome the deleterious effect of
parotid gland shrinkage on parotid dose
One adaptation dose most of the tric
You do not need deformable registration:
if the individual plans are safe the summation
is also safe
Radiotherapy
3: Art for (Un) expected changes
Lung cancer, tumor regression (?), atelectasis
(either appearing or dissolving)
Cervix, void of hematocolpos (Uterus with
blood)
Radiotherapy
ART for (un-)expected changes
Lung cancer and atelectasis
Rianne demonstrated the traffic light warning
system (i.e. guidelines on what to do with an
image finding at the treatment machine)
Radiotherapy
•
New situation during treatment