999 / 1601
4
Radiotherapy
Wu et al 2009 IJROBP
Target dose with replanning remains
good
Radiotherapy
Relative dose to the Parotid without
replanning is around 10% higher
Wu et al 2009 IJROBP
Radiotherapy
Wu et al 2009 IJROBP
Parotid dose and replanning improves
with around 5%
Radiotherapy
Largest gain with replanning y/n
Wu et al 2009 IJROBP
Radiotherapy
Warning….
Supposedly a large portion of the observed
effect is because of shrinking of the target
The publications/trials were not designed for
equivalent or superior outcome (you would
need a lot of patients and a long FU)
Nevertheless: adapting for obvious changes
like air etc. is safe, for non-obvious
boundaries like tongue it might be safe.
Radiotherapy
Adaptive RT in Head and Neck
15 patients with advanced HN cancer
70 Gy 7 weeks
Weekly repeat CT
Castelli 2015