Anatomical changes of trending nature
•
systematic shrinkage of tumor/parotid
volumes during treatment course, OARs
move into high dose
•
overdosage of OARs as compared to
planning, and potential partial misses of
CTVs
•
more serious esp. for IMRT due to steep
dose gradients
Wu et al. 2009
(IJROPB 75(3))
example:
planning CT and 6 weeks later…
ESTRO IMRT course 2016
Adaptive Radiotherapy
London April 7th, 2016
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My personal opinion:
High(est) potential for clinical
improvements by repeat imaging and
multiple replanning/adaptation.
Wishful for the future: ‘flag’/red light
identifying patients who benefit most from
one or multiple adaptations