Physics Bucharest 2017

Mistreatment IMRT H&N (2005)

• Monitor units from IMRT MLC field were used for the open field • Patient was treated with incorrect plan for 3 fractions • The console screen would have indicated that MLC was not being used during treatment. • After 3 fractions, QA was run for the new treatment plan. Operator noticed lack of MLC shapes and modulation

• Double Trouble

• Open fields instead of conformal fields • MUs of IMRT • Patient received 13 Gy per fraction