ASMR 2017

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