ESTRO course on Image Guided Radiotherapy in Clinical Practice 2018

Target dose with replanning remains good

Relative dose to the Parotid without replanning is around 10% higher

Wu et al 2009 IJROBP

Wu et al 2009 IJROBP

Radiotherapy

Radiotherapy

Parotid dose and replanning improves with around 5%

Largest gain with replanning y/n

Wu et al 2009 IJROBP

Wu et al 2009 IJROBP

Radiotherapy

Radiotherapy

Warning….

Adaptive RT in Head and Neck

 Supposedly a large portion of the observed effect is because of shrinking of the target

 15 patients with advanced HN cancer  70 Gy 7 weeks  Weekly repeat CT

 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.

Castelli 2015

Radiotherapy

Radiotherapy

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