IGRT 2016 Madrid

Overall observer variation (SD)

2 bottom

Lymph nodes GTV CT GTV CT MRI

Anatomical regions

SD CT (mm)

SD CT (mm)

SD CT (mm)

All regions 3.6

4.4

3.3

4.4

3.4

2.7

Anterior

3.7

3.6

2.7

Dorsal

4.6

7.7

3.5

Caudal

3.8

Cranial

3.0

L-R

4.0

Parotid

2.2

Vertebrae

2.3

Vessels

Overall observer variation (SD)

Phase III trial

Lymph nodes

Anatomical regions

60 patients early nasopharynx cancer – T1-2, N0-1, M0 66, 60, 54 Gy 33 fractions, 6.6 week – + brachytherapy boost if applicable 2DCRT versus IMRT Mean parotid dose 61-32 Gy

SD CT (mm)

All regions 3.6 Level 1 3.1 Level 2 2.5 Level 3 2.1 Level 4 3.0 Level 5 6.1 Level 6 3.1 Prevertebral 3.1 Level 234 2.4

•Kam et al JCO 2007

Phase III trial

Is toxicity decreased ?

Various reports with retrospective comparisons on salivary gland sparing including randomized trials No Phase III trial on safety performed yet

•Kam et al JCO 2007