IMRT

Wu et al. 2009 (IJROPB 75(3))

Anatomical changes of trending nature

example: planning CT and 6 weeks later…

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 • 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

ESTRO IMRT course 2015 Adaptive Radiotherapy Brussels October 8th, 2015

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