Michalis Aristophanous, Presenter: Research Grant, Varian Medical Systems, Inc

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Head and neck cancer is a difficult site for radiation therapy because of the complexity in target delineation, normal tissue sparing and treatment planning. Typically, head and neck patients are immobilized using thermoplastic masks, which are custom-made to fit the individual patient. Generic, or patient-specific neck supports may be used. In many institutions IGRT is considered standard of care for these patients. Thus, many of the uncertainties in head and neck treatments are minimized. However, it is important to understand the residual uncertainties. The immobilization devices are good at minimizing intrafraction movement, but the complex motions of the head and neck region mean that there can be day-to-day variations in the relative positions of different regions, such as between the neck and head. The extent of these variations has been well studied, and will be described in this presentation. There are also different approaches to the IGRT process, including the use of 2D or 3D imaging. This session will explore the uncertainties in head and neck radiation therapy, including inter-fraction variations and also variability in contouring. Mitigation strategies will be discussed. We will describe the treatment margins used by different institutions including their respective rationale.

Aristophanous, M, Head and Neck.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/12020063.html