Prospective study of adaptive radiotherapy in head and neck cancers with concurrent chemoradiation in volumetric modulated arc therapy

Abstract

Introduction:During the course of Head and neck radiotherapy, anatomical changes as body weight and/or tumour volume may result in under dosage or dose inhomogenisity in targets and overdosage in Organs at risk(OARs). so this study is undertaken to provide an overview of magnitude and frequency of these effects and to investigate the benefits of adaptive radiotherapy to patients of Head and neck cancers treated with VMAT.Aims: The main aim of the study is to see the benefit of adaptive radiotherapy in Head and neck cancer patients during treatment with Volumetric Modulated Arc Therapy by examining anatomical and dosimetric changes.Materials and method: The present study is a prospective, single arm studywas conducted at department of Radiation Oncology, at MNJ Institute of oncology and Regional cancer center, Osmania medical college, Hyderabad.20 patients of Head and neck cancers being treated with radiotherapy will be taken into study over a period of 2 years.Results: Mean doses to ipsilateral and contralateral parotids doses decreased to parotids in re-plans but with P value not significant. Mean Dmax doses to spinal cord (with significant P value) and brain stem (non significant p value) are also reduced with re-planning. Conclusion: As there is increase in the target volume coverage and decreased doses to OARs with re-planning, ART can be considered in locally advanced head and neck cancers for good tumour control and less side effects