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ey Dose evaluation of CNS structures © IPO in nasopharynx and oropharynx tumors IMRT vs.VMAT A.R.Pinho*”,A. Soares”, J. Lencart” "Medical Physics Department; "Radiotherapy Depatment Instituto Portugués de Oncologia do Porto VI CONGRESSO SPRO Sociedade Portuguesa de Radioterapla Oncolégica ens stony Materials/Methods Fee ae eared Twenty four patients with tumors of the nasopharynx (12) and oropharynx Tee ee (12) were selected for the study. All patients were treated with VMAT and SSE their creatment plans were retrospectively replanned with IMRT technique SRE eMC ORE mm using the same structures constrains as the VMAT plan. The VMAT plan Ce Ee em consisted of double arc and the IMRT plan consisted of seven equidistant UCR ficlds (beam angle: 207°, , 258°, 309°, 0°, 51°, 102° and 153°).A 50 Gy plan re SCC delivering 2 Gy fractions was prescribed followed by a boost of 20 Gy. The PRR eesti brainstem and spinal canal were delineated as OAR for VMAT planning and Pee aL TCREM SGM 2 posterior delineation of temporal lobes, occipital lobe and cerebellum was Fe Reem performed in patient’s planning CT datasets. The two techniques were Cee nana compared regarding the following parameters: Dix, maximum and median Cee eee dose and several V,c, (the volume of the structure receiving x Gy).The Pe hee EN EM patient's chatracteristics are described in Table |. xerostomia, dysphagia and hearing loss. In yee Cr oe Pee eee Rae due to MLC implementation, IMRT was om developed, using multiple fields with cieaa modulated intensity, with the objective of producing a better dose distribution with Sets Dee UL SUE Cerebral structures (temporal and occipital lobes and cerebellum) are i essentially more irradiated with IMRT than with VMAT, except for low doses Shee UL) (Vscy and Vioc,) of temporal lobes in tumors of the nasopharynx and occipital SU Re RCA SUCECME lobes in tumors of the oropharynx. On the other hand,VMAT irradiates a Te EES creater volume of brainstem and spinal canal with the same doses as IMRT. CE ee aL coo D2: and median dose of the temporal lobes, occipital lobes and cerebellum DU ACME were higher for IMRT plans, unlike for brainstem and spinal canal, whose Soe CURE OCLUCMMEm values were higher for VMAT.A statistically significant difference (*p < 0.05) Pee ee RRS SURE was found between both treatment techniques in spinal canal parameters. SEU CCM SLIME IMRT showed better organ sparing at higher doses than 30 Gy and Daxin Te eC EMME Me both tumor locations, and these results are presented in Table 2. and 3 ee cot kee ery CERCA ERIS 62 Conparscn beweenVOAr ans MET nthe Ce eC er ea Cea eS eco aa “ — eee Ret ce eed Sa ee aoe 1° ow wk ECE Gmc © ms of fatigue, an acute effect that affects all “ ° patients undergoing head and neck vee radiotherapy. Cel serie Be ee una Ae 0 eae ° nar 8 EU NONE ou eer ms acy :. ~~ a _ Semen Raat een oor a Pee eee ene ea) : = Pe Rene et Lt espana UC ete para ac with radiotherapy, assessing in which treatment technique these structures are Sesser seer tae Conclusions There is nearly no difference between the studied treatment techniques according to the mentioned CNS structures irradiation except for the spinal canal, to which IMRT has better results in organ sparing at higher doses than 30 Gy and Da.