Room to Move: Enhancing Head and Neck Radiotherapy With a Six-Degree-of-Freedom Couch
Peter L Lee, Joseph V Panetta, Alexander P Lukez, Mihir K Karande, Thomas J Galloway

TL;DR
This study shows that using a six-degree-of-freedom couch in head and neck radiotherapy improves target coverage and reduces variability in treatment delivery.
Contribution
The study demonstrates the clinical benefit of rotational adjustments in head and neck radiotherapy using a six-degree-of-freedom couch.
Findings
Rotational shifts were used in 212 of 214 treatment fractions, showing frequent need for adjustments.
Without rotational shifts, PTV V100% coverage dropped by a median of 1.97%.
43 fractions had a ≥3% decrease in PTV coverage without rotational corrections.
Abstract
Purpose Image-guided radiation therapy (IGRT) allows for a reduction in target volume margins, but relies on accurate daily set-up. Six-degree-of-freedom couches offer rotational adjustments during alignment. Given the often large and irregular target volumes treated in head and neck (H&N) cancers, rotational errors may contribute significantly to inter-fraction variability in both target coverage and critical-structure dose. We seek to evaluate the impact of rotational adjustments on target coverage and critical-structure dose in H&N radiotherapy. Methods We reviewed 214 radiotherapy fractions for H&N cancer. Patients were treated using a six-degree-of-freedom couch that allows a maximum of ±3° of roll, pitch, and yaw, in addition to linear shifts. Daily couch adjustments were recorded, and the CT simulation images and treatment plan were imported into the oncology management system…
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Taxonomy
TopicsAdvanced Radiotherapy Techniques · Head and Neck Cancer Studies · Advances in Oncology and Radiotherapy
