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Abstract
Twenty head and neck (H and N) locally advanced cancer patients were treated with external - beam (fifteen using IMRT and five using 3DCRT) with curative intent concomitant chemo. Each patient had 5 CT scans (1 simulation CT scan followed by scans at weeks 2, 3, 4 and 5). Via these scans the rate of volume change over time for the target volumes (TVs) and organs at risk (OARs) was calculated. On each of the subsequent CT studies, the approved treatment plan was transferred and the delivered dose distributions through the treatment were simulated. The changes in luences due to portal sensitivity, MLC and the scatter from rando phantom anatomy were quantified using portal imager. Also exit fluence variations from IMRT patients were analyzed during the treatment course. TLD and MOSFET detectors were placed on sites of enlarged lymph nodes and swelled neck to detect the surface dose changes during the treatment cours