The single-isocentre treatment of head and neck cancer: time gain using MLC and automatic set-up.
OBJECTIVE
In this manuscript, we studied the difference in the treatment time required to execute a single-isocentre three-field irradiation of the head and neck, using either tray-mounted cerrobend blocks or a multileaf collimator (MLC) for field shaping and automatic set-up.


METHODS
A total of twenty consecutive, unselected patients (16 males, four females), were eligible for this study because the dose they were to received was 44 Gy (2 Gy/fraction) to the head, neck and supraclavicular regions. Patients were randomly allocated to one of two treatment groups. The first group (n = 11) was treated on a Philips SL-75 linear accelerator (SL-75), using 5 MV photons and tray-mounted cerrobend blocks. The second group (n = 9) was treated on a Philips SL-25 linear accelerator (SL-25-MLC), using 6 MV photons and a MLC. Patients of the second group were treated using the automatic set-up facility of the SL-25-MLC, without entering the treatment room between consecutive fields.


RESULTS
Overall treatment time was significantly shorter on the SL-25-MLC than on the SL-75 (P < 0.0001). The difference in total treatment-execution time was in the range of 157 s per treatment session. The largest difference was observed in the set-up time. There was an average of a 125 s time gain per treatment day (P < 0.0001) in favour of the SL-25-MLC.


CONCLUSIONS
Compared to tray-mounted cerrobend blocks, a MLC and automatic set-up results in a significant time advantage when a single isocentre technique is used to treat head and neck cancer.
Division of Radiotherapy R-UZG, University Hospital, Gent, Belgium.
G O
GO
De Meerleer
L A
LA
Vakaet
M T
MT
Bate
C
C
De Wagter
B
B
De Naeyer
W J
WJ
De Neve
D003198:Computer Simulation; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000379:methods*; D013997:Time Factors