Abstract
Nasopharyngeal cancer (NPC) presents unique challenges in radiotherapy due to its complex anatomical location and proximity to critical structures. Volumetric Modulated Arc Therapy (VMAT) has emerged as a highly effective technique, offering precise dose distribution to the target volume and spearing of surrounding normal tissues and organ at risks (OARs). The integration of daily imaging in the treatment of NPC with VMAT is pivotal in enhancing treatment accuracy, patient safety and overall clinical outcomes. Daily imaging, utilizing technologies such as cone beam computed tomography (CBCT) and kilovoltage (KV) or megavoltage (MV) imaging plays a crucial role in verifying patient positioning and adapting to anatomical changes. This practice ensures that the radiation is delivered accurately to the target area while minimizing exposure to adjacent healthy tissues and OARs. By facilitating real-time adjustments, daily imaging allows for reduced safety margins around the tumor, thus optimizing the therapeutic ratio. Furthermore, daily imaging contributes to adaptive radiotherapy by monitoring tumor shrinkage and shifts in patient anatomy over the treatment course. This adaptability is essential for maintaining dose precision, particularly in the nasopharyngeal region where minor deviations can significantly impact treatment efficacy and toxicity. Clinical studies have consistently demonstrated that the use of daily imaging in VMAT for NPC leads to improved treatment accuracy, reduced recurrence rates and better preservation of critical structures. The ability to detect and correct for set-up errors and anatomical variations on a daily basis significantly enhances the overall treatment quality. In conclusion, daily imaging is indispensable in the management of nasopharyngeal cancer treated with VMAT. It not only ensures precise delivery of radiation therapy but also enhances patient outcomes by allowing for real-time adjustments and reducing unnecessary radiation exposure. As technological advancements continue, the role of daily imaging in radiotherapy will likely become even more integral, further improving the effectiveness and safety of cancer treatments.
Published Version
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