Abstract
BACKGROUND/AIM: The parotid glands in the head and neck are organs at risks (OARs) adjacent to high dose region and dose of OARs might be increased during the course of radiotherapy. The influence factors of the dose distribution for the parotid glands were investigated in terms of weight loss and mandibular rotation for head and neck cancers treated with volumetric modulated arc therapy (VMAT). PATIENTS AND METHODS: Ten oropharyngeal cancer patients (OPC) who underwent VMAT were enrolled. The dose volume histogram (DVH) parameters of the parotid glands and planning target volume (PTV) were compared between the planning computed tomography (CT) and the on board imager (OBI) at 1, 5, 10, 15, and 20 fractions. RESULTS: The variation of dose distribution in PTV was not observed in both factors. The relationship between the mandibular rotation and dose difference for the right and left parotid glands (linear regression, r(2)=0.1577 and -0.689) showed a slighty stronger correlation with dose difference than the weight loss (linear regression, r(2)=-0.079 and -0.547). CONCLUSION: The mandibular rotation tends to have a large influence on dose distribution of the parotid glands for head and neck cancers treated with VMAT.