Electronic compensation using multileaf collimation for involved field radiation to the neck and mediastinum in non-Hodgkin's lymphoma and Hodgkin's lymphoma

An efficient procedure is required for the preparation, planning, and delivery of radiation therapy for involved field radiation to the neck and mediastinum. This technique must reduce tissue complications while maintaining dose uniformity. An elegant intensity-modulated radiation therapy (IMRT) treatment that is forward planned has been developed. Both static fields and static subfields shaped by multileaf collimators (MLCs) and asymmetric jaws are used. Patients receiving involved field radiation to the neck and mediastinum are planned in 3 dimensions (3D), where 3D dose compensation is provided using subfields consisting of MLC or asymmetric jaws instead of physical compensators or wedges. Forward planning is performed, usually generating 2 pairs of parallel-opposed fields, with at least 1 of them consisting of subfields to eliminate elevated dose regions. Efficiency in the preparation, planning, and delivery of treatment has been achieved for more than 10 patients. Verification of treatment setup, target anatomy, and MLC configuration is quick when using an electronic portal imaging device. Thermoluminescent dosimeters (TLDs) have verified point-dose uniformity noticeably to ± 5%. An efficient technique using forward planning for simple IMRT consisting of static MLC and asymmetric jaws has been developed.