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The Importance of Verification Images during IMRT in the Area of Head and Neck.
MYSLÍKOVÁ, Petra
Tumours of the head and neck are the fifth most common cancers in the Czech Republic. Despite easily available medical examination and observable symptoms most patients come for treatment with various types of tumours in advanced phases which lowers their chance of being cured. The technique of IMRT has recently become the most often used curative method for the tumours of the head and neck, enabling better treatment of healthy tissues and critical organs in this area. The thesis is divided into the theoretical and practical part. In the first part, the areas of head and neck and the types of cancers found in these areas are analysed. The chapters concern symptoms, aetiology, diagnostics, prognosis and, of course, their treatment. Further, the common course of planning has been included and at the end of this part the history and presence of verification images is mentioned. The second part of this thesis includes objectives and a hypothesis. The objective of the thesis is to explore and evaluate portal verification images of target volume in tumours of the head and neck and compare these images with referential verification images as well as to state deviations in irradiation position and to prove the significance of verification images in the area of head and neck. This part also includes chapters describing methodology (with resources), and the course planning process in a patient using IMRT technology. Further, it includes the research result of the a collection of 50 patients with the tumours of the head and neck who were irradiated by IMRT technology and whose verification images of target volume were evaluated. The predicted objectives were fulfilled and the hypothesis was disproved. Verification portal images are made in oncology department once a week. I would suggest making verification portal images with a fixation mask at least twice a week in order to achieve better accuracy and control of the irradiation position.
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