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Study of dosimetric indices and dose constraints to critical organs for head and neck tumours treated with inverse planned simultaneous integrated boost intensity-modulated radiotherapy

  • Atia Atiq (a1), Maria Atiq (a1), Khalid Iqbal (a2), Qurat-ul-ain Shamsi (a1) and Saeed Ahmad Buzdar (a1)...



This study aimed to investigate tolerance dose to organs at risk (OARs) as well as degree of conformity and homogeneity for head and neck cancer patients by using simultaneous integrated boost intensity-modulated radiotherapy technique (SIB IMRT).

Materials and methods

This study analysed 15 head and neck cancer patients receiving treatment using inverse planned SIB IMRT technique. Using a beam energy of 6 MV, two dose levels of 70 and 55·4 Gy were used to treat the tumour. Doses of 2 Gy in 35 fractions and 1·68 Gy in 33 fractions were simultaneously delivered for effective planning target volume (PTV1) and boost planning target volume (PTV2), respectively.


Dose distribution in PTV and critical organs lies within tolerance dose guidelines protecting spinal cord, brain stem, optic chiasm, optic nerve, thus reducing the risk of damage to normal tissues. Minor deviation from tolerance limit was observed for parotid glands. This technique provided highly conformal and homogenous dose distribution as well as better sparing of OARs, hence verifying quality assurance results to be satisfactory.


SIB IMRT technique offers best solution for preserving organ function by keeping dose below tolerance level. Treatment of head and neck carcinoma using SIB IMRT is feasible, more efficient, and dose escalation is achieved in a single plan.


Corresponding author

Correspondence to: Atia Atiq, Physics Department, The Islamia University of Bahawalpur, Bahawalpur, Punjab 63100, Pakistan. Tel: +923336387927. E-mail:


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