Provide a successful trick or planning tip used to improve your HN plan score to your

assigned discussion group by the date listed in your syllabus.

I only have probably a month of experience planning head and neck so I'm still working on my craft. This
plan was tough. I spent forever optimizing my right parotid gland. I'm still not getting full points on that
and my lower dose is spilling outside of my PTV. I can't say I would turn this plan in and be happy about
it. If this was planned in our clinic we would push on the parotoid as much as we could without loosing
coverage on our PTV.

rx dose spilling out

of ptv

Parotid

After getting some guidance from my preceptor she told me that sometimes with these bigger volumes
she’ll split the x jaw with the first 2 arcs, she likes to keep it under x jaw under 15. When I first fit my
mlcs to my x jaw it was 22. Even though our machines have jaw tracking it does much better modulating
with smaller fields.
I also split the 90 collimator fields into two. That’s not necessarily a new trick for me. I do it quite often
on prostate plans with nodal involvement.