Patient selection and simulation
Of 81 patients previously treated with VMAT CSI at our institution
during 2012-2022, only five patients had PTV length less than 50 cm in
the cranio-caudal direction (current RefleXion X1 Treatment Planning
System (TPS) limitation). These five patients were included in the
planning feasibility study. Patients were simulated using Siemens CT
scanner (slice thickness 2 mm) in the head-first-supine (HFS) position
with arms by side, immobilized in 5-point head and neck mask and
AccuForm cushion (CIVCO) in the neutral neck position. All patients were
treated under anesthesia.