The calculation of treatment plan begins with balancing CT. Once you have determined the isocenter, the tattoos occur on the skin of a patient, which serve as reference for the placement during the subsequent treatment. The contouring of the lesion occurs on board graphics. Defining tumor margins and structures at risk we establish the dose requirements with their respective constraints. Most of the treatments provides a complex geometry, resolved by IMRT, method according to which the various radiation beams are broken down into several segments (even hundreds) in order to conform the dose to the therapeutic target. The IMRT technique allows to minimize the toxic effects on the organs at risk, respecting dose constraints set by optimizing the delivery to target organs. 

In this way, the definition of "curved rays" becomes more concrete. The IMRT technique, the most advanced and currently available in the panorama of radiotherapy, it is particularly suited to complex anatomical structures or with a convex profile, such as the nasal cavity, encephalon, pelvis, abdomen. In order to ensure an exact correspondence between calculated plan and anatomical landmarks, the positioning of the patient on the treatment table is checked by means of cone beam CT. During each session a 3D CT scan is performed to the patient already positioned in accelerator: the superimposition centering between CT and CT verification determines the movement of the bed space to get exactly the treatment prescribed.

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