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Table 4 Brachial plexus dose change (cm3) due to important shifts.

From: Assessment of shoulder position variation and its impact on IMRT and VMAT doses for head and neck cancer

  Patient 1 Patient 2 Patient 3
Shift IMRT VMAT IMRT VMAT IMRT VMAT
3 mm inferior       
   Max DVH dose (cGy) -1 -3 116 12 45 -29
   Max 0.1 cm3 (cGy) 0 40 100 45 40 60
   V60 (cm3) 0 0 0 0 0 0
15 mm inferior       
   Max DVH dose (cGy) 49 372 203 186 218 259
   Max 0.1 cm3 (cGy) 60 410 205 195 210 240
   V60 (cm3) 1 3 0 0 0 1
3 mm anterior       
   Max DVH dose (cGy) -1 0 22 1 23 -14
   Max 0.1 cm3 (cGy) 0 0 15 5 20 -20
   V60 (cm3) 0 0 0 0 0 0
15 mm anterior       
   Max DVH dose (cGy) -1 1 125 10 109 -64
   Max 0.1 cm3 (cGy) 0 0 100 0 100 -70
   V60 (cm3) 0 0 0 0 0 0
  1. The changes in maximum dose displayed on the dose volume histogram (DVH), maximum dose to 0.1 cm3, and volume receiving 60 Gy (V60) are shown. Inferior shifts show the greatest increase in dose to the brachial plexus for both intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans.