[quote]salivary gland are usually dosed under 30Gy[/quote]
As I never got to the dosimetrist, I was not able to learn more about the treatment plan as it translates into guidance of the radiation beam over the targeted areas.

The further I got was seeing the work the RO had done to map the areas he wanted to hit. The actual beam contouring and general painting of the other areas in the target zones was not fully understood.

The RO did make the comment that they would dose all areas as it was the most complete way to maximize the cancer kill. I pointed out to him since all the cancer was no the right and nothing was evident across the midline to go easy on the parotid glands on the left, minimizing saliva issues. His response was the priority was to dose to kill then secondary objectives would be entertained such as saving gland function.

One other thing is the target of 70gy total dosage. Given that the actual radiation is variable from zone to zone in a given session and from session to session, these must be general or computed averages.

Maybe something like 30gy to the parotids is reasonable as an average. From everything I have read thus far dosing at 30gy as a general target is far below what is considered effective. There are trials underway to deescalate to 60gy but nothing in the range of 30 for HNC.