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The purpose is to evaluate the effectiveness of a protocol to prevent oral mucositis, an usual complication of head and neck radiotherapy. This protocol consists of a previous oral cavity examination, mouth hygienization, infectious focuses remotion and administration of chlorhexidine, sucralfate and benzydamine mouthwashes. A retrospective study was made on 45 patients that received radiotherapy, 19 of them started without prevention and the others 26 were controlled since the beginning. Mucositis level was evaluated every week following the OMS criteria. U-Mann-Whitney test was used to compare the two groups. Statistical significant differences were found between both ( P = 0.000l). Median value mucositis in the prevention protocol (PPG) and no prevention protocol groups were 0 and 1 respectively. The differences were more important between the 3th and 5th weeks. Tolerance treatment was better in PPG.

The real advantages achieved by the boost and the different boost doses on the tumor bed in CTBC are still under debate. In our Center after limited surgery received whole breast radiotherapy (46–50 Gy) and boost with dose intensification depending on the presence and intensity of risk factors (RF) for local recurrence (LB). We analyzed 267 consecutive BC treated conservatively. 13 pTis, 192 pTl, 62pT2. 79% ≥ 1RF, 40% > 1RF, 21% > 2RF. No boost in 26 patients (pTis, EORTC protocol). Boost ≤ 15 Gy in 74 patients. Boost > 15 Gy in 167 patients. Actuarial local control (LC) was 95% (5 y), 97% for pTl and 89% for pT2 (NSD). 94% for boost ≤ 15 Gy and 96% for > 15 Gy (NSD). It seems that the prognosis of LC in presence of RF is equalized to without RF or with few intensity, when the intensification of boost dose is done.

To optimize BT in plastic tube technique for oral carcinomas we use real size CT slices (RSCTS). The day after the implant, the patients are referred to the radiology department with CT hyperdense dummy sources in the plastic tubes. Some RSCTS are performed to study the real relationship between the sources and to know the real distance to the neighborhood structures. After the dosimetric study is made, we know the dose distribution in the area of the implant and the dose in the healthy tissues. Some RSCTS are performed the last day, after treatment is finished. This allows us knowledge of variations in the dose distribution during the treatment time. We report our results.

To optimize the radiotherapy of the vocal cord carcinoma we started their simulation by a diagnosis CT. Since June 1994 to February 1995 ten patients were simulated and treated. With a thermoplastic mask the patients were referred to the radiology department. Some real size CT slices every 2 mm were obtained in the treatment position. The center, dimensions and limits of the fields were established in the CT room. After, a dosimetric study was performed in our department. We found anatomical differences in each patient that had repercussion in the treatment approach (location and size of the vocal cord and contour of the neck). This procedure allowed us the selection of the best radiotherapy approach for each patient. We report the advantages of this technique for each patient and we describe the rules for this simulation technique.