Wave ‘em like you just don’t care.

This pragmatic dosimetric analysis assesses what happens when your patient with lung cancer just can’t swing treatment with both arms up overhead. Plans for 10 patients simulated with arms up were compared to plans generated from PET scans of those same patients with arms down. Re-optimizing for arms down led to equally-good target coverage with marginal differences in organ at risk dose, save an average ipsilateral arm D2cc of 5.5 Gy. On the other arm, we mean hand, dropping the ipsilateral arm in the midst of treatments without re-planning has a significant detriment on target coverage while dropping the contralateral arm had only a <1% impact. | Murrel, J Thorac Dis 2019