Radiotherapy with tele-cobalt machine: efficacy and need for tissue compensation in head and neck treatments

External Beam Radiotherapy (EBRT) remains the mainstay for radical treatments, in malignancies in head and neck regions. Head and Neck malignancies form around 50% of radiotherapy patients in the north eastern parts of the Indian subcontinent. Because of less inter-field separations, the penetration requirements of the treatment plans makes the telecobalt beam sufficient for executing radiotherapy, with proper immobilization and use of wedges if required. Inter-field thickness variations and irregular contour affect uniformity in delivered doses, and adverse reactions are encountered because of skewed isodose curves seriously affecting the volume dose variations in treatment planning. Normal tissue reactions, affect effectiveness of the treatment and therefore deter the Quality Of Life (QOL)