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. 2020 Jul 30;93(1113):20200217. doi: 10.1259/bjr.20200217

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© 2020 The Authors. Published by the British Institute of Radiology

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Figure 2. — Example application of spatially fractionated dose in a patient with bulky mass in the neck from carcinoma of the head and neck using a GRID collimator designed to fit in a linear accelerator. Panel A: Commercially available GRID block (Radiation Products Design, Inc.). Panel B: Hand drawing of the GRID field as indicated by light guides from linear accelerator on patient that received GRID radiotherapy for a large neck nodal lesion. Panel C: Expected dose at 3 and 10 cm in the gross tumour volume using a 6 MV linear accelerator. Note the peak and valley doses are more consistent across the field when using the collimator in comparison to the IMRT application in Figure 1. Prescription was 20 Gy in one fraction. This patient proceeded to have a full course of adjuvant chemoradiotherapy (66 Gy in 30 fractions) after completing GRID therapy. IMRT, intensitymodulated radiotherapy.