Radical radiotherapy for locally advanced non-small cell lung cancer-what's up with arm positioning?

Radical thoracic radiotherapy is ideally delivered in the arms-up (AU) position; however, patient comfort may only allow for arms-down (AD) positioning to be feasible. Objectives of this study were (I) to evaluate the dosimetric impact of changing arm position during treatment and (II) to compare plan quality for optimization in AU AD positions. In this retrospective planning study, stage III lung cancer patients (n=10) who received 60 Gy in 30 fractions using volumetric modulated arc therapy (VMAT) were identified.