Advanced TP

IMRT for Tangent Beams

 Dose homogeneity and reduced hotspots  Kestin & Sharpe et al 2000  Donovan et al 2002  Vicini & Sharpe et al 2002  Dose to Critical Structures (lung, heart, contra breast)  Ajay et al 2006  Selvaraj et al 2007  Control of treatment side effects:  moist desquamation, tissue changes.  Donovan et al 2008  Pignol et al 2008  IMRT in Breast is controversial:

Benefits

Criticisms

Higher quality treatment

Evidence

Reproducible

Cost

Rapid planning & treatment

Time

Prompt care

Safety

 Potters et al IJROPB 56(3) 609 (2003).  Smith et al JNCI 103(10) 798 (2011).  Depends on reimbursement and workload efficiency