Advanced TP

State of the Evidence

Veldeman et al., Lancet Oncol 9: 367–375 (2008) J. Staffurth, Clinical Oncology 22:643-657 (2010) W. De Neve, Semin Radiat Oncol 22:40-49 (2012)

 The rational use of IMRT is a function of clinical outcome but also of the performance of the health care providers, the judgment of the patient, and the viewpoints of society.  Clinical outcome is the main argument determining rational use. The main rational use of IMRT is in reducing toxicity.  Level I clinical evidence makes this statement hard to dispute for whole-breast and head and neck IMRT, and variable levels of evidence exist for other tumor sites.  Reduced toxicity is consistent with in-silico studies that showed that IMRT offers the possibility to apply more severe dose constraints to OARs than non- IMRT.