Dose 2016

Effect: Second Primary Malignancies (SPM)

• SPM’s mostly in tissues >2Gy (fractionated)

– Thresholds of 0.6Gy (adult) and 0.1Gy (children)

• Practical guidelines: aim for reducing volume <3.5Gy Tubiana, R&O 2009 • SPM incidence has reduced due to better conformality of dose (heart, lung, breast) Tubiana, R&O 2009 • Somewhat controversial but clear need for organ specific doses and distributions

(patient specific?)

K.Trott R&O 2009

Dose?

Mesbahi etal, Jpn J Radiol 2010 28:398-403

Implantable devices etc too…

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