IMRT 2018

Second Cancers: IMRT vs. 3-D conformal RT

Key is the shape of the dose-response relationship for radiation-induced carcinogenesis...

High doses don ’ t matter

High doses do matter

OR

Cancer Risk

total dose

total dose

• IMRT minimizing high doses helps • IMRT ’ s extra lower doses less important

• IMRT minimizing high doses doesn ’ t help • IMRT ’ s extra lower doses are bad