IMRT

Tomotherapy for moving targets?

 Theoretical possibility of “ interplay effect ” when using IMRT for treatments with few fractions = Interplay between tumor motion and leaf opening  Scanning motion of Tomotherapy  Sterpin et al: very small effect on dose (coached patients)  Good resulting dose distribution when patients breathe regularly  Safe to keep in to account:  Large field width (2,5-5cm)  Low pitch  Low modulation factor

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