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Dosimetric gain is mostly for 3D CRT (i.e. 4-field box)
Irritation of the anal canal (hemorroids) Cho KJMS 2009
Complex procedure: may require frequent adjustments to avoid systematic
errors or deformations (Jones Med Phys 2012, Miralbell IJROBP 2010)
Increases treatment time
Rectal balloons disadvantages
Management of intrafraction motion
Mixed experience, complex and invasive procedure with
questionable benefit.