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What about second cancer risk?
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VMAT and multibeam-IMRT compared to 3D-CRT and tangential-IMRT:
- More beams
larger volume of normal tissue is exposed to a ‘low-dose-bath’
- Require a longer beam-on time
integral dose can increase because of head leakage and collimator scatter
Multibeam-IMRT and VMAT:
- for patients with left-sided cancer with high cardiac dose using
3D-CRT or t-IMRT
- in RT Internal Mammary Nodes, in special anatomy (funnel chest)
reduction in the risk of cardiac and lung complications
Abo Madyan RO 2014, Ibrahim BMC Cancer 2012, Boyce NEJM 2002