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State of the Evidence
Veldeman et al., Lancet Oncol 9: 367–375 (2008)
J. Staffurth, Clinical Oncology 22:643-657 (2010)
W. De Neve, Semin Radiat Oncol 22:40-49 (2012)
The rational use of IMRT is a function of clinical
outcome but also of the performance of the health
care providers, the judgment of the patient, and the
viewpoints of society.
Clinical outcome is the main argument determining
rational use. The main rational use of IMRT is in
reducing toxicity.
Level I clinical evidence makes this statement hard
to dispute for whole-breast and head and neck
IMRT, and variable levels of evidence exist for other
tumor sites.
Reduced toxicity is consistent with
in-silico
studies
that showed that IMRT offers the possibility to apply
more severe dose constraints to OARs than non-
IMRT.