L0_2016_Athens_Physics_Programme



Generally, the

benefits

of RT greatly

outweigh risks

for tumor induction!

(improvements are needed, increased survival).



Second tumor incidence far from

high dose areas

is often relatively low (non-

IMRT).



Depending on

tissue/primary tumor

,… the risk may increase, level off, or

decrease at high dose.



If probability of tumor induction levels off, or decreases for higher doses,

Clinical lessons - Discussion

tumor induction

may increase for IMRT and rotational therapy



High energy

photon beams (>10 MV)

may result in enhanced tumor

induction due to neutron peripheral dose.



Uncertainty in epidemiological data

: even studies based on large databases

of cancer registries (~100.000 patients) may have conflicting outcome on

second cancer incidence. More/better data is needed, e.g. to predict the impact

of new techniques such as IMRT or VMAT.