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beam
edge
Diallo et al, IJROBP 2009
 4581 cases of childhood cancer
 115 children with second tumor after RT
 mean age at diagnosis 5 years
 12 % in PTV
 66% around beam edge
 22% > 5 cm from beam edge
 70 % D>2.5 Gy
 20 % D<0.5 Gy
Majority of secondary solid cancers close to, or in PTV
28
Clinical data
Position of RT induced 2nd tumors relative to HIGH
DOSE AREA