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Studies show that interplay effect can

alter the dose distribution of a single

fraction

, but not a fractionated course of treatment.

Dose variation (Jiang et al. )

1 fraction, 1 field: 30%

1 fraction, 5 fields: 18%

30 fractions: 1-2%

SABR

: interplay effect is

negligible

, effects are averaged out due to

larger number of MU

increased treatment time

Strategies to reduce

interplay effect:

n

°

of arcs

dose rate

prolonging treatment time

avoid MLC motion perpendicular to the tumor motion.

Potential risks: interplay effect

Interplay effect: Lung cancer

Chan JTO 2014, Jiang Phys Med Biol 2003