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The AHARA principle
Make patient cure As High As Reasonably Achievable
Kill tumor and ….
limit complications by precisely delivering the treatment
Reduce secondary cancer by reducing the margin
Imaging (dose) is required to:
Eliminate geometric miss
improve outcome
Lower dose to adjacent organs at risk like rectum
Smaller margins
lower integral dose
Imaging dose contributes a few % to organs that already
receive a fairly high dose due to radiotherapy:
order of
magnitude less important than having good treatment