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Discussion – Point III

Facts:

Mean Heart dose with protons almost always <2Gy

(based on supine, free breathing)

Photon dose can vary greatly and in many patients

might be 2Gy

(DIBH, Gated, prone etc.), but also might be >10 Gy

(some IMRT scenarios)

QUESTION: How to predict patient with mean heart

dose significantly greater than with protons)