A prediction study on radiation-induced second malignancies for IMRT treatment delivery

Sotirios Stathakis, Teboh Roland, Niko Papanikolaou, Jinseng Li, Charlie Ma

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Low-level peripheral organ dose and its effect on second malignancies for patients undergoing radiation therapy have been reported in the literature. However, a comprehensive database outlining the treatment modalities, the tumor location, and a quantification of the overall relative risk of second malignancies is rather limited. In this work, we quantify the relative risks or percent likelihood of second malignancies for patients undergoing IMRT and conventional radiotherapy for four different tumor sites: breast, head and neck, lung, and prostate. We utilize Monte Carlo methods based on actual patient plans to compute the whole body effective dose equivalent for each plan and then deduce the percent likelihood of the occurrence of second malignancy. Based on an evaluation of over 30 actual patient plans and Monte Carlo simulations using 6, 10, and 18MV photon beam energies, we observed that the IMRT patients treated for head and neck cancer showed a 40% increase in risk for developing a second malignancy compared to those treated with conventional radiotherapy. The increase in risk for prostrate patients was 30% while the IMRT lung patients gave the highest relative risk almost tripling that observed in their conventionally treated counterparts. There was negligible difference in risk between breast patients undergoing IMRT treatment versus conventional therapy. The overall relative risk of radiation induced malignancy observed was below 6% in all treatment plans considered.

Original languageEnglish (US)
Pages (from-to)141-148
Number of pages8
JournalTechnology in Cancer Research and Treatment
Issue number2
StatePublished - Apr 2009


  • Conventional radiotherapy
  • IMRT
  • Monte Carlo
  • Second malignancy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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