17
Figure 4. CIED Management for Radiation Therapy
CIED relocation
is recommended
(I/C-EO)
It may be reasonable
to do weekly complete
CIED evaluations
(IIb/B-NR)
Do a complete CIED evaluation
Establish treatment plan
YES
NO
Will the
device interfere
with adequate tumor
treatment?
CIED relocation is not
recommended for devices
receiving a maximum
cumulative incident dose of
<5 Gy (III/B-NR)
Weekly complete
CIED evaluation is
recommended (I/B-NR)
YES
NO
Will neutron-
producing treatment
be used?
YES
NO
Complete CIED evaluation to be completed at conclusion of radiation therapy
(I/B-NR)
Is the patient
pacemaker-
dependent?