**7. Mitigation strategies in planning**

As many of the side effects of radiation therapy are difficult to anticipate and manage, a great deal of effort has been put into reducing the amount of non-tumor tissue exposed to radiation. In the early days of radiation, this was difficult simply due to the lack of technology. Now, most radiation oncologists have access to various new tools, such as 4-dimensional conformal avoidance techniques to minimize

off-target exposure [34]. Compact structures that were traditionally difficult to irradiate without significant off-target, such as the axilla and chest, can now be treated much more accurately with minimal exposure to non-tumor tissue [41]. Modern imaging techniques can be utilized to assess organ performance even before the administration of radiation to determine the risk of post-radiation symptoms. Indocyanine retention assays used in conjunction with MRI have determined the pre-exposure function of liver to assess if the patient is a good candidate for radiation therapy [25]. New guidelines are constantly being updated to ensure that the risks of radiation therapy are minimized. Novel pharmacological agents, such as the development of immunotherapy, are being implemented to supplement the efficiency of radiation therapy. As medicine becomes more collaborative and data is more available, physicians outside of radiation oncology will be able to better understand the radiation therapy treatment plans and define survivorship care plans accordingly.
