Planning and delivery of intensity-modulated radiation therapy (original) (raw)
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Intensity modulated radiation therapy (IMRT): a new promising technology in radiation oncology
The oncologist, 1999
Intensity modulated radiation therapy (IMRT) is a new technology in radiation oncology that delivers radiation more precisely to the tumor while relatively sparing the surrounding normal tissues. It also introduces new concepts of inverse planning and computer-controlled radiation deposition and normal tissue avoidance in contrast to the conventional trial-and-error approach. IMRT has wide application in most aspects of radiation oncology because of its ability to create multiple targets and multiple avoidance structures, to treat different targets simultaneously to different doses as well as to weight targets and avoidance structures according to their importance. By delivering radiation with greater precision, IMRT has been shown to minimize acute treatment-related morbidity, making dose escalation feasible which may ultimately improve local tumor control. IMRT has also introduced a new accelerated fractionation scheme known as SMART (simultaneous modulated accelerated radiation t...
Intensity-modulated radiation therapy (IMRT): the radiation oncologist's perspective
Medical dosimetry : official journal of the American Association of Medical Dosimetrists, 2002
Intensity-modulated radiation therapy (IMRT) is a new and evolving technological advance in high-precision radiation therapy. It is an extension of 3-dimensional conformal radiotherapy (3D-CRT) that allows the delivery of highly complex isodose profiles to the target while minimizing radiation exposure to surrounding normal tissues. Clinical data on IMRT are emerging and being collected, as more institutions are implementing or expanding the use of IMRT. However, the currently available IMRT and its applications are far from being well understood and established. In some circumstances, it remains impractical and too costly. This article discusses some practical issues from the radiation oncologist's perspective.
Intensity modulated radiotherapy (IMRT)—an introduction
Radiography, 2002
Intensity modulated radiotherapy (IMRT) is a new radiotherapy technique now coming into clinical use which offers better control of the shaping of dose distributions. This could potentially lead to reduced side-effects due to decreased dose to surrounding structures. It may also allow dose escalation without increased dose to surrounding organs, with the resultant possibilities of improved control of disease and increased survival rates for some patients. In this overview, methods for planning and delivery of IMRT are explained, the main clinical sites are identified and practical delivery aspects are discussed.
Medical Physics, 2003
Intensity-modulated radiation therapy ͑IMRT͒ represents one of the most significant technical advances in radiation therapy since the advent of the medical linear accelerator. It allows the clinical implementation of highly conformal nonconvex dose distributions. This complex but promising treatment modality is rapidly proliferating in both academic and community practice settings. However, these advances do not come without a risk. IMRT is not just an add-on to the current radiation therapy process; it represents a new paradigm that requires the knowledge of multimodality imaging, setup uncertainties and internal organ motion, tumor control probabilities, normal tissue complication probabilities, three-dimensional ͑3-D͒ dose calculation and optimization, and dynamic beam delivery of nonuniform beam intensities. Therefore, the purpose of this report is to guide and assist the clinical medical physicist in developing and implementing a viable and safe IMRT program. The scope of the IMRT program is quite broad, encompassing multileaf-collimatorbased IMRT delivery systems, goal-based inverse treatment planning, and clinical implementation of IMRT with patient-specific quality assurance. This report, while not prescribing specific procedures, provides the framework and guidance to allow clinical radiation oncology physicists to make judicious decisions in implementing a safe and efficient IMRT program in their clinics.
A review of intensity-modulated radiation therapy
Current Oncology Reports, 2008
Intensity-modulated radiation therapy (IMRT) is a sophisticated form of three-dimensional treatment planning and delivery. In some situations, IMRT allows more conformal radiation therapy to complex targets within the lung. As problems related to organ motion are increasingly addressed, the use of IMRT in the treatment of lung cancer, particularly in non-small cell lung cancer and mesothelioma, continues to rise.
New developments in intensity modulated radiation therapy
Technology in cancer research & treatment, 2006
As intensity modulated radiation therapy (IMRT) becomes routine clinical practice, its advantages and limitations are better understood. With these new understandings, some new developments have emerged in an effort to alleviate the limitations of the current IMRT practice. This article describes a few of these efforts made at the University of Maryland, including: i) improving IMRT efficiency with direct aperture optimization; ii) broadening the scope of optimization to include the mode of delivery and beam angles; and iii) new planning methods for intensity modulated arc therapy (IMAT).
Intensity modulated radiotherapy (IMRT) the white, black and grey: a clinical perspective
Reports of Practical Oncology & Radiotherapy, 2009
The radiotherapy community has in the past few decades witnessed dramatic shift in the treatment modalities from conventional 2-D radiotherapy to the now widely practiced 3-DCRT, IMRT and evolving IGRT. IMRT has generated so much interest because of it s unique dosimetric modulation to concentrate doses to the targets of interests while also being able to relatively spare neighboring normal tissue. However IMRT is not the all in one solution for radiotherapeutic management of solid malignancies. The current enthusiasm in IMRT most be tempered with an understanding of the complexities of IMRT planning, treatment delivery, quality assurance, monitoring and clinical limitations. The widespread implementation of this technological innovat ion may have been a bit premature considering that clinical information regarding the same is still being generated. This article tries to give an overview of the potential advantages/disadvantages of IMRT in the clinical set up and the few controversies (Grey Zone) that are still being resolved. There is evidence to indicate that indiscriminately used IMRT may even harm the patient or have an inferior therapeutic index to 3DCRT. This and other pertinent issues will be covered by the authors in this short review of IMRT in clinical practice.
Intensity-modulated radiation therapy: emerging cancer treatment technology
2005
The use of intensity-modulated radiation therapy (IMRT) is rapidly advancing in the field of radiation oncology. Intensity-modulated radiation therapy allows for improved dose conformality, thereby affording the potential to decrease the spectrum of normal tissue toxicities associated with IMRT. Preliminary results with IMRT are quite promising; however, the clinical data is relatively immature and overall patient numbers remain small. High-quality IMRT requires intensive physics support and detailed knowledge of threedimensional anatomy and patterns of tumour spread. This review focuses on basic principles, and highlights the clinical implementation of IMRT in head and neck and prostate cancer.
Intensity modulated radiation therapy: a clinical review
The British Journal of Radiology, 2000
Intensity modulated radiotherapy represents a signi®cant advance in conformal radiotherapy. In particular, it allows the delivery of dose distributions with concave isodose pro®les such that radiosensitive normal tissue close to, or even within a concavity of, a tumour may be spared from radiation injury. This article reviews the clinical application of this technique to date, and discusses the practical issues of treatment planning and delivery from the clinician's perspective.