By Yasumasa Nishimura, Ritsuko Komaki

Successful scientific use of intensity-modulated radiation treatment (IMRT) represents an important boost in radiation oncology. simply because IMRT can carry high-dose radiation to a goal with a discounted dose to the encircling organs, it might enhance the neighborhood regulate cost and decrease toxicities linked to radiation treatment. considering that IMRT all started getting used within the mid-1990s, a wide quantity of medical proof of some great benefits of IMRT has been accumulated. even though, remedy making plans and caliber coverage (QA) of IMRT are advanced and hard for the clinician and the scientific physicist. This publication, through authors popular for his or her services of their fields, offers cumulative scientific proof and acceptable suggestions for IMRT for the clinician and the physicist. half I bargains with the rules and strategies, historical past, rules, QA, therapy making plans, radiobiology and comparable points of IMRT. half II covers scientific functions with a number of case reviews, describing contouring and dose distribution with medical effects besides descriptions of symptoms and a evaluate of scientific facts for every tumor web site. the data provided during this ebook serves as a necessary source for the practising clinician and physicist.

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Additional info for Intensity-Modulated Radiation Therapy: Clinical Evidence and Techniques

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An example of such consequences was described by Allen and colleagues, who found that IMRT for mesothelioma led to an unexpectedly high rate of fatal pneumonitis [2]. This case highlighted the need for extreme care when applying DVH constraints to new clinical treatment techniques [2, 59]. , out-of-field dose) [7, 14, 61]. 4 % among patients surviving more than 10 years after treatment [14]. , tungsten or lead) [62]. Contributions of these factors depend on photon energy as well as distance from the target, with the former MU-dependent sources being most importantly distant from the field edge.

Webb S (1994) Optimizing the planning of intensity-modulated radiotherapy. Phys Med Biol 39(12):2229–2246 128. Weksberg DC, Palmer MB, Vu KN, Rebueno NC, Sharp HJ, Luo D, Yang JN, Shiu AS, Rhines LD, McAleer MF, Brown PD, Chang EL (2012) Generalizable class solutions for treatment planning of spinal stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 84(3):847–853 129. Welsh J, Gomez D, Palmer MB, Riley BA, Mayankkumar AV, Komaki R, Dong L, Zhu XR, Likhacheva A, Liao Z, Hofstetter WL, Ajani JA, Cox JD (2011) Intensity-modulated proton therapy further reduces normal tissue exposure during definitive therapy for locally advanced distal esophageal tumors: a dosimetric study.

This process has been shown to increase the target coverage, but it also results in an increase in the number of MLC segments (MLC shapes). Because the beam is turned off as the MLCs move between segments, this can significantly affect the treatment delivery time. E. Court et al. Fig. 2 (a) Leaf trajectory as a function of dose index for a step-and-shoot IMRT delivery. 00 -6 -4 -2 0 Leaf Positions (cm) 2 4 Fig. 3 (a) Leaf trajectories as a function of dose index for dynamic multileaf collimator (MLC) delivery.

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