Advances in treatment techniques: arc-based and other intensity modulated therapies.

Published

Journal Article (Review)

Treatment planning and radiation delivery techniques have advanced significantly during the past 2 decades. The development of the multileaf collimator has changed the scope of radiotherapy. The dynamic conformal arc technique emerged from traditional cone-based conformal arc therapies, which aim to improve target dose uniformity and reduce normal tissue doses. With dynamic conformal arc, the multileaf collimator aperture is shaped dynamically to conform to the target. With the advent of intensity-modulated radiotherapy (IMRT), the concept of arc therapy in combination with IMRT has enabled better-quality dose distributions and more efficient delivery. Helical tomotherapy has been developed to treat targets sequentially by modulating the beam intensity in each "slice" of the patient. Helical tomotherapy offers improved dose distributions for complicated treatments, such as whole-body radiation. Intensity-modulated arc therapy has been studied to modulate fluences in a cone beam rather than fan beam geometry to improve delivery efficiency. This article reviews arc-based IMRT, intensity-modulated arc therapy, and helical tomotherapy techniques. We compare the dosimetric results reported in the literature for each technique in various treatment sites. We also review the application of these techniques in specialized clinical procedures including total marrow irradiation, simultaneous treatment of multiple brain metastases, dose painting, simultaneous integrated boost, and stereotactic radiosurgery.

Full Text

Duke Authors

Cited Authors

  • Jin, J-Y; Wen, N; Ren, L; Glide-Hurst, C; Chetty, IJ

Published Date

  • May 2011

Published In

Volume / Issue

  • 17 / 3

Start / End Page

  • 166 - 176

PubMed ID

  • 21610470

Pubmed Central ID

  • 21610470

Electronic International Standard Serial Number (EISSN)

  • 1540-336X

Digital Object Identifier (DOI)

  • 10.1097/PPO.0b013e31821f8318

Language

  • eng

Conference Location

  • United States