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Titolo:
3D treatment planning and intensity-modulated radiation therapy
Autore:
Purdy, JA;
Indirizzi:
Washington Univ, Sch Med, Edward Mallinckrodt Inst Radiol, Ctr Radiat Oncol, St Louis, MO 63110 USA Washington Univ St Louis MO USA 63110 adiat Oncol, St Louis, MO 63110 USA
Titolo Testata:
ONCOLOGY-NEW YORK
fascicolo: 10, volume: 13, anno: 1999, supplemento:, 5
pagine: 155 - 168
SICI:
0890-9091(199910)13:10<155:3TPAIR>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
3-DIMENSIONAL CONFORMAL RADIOTHERAPY; DYNAMIC MULTILEAF COLLIMATION; MONTE-CARLO CODE; PROSTATE-CANCER; DOSIMETRIC VERIFICATION; DOSE-ESCALATION; BEAM; DELIVERY; TOMOTHERAPY; COMPENSATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
67
Recensione:
Indirizzi per estratti:
Indirizzo: Purdy, JA Washington Univ, Sch Med, Edward Mallinckrodt Inst Radiol, Ctr Radiat Oncol, 510 So Kingshighway Blvd, St Louis, MO 63110 USA Washington Univ 510 So Kingshighway Blvd St Louis MO USA 63110 A
Citazione:
J.A. Purdy, "3D treatment planning and intensity-modulated radiation therapy", ONCOLOGY-NY, 13(10), 1999, pp. 155-168

Abstract

Three-dimensional (3D) image-based treatment planning and new delivery technologies have spurred the implementation of external beam radiation therapy techniques, in which the high-dose region is conformed much more closely to the target volume than previously possible, thus reducing the volume of normal tissues receiving a high dose. This form of external beam irradiation is referred to as 3D conformal radiation therapy (3DCRT). 3DCRT is not just art add-on to the current radiation oncology process; it represents a radical change in practice, particularly for the radiation oncologist. Defining tal get volumes and organs at risk in 3D by drawing contours on CT images on a slice-by-slice basis, as opposed to drawing beam portals on a simulator radiograph, can be challenging, because radiation oncologists are generally not well trained in cross-sectional imaging. Currently, the 3DCRT approach will increase the time and effort required by physicians inexperiencedwith 3D treatment planning. Intensity-modulated radiation therapy (IMRT) is a more advanced form of 3DCRT, but there is considerable developmental work remaining. The instrumentation arn methods used for IMRT quality assurance procedures and testing are not well established. Computer optimization cost functions are too simplistic, and thus time-consuming. Subjective plan evaluation by the radiation oncologist is still the norm. In addition, manyfundamental questions regarding IMRT remain unanswered. For example, the radiobiophysical consequences of altered time-dose-fraction are unknown. Also, the fact that there is much greater dose heterogeneity for both the target and normal critical structures with IMRT compared to traditional in radiation techniques challenges current radiation oncology planning principles. However, this new process of planning and treatment delivery shows significant potential for improving the therapeutic ratio. In addition, while inefficient today, these systems, when fully developed, will improve the efficiency with which external beam radiation therapy cart be planned and delivered, thus lowering costs.

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Documento generato il 29/03/20 alle ore 15:16:07