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

JianYue Jin, Ning Wen, Lei Ren, Carri Glide-Hurst, Indrin J. Chetty

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)166-176
Number of pages11
JournalCancer Journal
Volume17
Issue number3
DOIs
Publication statusPublished - May 1 2011

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Keywords

  • Image guidance
  • arc-based IMRT
  • dynamic conformal arcs treatment
  • intensity-modulated radiotherapy
  • target localization
  • three-dimensional conformal radiotherapy
  • treatment planning

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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