Technical considerations in the application of intensity-modulated radiotherapy as a concomitant integrated boost for locally-advanced cervix cancer.

The technical aspects of IMRT applied to cervix cancer are discussed in this paper, as well as issues related to tumor delineation, target volume definitions, inverse planning, and IMRT delivery. A theoretical example illustrating how IMRT can accurately mimic dose distributions obtained using conventional planning plus HDR brachytherapy is also shown. The notion of clinical optimization parameters is introduced to account for the radiation delivery variables, which affect the overall treatment time. This is especially relevant to the possible introduction of intrafractional movement and resulting inaccuracy, as well as facility efficiency.

[1]  J Salk,et al.  Impact of the filling status of the bladder and rectum on their integral dose distribution and the movement of the uterus in the treatment planning of gynaecological cancer. , 1999, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[2]  C C Ling,et al.  High dose radiation delivered by intensity modulated conformal radiotherapy improves the outcome of localized prostate cancer. , 2001, The Journal of urology.

[3]  G T Chen,et al.  Fast iterative algorithms for three-dimensional inverse treatment planning. , 1998, Medical physics.

[4]  P J Eifel,et al.  Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. , 1999, The New England journal of medicine.

[5]  C C Ling,et al.  Towards multidimensional radiotherapy (MD-CRT): biological imaging and biological conformality. , 2000, International journal of radiation oncology, biology, physics.

[6]  R Mohan,et al.  The potential for sparing of parotids and escalation of biologically effective dose with intensity-modulated radiation treatments of head and neck cancers: a treatment design study. , 2000, International journal of radiation oncology, biology, physics.

[7]  C. Reddy,et al.  Short-course intensity-modulated radiotherapy (70 GY at 2.5 GY per fraction) for localized prostate cancer: preliminary results on late toxicity and quality of life. , 2001, International journal of radiation oncology, biology, physics.

[8]  B N Bundy,et al.  Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. , 1999, The New England journal of medicine.

[9]  T LoSasso,et al.  Dosimetric verification of intensity-modulated fields. , 1996, Medical physics.

[10]  R Mohan,et al.  Algorithms and functionality of an intensity modulated radiotherapy optimization system. , 2000, Medical physics.

[11]  T E Schultheiss,et al.  Ultrasound-based stereotactic guidance in prostate cancer--quantification of organ motion and set-up errors in external beam radiation therapy. , 2000, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[12]  R Mohan,et al.  Dynamic splitting of large intensity-modulated fields. , 2000, Physics in medicine and biology.

[13]  J. Roeske,et al.  Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies. , 2000, International journal of radiation oncology, biology, physics.

[14]  L. Dawson,et al.  Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. , 2001, International journal of radiation oncology, biology, physics.

[15]  B. Kavanagh,et al.  Long-term Local Control and Survival After Concomitant Boost Accelerated Radiotherapy for Locally Advanced Cervix Cancer , 2001, American journal of clinical oncology.

[16]  Lei Xing,et al.  Computer assisted selection of beam energy and orientation in IMRT , 2001 .

[17]  D. Arthur,et al.  A pilot study of concomitant boost accelerated superfractionated radiotherapy for stage III cancer of the uterine cervix. , 1997, International journal of radiation oncology, biology, physics.

[18]  J. Reiber,et al.  Tumor diameter and volume assessed by magnetic resonance imaging in the prediction of outcome for invasive cervical cancer. , 2001, Gynecologic oncology.

[19]  H. Shirato,et al.  Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor. , 2000, International journal of radiation oncology, biology, physics.

[20]  Jay S. Cooper,et al.  A radiation therapy oncology group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003 , 1999 .

[21]  G Starkschall,et al.  Preliminary results of a randomized radiotherapy dose-escalation study comparing 70 Gy with 78 Gy for prostate cancer. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  R K Ten Haken,et al.  The reproducibility of organ position using active breathing control (ABC) during liver radiotherapy. , 2001, International journal of radiation oncology, biology, physics.

[23]  E. B. Butler,et al.  Intensity modulated radiation therapy (IMRT): a new promising technology in radiation oncology. , 1999, The oncologist.

[24]  D Low,et al.  Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation. , 2001, International journal of radiation oncology, biology, physics.

[25]  R. Mohan,et al.  Clinical application of intensity-modulated radiotherapy for locally advanced cervical cancer. , 2002, Seminars in radiation oncology.