American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) Practice Guidelines for Intensity-Modulated Radiation Therapy (IMRT)

Hartford, Alan C.; Palisca, Madeline G.; Eichler, Thomas; Beyer, David; Devineni, Venkata Rao; Ibbott, Geoffrey S.; Kavanagh, Brian D.; Kent, John S.; Rosenthal, Seth A.; Schultz, C. J.; Tripuraneni, Prabhakar; Gaspar, Laurie E.

doi:10.1016/j.ijrobp.2008.04.049

Cited by 77 publications

(64 citation statements)

References 7 publications

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“…IMRT is not only a technique for delivering optimized non-uniform beam intensities to a target volume, but it also provides a new approach to the entire treatment process. [7][8][9] Clinical implementation of IMRT requires thorough knowledge of setup uncertainties, adequate selection of target volumes based on natural history of disease and patterns of spread, optimal delineation of target volumes and critical structures using multimodality imaging, appropriate specification and dose prescription regarding dose volume constraints, and quality control of both the clinical and physical aspects of the whole procedure. [7][8][9] High-precision techniques are relatively intolerant to set-up errors, mandating imageguidance for precise delivery.…”

Section: -4mentioning

confidence: 99%

“…[7][8][9] Clinical implementation of IMRT requires thorough knowledge of setup uncertainties, adequate selection of target volumes based on natural history of disease and patterns of spread, optimal delineation of target volumes and critical structures using multimodality imaging, appropriate specification and dose prescription regarding dose volume constraints, and quality control of both the clinical and physical aspects of the whole procedure. [7][8][9] High-precision techniques are relatively intolerant to set-up errors, mandating imageguidance for precise delivery. Image-guided radiation therapy (IGRT) 10,11 thus represents a logical advancement in the field of high-precision radiotherapy and is a natural corollary to IMRT.…”

Section: -4mentioning

confidence: 99%

“…IMRT and IGRT thus demand precision and accuracy that surpasses the requirements of conventional radiotherapy treatment planning and delivery techniques. 7,9,12 It requires a coordinated team effort between the radiation oncologist, medical physicist, and radiation therapy technologist.…”

mentioning

confidence: 99%

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IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Gupta

Agarwal

Susovan

et al. 2010

Indian J Surg Oncol

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Intensity-modulated radiation therapy (IMRT) is a revolutionary new paradigm that aims at improving the therapeutic ratio by increasing the dosegradient between target tissues and surrounding normal structures thereby offering probability of better loco-regional control with decreased risk of complications. IMRT is relatively intolerant to set-up uncertainties, warranting periodic image-guidance, making Image-Guided Radiation Therapy (IGRT) a natural corollary to IMRT. There are several challenges associated with the planning, delivery, and quality assurance of the IMRT and IGRT processes that must be addressed to realize the full potential of such exciting and promising technology. Given the complexities involved, it is quite intuitive to understand that IMRT and IGRT are resource-intensive, demanding increased labor, rigour, and expenses too. Other disadvantages associated with high-precision techniques include potentially increased risk of marginal failures, decreased dose homogeneity, and an increase in total body dose with increased risk of secondary carcinogenesis. The aim of this review is to define the role of IMRT and IGRT in contemporary head and neck oncologic practice through a critical appraisal of pertinent literature. Despite relatively short follow-up and limited clinical outcomes data, the weight of evidence suggests that loco-regional control is not inferior (either comparable or even better) and toxicity lesser with IMRT resulting in potentially improved quality-oflife, prompting the widespread adoption of such technology in community practice. Ongoing clinical trials in head and neck IMRT are currently addressing issues to optimize the IMRT process, adopting functional imaging for dose-painting, and incorporating adaptive re-planning strategies to further improve outcomes.

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Section: -4mentioning

confidence: 99%

Section: -4mentioning

confidence: 99%

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IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Gupta

Agarwal

Susovan

et al. 2010

Indian J Surg Oncol

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“…This multi-institutional study group is focused on greater safety and enhanced quality through the optimization of Head and Neck Intensity/Volumetric Modulated Radiation/Arc Therapy (H&N IMRT/VMAT) radiotherapy process [1]. An inter comparison among three institutions was considered to be the optimum starting point in the context of the developing Mexican collaborative radiotherapy safety culture.…”

Section: Introductionmentioning

confidence: 99%

Design of a quality management program for head & neck cancer IMRT/VMAT technique based on prospective risk analysis: A multi-institutional trial

Figueroa-Medina¹,

Hernández-Bojórquez²,

Mendoza-Sánchez

2016

AIP Conference Proceedings

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Absorbed dose distribution in liquid water for a CyberKnife VSI using radiochromic EBT3 film AIP Conference Proceedings 1747, 060004 (2016) Abstract. In this work we describe the first steps of the development of a quality management program for physics related staffing activities during Intensity Modulated Radiation Therapy for Head and Neck treatment process. The methodology adopted was prospective process-and clinic-specific risk analysis leading to the formulation of the quality management program. This methodology was described during "A hands-on Workshop on TG-100" which took place in October 2015 in Mexico City and was conducted

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“…Research module fee. assurance checks [6]- [8]. With IMRT a large volume of normal tissue can get low doses of radiation that increases the potential risk of secondary cancers [9]- [11].…”

Section: Introductionmentioning

confidence: 99%

Investigation of VMAT Algorithms and Dosimetry

Taqaddas

2013

Practical Radiation Oncology

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Abstract-Purpose: Planning and dosimetry of different VMAT algorithms (SmartArc, Ergo++, Autobeam) is compared with IMRT for Head and Neck Cancer patients. Modelling was performed to rule out the causes of discrepancies between planned and delivered dose.Methods: Five HNC patients previously treated with IMRT were re-planned with SmartArc (SA), Ergo++ and Autobeam. Plans were compared with each other and against IMRT and evaluated using DVHs for PTVs and OARs, delivery time, monitor units (MU) and dosimetric accuracy. Modelling of control point (CP) spacing, Leafend Separation and MLC/Aperture shape was performed to rule out causes of discrepancies between planned and delivered doses. Additionally estimated arc delivery times, overall plan generation times and effect of CP spacing and number of arcs on plan generation times were recorded.Results: Single arc SmartArc plans (SA4d) were generally better than IMRT and double arc plans (SA2Arcs) in terms of homogeneity and target coverage. Double arc plans seemed to have a positive role in achieving improved Conformity Index (CI) and better sparing of some Organs at Risk (OARs) compared to Step and Shoot IMRT (ss-IMRT) and SA4d. Overall Ergo++ plans achieved best CI for both PTVs. Dosimetric validation of all VMAT plans without modelling was found to be lower than ss-IMRT. Total MUs required for delivery were on average 19%, 30%, 10.6% and 6.5% lower than ss-IMRT for SA4d, SA2d (Single arc with 2 0 Gantry Spacing), SA2Arcs and Autobeam plans respectively. Autobeam was most efficient in terms of actual treatment delivery times whereas Ergo++ plans took longest to deliver.Conclusion: Overall SA single arc plans on average achieved best target coverage and homogeneity for both PTVs. SA2Arc plans showed improved CI and some OARs sparing. Very good dosimetric results were achieved with modelling. Ergo++ plans achieved best CI. Autobeam resulted in fastest treatment delivery times.

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American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) Practice Guidelines for Intensity-Modulated Radiation Therapy (IMRT)

Cited by 77 publications

References 7 publications

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

IMRT and IGRT in head and neck cancer: Have we delivered what we promised?

Design of a quality management program for head & neck cancer IMRT/VMAT technique based on prospective risk analysis: A multi-institutional trial

Investigation of VMAT Algorithms and Dosimetry

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