Intensity-modulated radiation therapy (IMRT) is a complex technique for the delivery of radiation therapy preferentially to target structures while minimizing doses to adjacent normal critical structures.
It is widely utilized in the treatment of a variety of clinical indications in radiation oncology, including tumors of the central nervous system, head and neck, breast, prostate, gastrointestinal tract, and gynecologic organs, as well as in situations where previous radiation therapy has been delivered, and has allowed for significant therapeutic advances in many clinical areas. IMRT treatment planning and delivery is a complex process. Safe and reliable delivery of IMRT requires appropriate process design and adherence to quality assurance (QA) standards. A collaborative effort of the American College of Radiology and American Society for Therapeutic Radiation Oncology has produced a practice guideline for IMRT. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist, dosimetrist, and radiation therapist. Factors with respect to the QA of the treatment planning system, treatment-planning process, and treatment-delivery process are discussed, as are issues related to the utilization of volumetric modulated arc therapy. Patient-specific QA procedures are presented. Successful IMRT programs involve integration of many processes: patient selection, patient positioning/immobilization, target definition, treatment plan development, and accurate treatment delivery. Appropriate QA procedures, including patient-specific QA procedures, are essential to ensure quality in an IMRT program and to assure patient safety.
Written by:
Hartford AC, Galvin JM, Beyer DC, Eichler TJ, Ibbott GS, Kavanagh B, Schultz CJ, Rosenthal SA. Are you the author?
Department of Medicine, Section of Radiation Oncology, Dartmouth Medical School, Hanover, NH; Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA; Arizona Oncology Services, Scottsdale, AZ; Department of Radiation Oncology, Thomas Johns Cancer Hospital, Richmond, VA; Department of Radiation Physics, M.D. Anderson Cancer Center, Division of Radiation Oncology, University of Texas, Houston, TX; Department of Radiation Oncology, University of Colorado, Denver, Aurora, CO; Department of Radiation Oncology, Medical College of Wisconsin, Wisconsin, WI; Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA.
Reference: Am J Clin Oncol. 2012 Dec;35(6):612-617.
doi: 10.1097/COC.0b013e31826e0515
PubMed Abstract
PMID: 23165357
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