Intensity-Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Lung Cancer
Book Title
Advances in Radiation Oncology in Lung Cancer
Files
Download Full Text
Editors
Jeremic Branislav
Description
Per 2021 American Cancer Society estimates, lung cancer has the second highest incidence and highest mortality of all malignancies in the United States. Outcomes have improved considerably over the past decade, with radiation therapy (RT) serving as a cornerstone of locoregional therapy. The technical challenges of delivering biologically effective doses of RT capable of achieving local control include accurate target definition and accounting for respiratory tumor motion, tissue heterogeneities, and normal tissue tolerance. Three-dimensional conformal radiation therapy (3D CRT) is now the minimum technical standard for treating NSCLC. Intensity-modulated radiation therapy (IMRT) and volumetrically modulated radiation therapy (VMAT), in addition to four-dimensional (4D) CT simulation and planning techniques, biological targeting via positron emission tomography (PET), and 2D and 3D image-guided delivery methods, have facilitated radiation dose escalation while respecting normal tissue tolerance of organs at risk (OAR). In patients with locally advanced disease, IMRT has demonstrated improved dosimetric and toxicity profiles when compared to 3D CRT. However, this comes at the cost of long treatment times and high integral dose. With improvements in commercial planning software and quality assurance measures, VMAT is now commonly employed to achieve the improved conformality found with IMRT along with shorter treatment times and fewer monitor units delivered. Though no randomized trials comparing 3D CRT to IMRT/VMAT have been performed, these advanced modalities should be strongly considered in patients with locally advanced disease.
First Page
1021
Last Page
1047
ISBN
978-3-031-34846-4
Publication Date
2023
Publisher
Springer
City
Cham, Switzerland
Keywords
lung cancer, radiation therapy, IMRT, VMAT
Disciplines
Oncology | Radiation Medicine
Recommended Citation
Parzen JS, Grills IS. Intensity-modulated radiation therapy and volumetric modulated arc therapy for lung cancer. In: Jeremic, B, editor. Advances in radiation oncology in lung cancer. 3rd ed. Cham, Switzerland: Springer;2023. p. 1021-1047.doi:10.1007/978-3-031-34847-1.