Abstract
Although a significant improvement in cancer cure (i.e. 20% increment) has been obtained in the last 2–3 decades, 30–40% of patients still fail locally after curative radiotherapy. In order to improve local tumor control rates with radiotherapy high doses to the tumor volume are frequently necessary. Three-dimensional conformal radiation therapy (3-D CRT) is used to denote a spectrum of radiation planning and delivery techniques that rely on three-dimensional imaging to define the target (tumor) and to distinguish it from normal tissues. Modern, high-precision radiotherapy (RT) techniques are needed in order to implement the goal of optimal tumor destruction delivering minimal dose to the non-target normal tissues. A better target definition is nowadays possible with contemporary imaging (computerized tomography, magnetic resonance imaging, and positron emission tomography) and image registration technology. A highly precise dose distributions can be obtained with optimal 3-D CRT treatment delivery techniques such as stereotactic RT, intensity modulated RT (IMRT), or protontherapy (the latter allowing for in-depth conformation). Patient daily set-up repositioning and internal organ immobilization systems are necessary before considering to undertake any of the above mentioned high-precision treatment approaches. Prostate cancer, brain tumors, and base of skull malignancies are among the sites most benefitting of dose escalation approaches. Nevertheless, a significant dose reduction to the normal tissues in the vicinity of the irradiated tumor also achievable with optimal 3-D CRT may also be a major issue in the treatment of pediatric tumors in order to preserve growth, normal development, and to reduce the risk of developing radiation induced diseases such as cancer or endocrinologic disorders.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Jemal A, Clegg LX, Ward E, et al. Annual report to the nation on the status of cancer, 1975– 2001, with a special feature regarding survival. Cancer 2004; 101:3–27.
Norlund A. Cost of radiotherapy. Acta Oncol 2003; 42:411–415.
Dearnaley DP, Khoo VS, Norman AR, et al. Comparison of radiation side effects of con-formal and conventional radiotherapy in prostate cancer: a randomised trial. Lancet 1999; 353: 267–272.
Pollack A, Zagars GK, Starkschall G, et al. Prostate cancer radiation dose response: results of the M.D. Anderson Phase III randomized trial. Int J Radiat Oncol Biol Phys 2002; 53:1097– 1105.
Zietman AL, DeSilvio ML, Slater JD, et al. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate. A randomized controlled Trial. JAMA 2005; 294:1233–1239.
Sathya JR, Davis IR, Julian JA, et al. Randomized trial comparing Iridium implants plus esxternal-beam radiation therapy with external-beam radiation therapy alone in node-negative locally advanced cancer of the prostate. J Clin Oncol 2005; 23:1192–1199.
Miralbell R, Lomax A, Russo M. Potential role of proton therapy in the treatment of pediatric medulloblastoma/primitive neuroectodermal tumors: spinal theca irradiation. Int J Radiat Oncol Biol Phys 1997; 38:805–811.
Miralbell R, Lomax A, Cella L, Schneider U. Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumors. Int J Radiat Oncol Biol Phys 2002; 54:824–829.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer Science + Business Media B.V.
About this paper
Cite this paper
Miralbell, R. (2009). Clinical Applications of 3-D Conformal Radiotherapy. In: Lemoigne, Y., Caner, A. (eds) Radiotherapy and Brachytherapy. NATO Science for Peace and Security Series B: Physics and Biophysics. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-3097-9_7
Download citation
DOI: https://doi.org/10.1007/978-90-481-3097-9_7
Publisher Name: Springer, Dordrecht
Print ISBN: 978-90-481-3095-5
Online ISBN: 978-90-481-3097-9
eBook Packages: Physics and AstronomyPhysics and Astronomy (R0)