Three-dimensional treatment planning and conformal radiation therapy: preliminary evaluation.
Preliminary clinical results are presented for 209 patients with cancer who had treatment planned on our three-dimensional radiation treatment planning (3-D RTP) system and were treated with external beam conformal radiation therapy. Average times (min) for CT volumetric simulation were: 74 without or 84 with contrast material; 36 for contouring of tumor/target volume and 44 for normal anatomy; 78 for treatment planning; 53 for plan evaluation/optimization; and 58 for verification simulation. Average time of daily treatment sessions with 3-D conformal therapy or standard techniques was comparable for brain, head and neck, thoracic, and hepatobiliary tumors (11.8-14 min and 11.5-12.1, respectively). For prostate cancer patients treated with 3-D conformal technique and Cerrobend blocks, mean treatment time was 19 min; with multileaf collimation it was 14 min and with bilateral arc rotation, 9.8 min. Acute toxicity was comparable to or lower than with standard techniques. Sophisticated 3-D RTP and conformal irradiation can be performed in a significant number of patients at a reasonable cost. Further efforts, including dose-escalation studies, are necessary to develop more versatile and efficient 3-D RTP systems and to enhance the cost benefit of this technology in treatment of patients with cancer.
Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63108, USA.
C A
CA
Perez
J A
JA
Purdy
W
W
Harms
R
R
Gerber
M V
MV
Graham
J W
JW
Matthews
W
W
Bosch
R
R
Drzymala
B
B
Emami
S
S
Fox
D001650:Bile Duct Neoplasms / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000532:radiotherapy; D002648:Child; D003198:Computer Simulation; D003287:Contrast Media; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000532:radiotherapy; D008297:Male; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000191:economics / Q000379:methods; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D013899:Thoracic Neoplasms / Q000532:radiotherapy; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media