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.
Perez
C A
CA
Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63108, USA.
Purdy
J A
JA
Harms
W
W
Gerber
R
R
Graham
M V
MV
Matthews
J W
JW
Bosch
W
W
Drzymala
R
R
Emami
B
B
Fox
S
S
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