title: IMRT: high-definition radiation therapy in a community hospital.
abstract: A multileaf collimator (MLC)-based intensity-modulated radiation therapy (IMRT) program was implemented successfully at Monmouth Medical Center, a community hospital at Long Branch, New Jersey. Our clinical experience gained in the treatment of over 80 patients using IMRT for prostate, head and neck, and brain is reviewed, and some of the clinical issues are also, discussed. Implementation of the IMRT requires a treatment planning system, computer-controlled beam-shaping aperture, electronic record and verify system, and a good physics quality assurance program. These components, by grouping them efficiently, have created a seamless workflow for our complete radiotherapy process of IMRT. Each of these radiotherapy processes are discussed for clarity and the clinical importance is also evaluated. Of particular interest is inverse treatment planning that will impact treatment delivery such as beam orientation, treatment ports, and organ motion of IMRT. A checklist for physics and departmental quality assurance is suggested, with the intention of providing systematic workflow, making IMRT feasible at a community medical center setting. This is especially important because most of our cancer patients received radiation therapy locally. Lastly, the reimbursement issue affecting the implementation of IMRT at our medical center is also discussed to justify this new treatment protocol for future clinical outcomes.
authors.affiliation: Monmouth Medical Center, Department of Radiation Oncology, Long Branch, NJ 07740, USA. jyang@sbhcs.com
authors.forename: C C
authors.initials: CC
authors.lastname: Jack Yang
authors.forename: A
authors.initials: A
authors.lastname: Raben
authors.forename: D
authors.initials: D
authors.lastname: Carlson
mesh_terms: D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D009515:New Jersey; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging; D011786:Quality Control; D011859:Radiography; D020266:Radiotherapy, Conformal / Q000191:economics / Q000379:methods*; D012051:Reimbursement Mechanisms