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Three-dimensional conformal radiation therapy: A testable hypothesis

1991; Elsevier BV; Volume: 21; Issue: 3 Linguagem: Inglês

10.1016/0360-3016(91)90708-c

1879-355X

Allen S. Lichter,

Radiation Therapy and Dosimetry

The concepts of 3-dimensional treatment planning and 3-dimensional conformal dose delivery are being evaluated and critically analyzed. Reviews are mixed. At one extreme are the enthusiasts who insist that 3-D treatment planning and dose delivery represent a major step forward in radiation oncology, and that all dose planning and treatment delivery will be done in this fashion in years to come. At the other extreme are the skeptics who believe that 3-D treatment planning has done little more than create pretty pictures, and consider its potential to cure additional patients limited if not non-existent. How may we investigate whether truth lies at either of these extremes or somewhere in the middle? It is probably best to begin an analysis of this topic by stating points that are widely accepted by the majority of radiation oncologists. We would all agree, for instance, that not all tumors are controlled by radiation, and that despite our best efforts, some tumors locally fail. It is also generally agreed that the technical delivery of radiation has not reached its limit, but is still developing. Major steps forward have been taken with the progression from orthovoltage, through cobalt, and now to linear accelerators (3). Additional advances have been made in treatment planning with the advent of cross-sectional imaging such as CT and MRI. However, additional developments in machine technology, localization techniques, treatment planning, and dose calculation will likely produce new developments that will improve upon today’s technology in the same way that linear accelerators improved upon cobalt technology. Such has been the history of our field and other fields of technical endeavor over the past 50 years, and this history will likely continue. Some of the technological advances in radiation treat