Clinical Oncology
Volume 22, Issue 8 , Pages 643-657 , October 2010

A Review of the Clinical Evidence for Intensity-modulated Radiotherapy

  • J. Staffurth

      Affiliations

    • Corresponding Author InformationAuthor for correspondence: J. Staffurth, Research Department, Velindre Hospital, Whitchurch, Cardiff CF14 2TL, UK. Tel: +29-2031-6964; Fax: +29-2052-09625.
    • ,
  • on behalf of the Radiotherapy Development Board

      Affiliations

    • Radiotherapy Development Board: A. Barrett (University of East Anglia, representing the National Radiotherapy Action Group, UK), J. Barrett (Royal Berkshire Hospital, representing the Royal College of Radiologists [RCR], UK), C. Beardmore (representing the Society and College of Radiographers [SCoR], UK), T. Cooper (representing National Cancer Action Team, UK), S. Davies (North Middlesex University Hospital NHS Trust, UK), S. Hood (lay representative), R. Mackay (Christie NHS Foundation Trust, representing the Institute of Physics in Engineering and Medicine [IPEM], UK), P. Mayles (Clatterbridge Centre for Oncology, representing the National Cancer Research Institute [NCRI], UK), A. Poynter (Ipswich Hospital NHS Trust, representing the Academic Clinical Oncology and Radiobiology Research Network [ACORRN], UK), P. Price (University of Manchester, ACORRN, UK), D. Routsis (Addenbrooke’s Hospital, SCoR, UK), J. Staffurth (Cardiff University, NCRI, UK), S. Thomas (Addenbrooke’s Hospital, IPEM, UK), M. Williams (Addenbrooke’s Hospital, RCR, UK).

Received 13 May 2009 ,Revised 3 March 2010 ,Accepted 23 June 2010.

References 

  1. Veldeman L, Madani I, Hulstaert F, De Meerleer G, Mareel M, De Neve W. Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies. Lancet Oncol. 2008;9(4):367–375
  2. National Radiotherapy Advisory Group . Radiotherapy: developing a world class service for England. Report to Ministers. Available at: http://www.cancer.nhs.uk/nrag.htm2007;
  3. Mayles P. Introduction to the special issue on the technology of radiotherapy. J Clin Oncol. 2010;22:621–622
  4. Whitton A, Warde P, Sharpe M, et al. Organisational standards for the delivery of intensity-modulated radiation therapy in Ontario. Clin Oncol (R Coll Radiol). 2009;21(3):192–203
  5. Cannon DM, Lee NY. Recurrence in region of spared parotid gland after definitive intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;70(3):660–665
  6. Hall EJ, Wuu CS. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys. 2003;56(1):83–88
  7. Ruben JD, Davis S, Evans C, et al. The effect of intensity-modulated radiotherapy on radiation-induced second malignancies. Int J Radiat Oncol Biol Phys. 2008;70(5):1530–1536
  8. Miles EA, Clark CH, Urbano MT, et al. The impact of introducing intensity modulated radiotherapy into routine clinical practice. Radiother Oncol. 2005;77(3):241–246
  9. Nutting C, A’Hern R, Rogers M, et al. First results of a phase III multicenter randomized controlled trial of intensity modulated (IMRT) versus conventional radiotherapy (RT) in head and neck cancer (PARSPORT: ISRCTN48243537; CRUK/03/005). J Clin Oncol. 2009;27(Suppl. 18):LBA006
  10. http://controlled-trials.com/mrct/
  11. International Atomic Energy Agency. Transition from 2-D radiotherapy to 3-D conformal and intensity modulated radiotherapy. IAEA Technical Document, 2008.
  12. Mayles WP, Yarnold JR, Webb S. Improved dose homogeneity in the breast using tissue compensators. Radiother Oncol. 1991;22(4):248–251
  13. Wilkinson JM, Lewis J, Lawrence GP, Lucraft H, Murphy E. Craniospinal irradiation using a forward planned segmented field technique. Br J Radiol. 2007;80:209–215
  14. Donovan EM, Johnson U, Shentall G, Evans PM, Neal AJ, Yarnold JR. Evaluation of compensation in breast radiotherapy: a planning study using multiple static fields. Int J Radiat Oncol Biol Phys. 2000;46(3):671–679
  15. MacDonald S, Bernard S, Balogh A, Spencer D, Sawchuk S. Electronic compensation using multileaf collimation for involved field radiation to the neck and mediastinum in non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. Med Dosim. 2005;30(2):59–64
  16. Lee N, Akazawa C, Akazawa P, et al. A forward-planned treatment technique using multisegments in the treatment of head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2004;59(2):584–594
  17. Poon I, Xia P, Weinberg V, et al. A treatment planning analysis of inverse-planned and forward-planned intensity-modulated radiation therapy in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2007;69(5):1625–1633
  18. Vaarkamp J, Adams EJ, Warrington AP, Dearnaley DP. A comparison of forward and inverse planned conformal, multi segment and intensity modulated radiotherapy for the treatment of prostate and pelvic nodes. Radiother Oncol. 2004;73(1):65–72
  19. Donovan E, Bleakley N, Denholm E, et al. Randomised trial of standard 2D radiotherapy (RT) versus intensity modulated radiotherapy (IMRT) in patients prescribed breast radiotherapy. Radiother Oncol. 2007;82(3):254–264
  20. Evans PM, Hansen VN, Mayles WP, Swindell W, Torr M, Yarnold JR. Design of compensators for breast radiotherapy using electronic portal imaging. Radiother Oncol. 1995;37(1):43–54
  21. Barnett G, Wilkinson J, Moody A, et al. A randomised controlled trial of forward-planned radiotherapy (IMRT) for early breast cancer: baseline characteristics and dosimetry results. Radiother Oncol. 2009;92(1):34–41
  22. Li Y, Taylor JM, Ten Haken RK, Eisbruch A. The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy. Int J Radiat Oncol Biol Phys. 2007;67(3):660–669
  23. Marmiroli L, Salvi G, Caiazza A, et al. Dose and volume impact on radiation-induced xerostomia. Rays. 2005;30(2):145–148
  24. Feng M, Jabbari S, Lin A, et al. Predictive factors of local-regional recurrences following parotid sparing intensity modulated or 3D conformal radiotherapy for head and neck cancer. Radiother Oncol. 2005;77(1):32–38
  25. Kam MK, Leung SF, Zee B, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol. 2007;25(31):4873–4879
  26. Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006;354:567–578
  27. Newbold K, Partridge M, Cook G, et al. Advanced imaging applied to radiotherapy planning in head and neck cancer: a clinical review. Br J Radiol. 2006;79:554–561
  28. Vanderstraeten B, Duthoy W, De Gersem W, De Neve W, Thierens H. [18F]fluoro-deoxy-glucose positron emission tomography ([18F]FDG-PET) voxel intensity-based intensity-modulated radiation therapy (IMRT) for head and neck cancer. Radiother Oncol. 2006;79:249–258
  29. Pow EH, Kwong DL, McMillan AS, et al. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys. 2006;66(4):981–991
  30. Laskar S, Bahl G, Muckaden M, et al. Nasopharyngeal carcinoma in children: comparison of conventional and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2008;72(3):728–736
  31. Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ. Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys. 2006;64(1):57–62
  32. Hsiung CY, Ting HM, Huang HY, Lee CH, Huang EY, Hsu HC. Parotid-sparing intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma: preserved parotid function after IMRT on quantitative salivary scintigraphy, and comparison with historical data after conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66(2):454–461
  33. Fang FM, Tsai WL, Chen HC, et al. Intensity-modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma: comparisons of four radiotherapy techniques. Cancer. 2007;109:313–321
  34. Fang FM, Chien CY, Tsai WL, et al. Quality of life and survival outcome for patients with nasopharyngeal carcinoma receiving three-dimensional conformal radiotherapy vs. intensity-modulated radiotherapy—a longitudinal study. Int J Radiat Oncol Biol Phys. 2008;72(2):356–364
  35. Braam PM, Terhaard CHJ, Roesink JM, Raaijmakers CPJ. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66(4):975–980
  36. Chao KS, Majhail N, Huang CJ, et al. Intensity-modulated radiation therapy reduces late salivary toxicity without compromising tumor control in patients with oropharyngeal carcinoma: a comparison with conventional techniques. Radiother Oncol. 2001;61(3):275–280
  37. Daly ME, Lieskovsky Y, Pawlicki T, et al. Evaluation of patterns of failure and subjective salivary function in patients treated with intensity modulated radiotherapy for head and neck squamous cell carcinoma. Head Neck. 2007;29:211–220
  38. Graff P, Lapeyre M, Desandes E, et al. Impact of intensity-modulated radiotherapy on health-related quality of life for head and neck cancer patients: matched-pair comparison with conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2007;67(5):1309–1317
  39. Jabbari S, Kim HM, Feng M, et al. Matched case-control study of quality of life and xerostomia after intensity-modulated radiotherapy or standard radiotherapy for head-and-neck cancer: initial report. Int J Radiat Oncol Biol Phys. 2005;63(3):725–731
  40. Lee NY, de Arruda FF, Puri DR, et al. A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006;66(4):966–974
  41. Münter MW, Hoffner S, Hof H, et al. Changes in salivary gland function after radiotherapy of head and neck tumors measured by quantitative pertechnetate scintigraphy: comparison of intensity-modulated radiotherapy and conventional radiation therapy with and without amifostine. Int J Radiat Oncol Biol Phys. 2007;67(3):651–659
  42. Pacholke HD, Amdur RJ, Morris CG, et al. Late xerostomia after intensity-modulated radiation therapy versus conventional radiotherapy. Am J Clin Oncol. 2005;28(1):351–358
  43. Rades D, Fehlauer F, Wroblesky J, Albers D, Schild SE, Schmidt R. Prognostic factors in head-and-neck cancer patients treated with surgery followed by intensity-modulated radiotherapy (IMRT), 3D-conformal radiotherapy, or conventional radiotherapy. Oral Oncol. 2007;43(6):535–543
  44. Rothschild S, Studer G, Seifert B, et al. PET/CT staging followed by intensity-modulated radiotherapy (IMRT) improves treatment outcome of locally advanced pharyngeal carcinoma: a matched-pair comparison. Radiat Oncol. 2007;2:22:
  45. Studer G, Zwahlen RA, Graetz KW, Davis BJ, Glanzmann C. IMRT in oral cavity cancer. Radiat Oncol. 2007;2:16:
  46. van Rij CM, Oughlane-Heemsbergen WD, Ackerstaff AH, Lamers EA, Balm AJ, Rasch CR. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life. Radiat Oncol. 2008;3:41
  47. Vergeer MR, Doornaert PA, Rietveld DH, Leemans CR, Slotman BJ, Langendijk JA. Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program. Int J Radiat Oncol Biol Phys. 2008;74(1):1–8
  48. Yao M, Karnell LH, Funk GF, Lu H, Dornfeld K, Buatti JM. Health-related quality-of-life outcomes following IMRT versus conventional radiotherapy for oropharyngeal squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2007;69(5):1354–1360
  49. Milano MT, Yokes EE, Kao J, et al. Intensity-modulated radiation therapy in advanced head and neck patients treated with intensive chemoradiotherapy: preliminary experience and future directions. Int J Oncol. 2006;28(5):1141–1151
  50. Duthoy W, Boterberg T, Claus F, et al. Postoperative intensity-modulated radiotherapy in sinonasal carcinoma: clinical results in 39 patients. Cancer. 2005;104(1):71–82
  51. Chen AM, Daly ME, Bucci MK, et al. Carcinomas of the paranasal sinuses and nasal cavity treated with radiotherapy at a single institution over five decades: are we making improvement?. Int J Radiat Oncol Biol Phys. 2007;69:141–147
  52. Hoppe BS, Stegman LD, Zelefsky MJ, et al. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting—the MSKCC experience. Int J Radiat Oncol Biol Phys. 2007;67:691–702
  53. Lee N, Chan K, Bekelman JE, et al. Salvage re-irradiation for recurrent head and neck cancer. Int J Radiat Oncol Biol Phys. 2007;68(3):731–740
  54. Madani I, Vakaet L, Bonte K, Boterberg T, De Neve W. Intensity-modulated radiotherapy for cervical lymph node metastases from unknown primary cancer. Int J Radiat Oncol Biol Phys. 2008;71(4):1158–1166
  55. National Collaborating Centre for Cancer . Prostate cancer: diagnosis and treatment. Cardiff: National Collaborating Centre for Cancer; 2008;
  56. Fiorino C, Valdagni R, Rancati T, Sanguineti G. Dose-volume effects for normal tissues in external radiotherapy: pelvis. Radiother Oncol. 2009;93(2):153–167
  57. Kuban DA, Tucker SL, Dong L, et al. Long-term results of the M.D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys. 2008;70(1):67–74
  58. Dearnaley DP, Sydes MR, Graham JD, et al. Escalated-dose versus standard-dose conformal radiotherapy in prostate cancer: first results from the MRC RT01 randomised controlled trial. Lancet Oncol. 2007;8(6):475–487
  59. Dearnaley DP, Hall E, Lawrence D, et al. Phase III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects. Br J Cancer. 2005;92(3):488–498
  60. Peeters ST, Heemsbergen WD, Koper PC, et al. Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68Gy of radiotherapy with 78Gy. J Clin Oncol. 2006;24(13):1990–1996
  61. 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(10):1233–1239
  62. Heemsbergen WD, Hoogeman MS, Witte MG, Peeters ST, Incrocci L, Lebesque JV. Increased risk of biochemical and clinical failure for prostate patients with a large rectum at radiotherapy planning: results from the Dutch trial of 68Gy versus 78Gy. Int J Radiat Oncol Biol Phys. 2007;67(5):1418–1424
  63. de Crevoisier R, Tucker SL, Dong L, et al. Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys. 2005;62(4):965–973
  64. Engels B, Soete G, Verellen D, Storme G. Conformal arc radiotherapy for prostate cancer: increased biochemical failure in patients with distended rectum on the planning computed tomogram despite image guidance by implanted markers. Int J Radiat Oncol Biol Phys. 2009;74(2):383–391
  65. Khoo VS, Dearnaley DP. Question of dose, fractionation and technique: ingredients for testing hypofractionation in prostate cancer—the CHHiP trial. Clin Oncol (R Coll Radiol). 2008;20(1):12–14
  66. De Meerleer GO, Vakaet LA, De Gersem WR, De Wagter C, De Naeyer B, De Neve W. Radiotherapy of prostate cancer with or without intensity modulated beams: a planning comparison. Int J Radiat Oncol Biol Phys. 2000;47(3):639–648
  67. Nutting CM, Convery DJ, Cosgrove VP, et al. Reduction of small and large bowel irradiation using an optimized intensity-modulated pelvic radiotherapy technique in patients with prostate cancer. Int J Radiat Oncol Biol Phys. 2000;48(3):649–656
  68. Luxton G, Hancock SL, Boyer AL. Dosimetry and radiobiologic model comparison of IMRT and 3D conformal radiotherapy in treatment of carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 2004;59(1):267–284
  69. Ashman JB, Zelefsky MJ, Hunt MS, Leibel SA, Fuks Z. Whole pelvic radiotherapy for prostate cancer using 3D conformal and intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2005;63(3):765–771
  70. Kao J, Turian J, Meyers A, et al. Sparing of the penile bulb and proximal penile structures with intensity-modulated radiation therapy for prostate cancer. Br J Radiol. 2004;77:129–136
  71. Zelefsky MJ, Fuks Z, Happersett L, et al. Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiother Oncol. 2000;55(3):241–249
  72. Guerrero Urbano M, Norman A, Adams A, et al. A phase 1 dose escalation study of intensity modulated radiotherapy (IMRT) to treat the prostate and pelvic nodes in patients with locally advanced prostate cancer. Proc Multidisciplinary Prostate Cancer Symposium 2005;1:123.
  73. Cozzarini C, Fiorino C, Di Muzio N, et al. Significant reduction of acute toxicity following pelvic irradiation with helical tomotherapy in patients with localized prostate cancer. Radiother Oncol. 2007;84(2):164–170
  74. Lawton CA, Michalski J, El-Naqa I, et al. RTOG GU radiation oncology specialists reach consensus on pelvic lymph node volumes for high-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2008;74(2):383–387
  75. Vora SA, Wong WW, Schild SE, Ezzell GA, Halyard MY. Analysis of biochemical control and prognostic factors in patients treated with either low-dose three-dimensional conformal radiation therapy or high-dose intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2007;68(4):1053–1058
  76. Kupelian PAR, Reddy CA, Carlson TP, Altsman KA, Willoughby TR. Preliminary observations on biochemical relapse-free survival rates after short-course intensity-modulated radiotherapy (70Gy at 2.5Gy/fraction) for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2002;53:904–912
  77. Zelefsky MJ, Fuks Z, Hunt M, et al. High dose radiation delivered by intensity modulated conformal radiotherapy improves the outcome of localized prostate cancer. J Urol. 2001;166(3):876–881
  78. Morgan P, Ruth K, Horwitz E, Buyyounouski M, Uzzo R, Pollack A. A matched pair comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy for prostate cancer: toxicity and outcomes. Int J Radiat Oncol Biol Phys. 2007;69(3):S319
  79. Al-Mamgani A, Heemsbergen WD, Peeters ST, Lebesque JV. Role of intensity-modulated radiotherapy in reducing toxicity in dose escalation for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2009;73(3):685–691
  80. Sanguineti G, Cavey ML, Endres EJ, et al. Does treatment of the pelvic nodes with IMRT increase late rectal toxicity over conformal prostate-only radiotherapy to 76Gy?. Strahlenther Onkol. 2006;182(9):543–549
  81. Zelefsky MJ, Levin EJ, Hunt M, et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2008;80:1124–1129
  82. Kirichenko A, Ruth K, Horwitz E, et al. Intensity modulated radiation therapy for prostate cancer: preliminary results on treatment morbidity compared to 3-D conformal radiation therapy. Int J Radiat Oncol Biol Phys. 2006;66(3):S326
  83. Sharma NK, Li T, Horwitz EM, Pollack A, Buyyounouski MK. Intensity modulated radiation therapy reduces gastrointestinal morbidity in patients treated with androgen deprivation therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2007;69(3):S10
  84. Martinez A, Yan D, Brabbins D, et al. Acute and chronic toxicity of adaptive image guided radiation therapy (A-IGRT) delivered with 3D-conformal technique (3D-CRT) vs. intensity modulation (IMRT) in 728 prostate cancer patients. Int J Radiat Oncol Biol Phys. 2007;69(3):S317
  85. Jani AB, Su A, Correa D, Gratzle J. Comparison of late gastrointestinal and genitourinary toxicity of prostate cancer patients undergoing intensity-modulated versus conventional radiotherapy using localized fields. Prostate Cancer Prostatic Dis. 2007;10(1):82–86
  86. Shu HK, Lee TT, Vigneauly E, et al. Toxicity following high-dose three-dimensional conformal and intensity-modulated radiation therapy for clinically localized prostate cancer. Urology. 2001;57(1):102–107
  87. Boehmer D, Herschel R, Badakhshi H, Eichwurzel I, Wernecke K, Budach V. Matched pair analysis of patients with prostate cancer treated with IMRT or 3-D conformal radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66(3):S394
  88. Su AW, Jani AB. Chronic genitourinary and gastrointestinal toxicity of prostate cancer patients undergoing pelvic radiotherapy with intensity-modulated versus 4-field technique. Am J Clin Oncol. 2007;30(3):215–219
  89. Namiki S, Ishidoya S, Tochigi T, et al. Health-related quality of life after intensity modulated radiation therapy for localized prostate cancer: comparison with conventional and conformal radiotherapy. Jpn J Clin Oncol. 2006;36(4):224–230
  90. Lips I, Dehnad H, Kruger AB, et al. Health-related quality of life in patients with locally advanced prostate cancer after 76Gy intensity-modulated radiotherapy vs 70Gy conformal radiotherapy in a prospective and longitudinal study. Int J Radiat Oncol Biol Phys. 2007;69:656–661
  91. Yoshimura K, Kamoto T, Nakamura E, et al. Health-related quality-of-life after external beam radiation therapy for localized prostate cancer: intensity-modulated radiation therapy versus conformal radiation therapy. Prostate Cancer Prostatic Dis. 2006;10:288–292
  92. Zelefsky MJ, Yamada Y, Hunt M, Cohen GN, Shippy AM, Zaider M. Comparison of 7-year outcomes between LDR brachytherapy and high dose IMRT for patients with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys. 2007;69(3):S178
  93. Eade TN, Horwitz EM, Ruth K, et al. A comparison of acute and chronic toxicity for men with low-risk prostate cancer treated with intensity-modulated radiation therapy or 125I permanent implant.. Int J Radiat Oncol Biol Phys. 2008;71(2):338–345
  94. Deutsch I, Zelefsky MJ, Cahlon O, et al. Comparison of PSA relapse free survival in patients treated with ultra-high dose IMRT versus combination HDR brachytherapy and IMRT. Int J Radiat Oncol Biol Phys. 2008;69(3):S135
  95. Su AW, Milano MT, Jani AB. IMRT versus conventional whole pelvis radiotherapy for prostate cancer: planning comparison and analysis of acute toxicity. Int J Radiat Oncol Biol Phys. 2005;63(2):S312
  96. Jani AB, Su A, Milano MT. Intensity-modulated versus conventional pelvic radiotherapy for prostate cancer: analysis of acute toxicity. Urology. 2006;67(1):147–151
  97. Jani AB, Gratzle J, Correa D. Influence of intensity-modulated radiotherapy on acute genitourinary and gastrointestinal toxicity in the treatment of localized prostate cancer. Technol Cancer Res Treat. 2007;6(1):11–15
  98. Alongi F, Fiorino C, Cozzarini C, et al. IMRT significantly reduces acute toxicity of whole-pelvis irradiation in patients treated with post-operative adjuvant or salvage radiotherapy after radical prostatectomy. Radiother Oncol. 2009;93:207–212
  99. Pignol JP, Olivotto I, Rakovitch E, et al. A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis. J Clin Oncol. 2008;26(13):2085–2092
  100. Freedman G, Anderson PR, Li J, et al. Intensity modulated radiation therapy (IMRT) decreases acute skin toxicity for women receiving radiation for breast cancer. Am J Clin Oncol. 2006;29(1):66–70
  101. Harsolia A, Kestin L, Grills I, et al. Intensity-modulated radiotherapy results in significant decrease in clinical toxicities compared with conventional wedge-based breast radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(5):1375–1380
  102. McDonald MW, Godette KD, Butker EK, Davis LW, Johnstone PA. Long-term outcomes of IMRT for breast cancer: a single-institution cohort analysis. Int J Radiat Oncol Biol Phys. 2008;72(4):1031–1040
  103. Morganti AG, Cilla S, Valentini V, et al. Phase I–II studies on accelerated IMRT in breast carcinoma: technical comparison and acute toxicity in 332 patients. Radiother Oncol. 2009;90(1):86–92
  104. Blake P, Swart AM, Orton J, et al. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis. Lancet. 2009;373(9658):137–146
  105. Roeske JC, Lujan A, Rotmensch J, Waggoner SE, Yamada D, Mundt AJ. Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2000;48(5):1613–1621
  106. Lujan AE, Mundt AJ, Yamada SD, Rotmensch J, Roeske JC. Intensity-modulated radiotherapy as a means of reducing dose to bone marrow in gynecologic patients receiving whole pelvic radiotherapy. Int J Radiat Oncol Biol Phys. 2003;57(2):516–521
  107. Esthappan J, Chaudhari S, Santanam L, et al. Prospective clinical trial of positron emission tomography/computed tomography image-guided intensity-modulated radiation therapy for cervical carcinoma with positive para-aortic lymph nodes. Int J Radiat Oncol Biol Phys. 2008;72(4):1134–1139
  108. Small W, Mell LK, Anderson P, et al. Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy in postoperative treatment of endometrial and cervical cancer. Int J Radiat Oncol Biol Phys. 2008;71(2):428–434
  109. Taylor A, Rockall AG, Reznek RH, Powell ME. Mapping pelvic lymph nodes: guidelines for delineation in intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2005;63(5):1604–1612
  110. Mundt AJ, Roeske JC, Lujan AE, et al. Initial clinical experience with intensity-modulated whole-pelvis radiation therapy in women with gynecologic malignancies. Gynecol Oncol. 2001;82(3):456–463
  111. Brixey CJ, Roeske JC, Lujan AE, Yamada SD, Rotmensch J, Mundt AJ. Impact of intensity-modulated radiotherapy on acute hematologic toxicity in women with gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2002;54(5):1388–1396
  112. Mundt AJ, Mell LK, Roeske JC. Preliminary analysis of chronic gastrointestinal toxicity in gynecology patients treated with intensity-modulated whole pelvic radiation therapy. Int J Radiat Oncol Biol Phys. 2003;56(5):1354–1360
  113. Chen MF, Tseng CJ, Tseng CC, Kuo YC, Yu CY, Chen WC. Clinical outcome in posthysterectomy cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy: comparison with conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2007;67(5):1438–1444
  114. Bjork-Eriksson T, Glimelius B. The potential of proton beam therapy in paediatric cancer. Acta Oncol. 2005;44(8):871–875
  115. Fuller CD, Choi M, Forthuber B, et al. Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme. Radiat Oncol. 2007;2:26
  116. Iuchi T, Hatano K, Narita Y, Kodama T, Yamaki T, Osato K. Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT. Int J Radiat Oncol Biol Phys. 2006;64(5):1317–1324
  117. Huang E, Teh BS, Strother DR, et al. Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity. Int J Radiat Oncol Biol Phys. 2002;52(3):599–605
  118. Mell LK, Schomas DA, Salama JK, et al. Association between bone marrow dosimetric parameters and acute hematologic toxicity in anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70(5):1431–1437
  119. Saarilahti K, Arponen P, Vaalavirta L, Tenhunen M. The effect of intensity-modulated radiotherapy and high dose rate brachytherapy on acute and late radiotherapy-related adverse events following chemoradiotherapy of anal cancer. Radiother Oncol. 2008;87(3):383–390
  120. Myerson RJ, Garofalo MC, Naqa IE, et al. Elective clinical target volumes for conformal therapy in anorectal cancer: a Radiation Therapy Oncology Group Consensus Panel contouring atlas. Int J Radiat Oncol Biol Phys. 2008;72(1):S71
  121. Graham MV, Purdy JA, Emami B, et al. Clinical dose–volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 1999;45(2):323–329
  122. Yom SS, Liao Z, Liu HH, et al. Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(1):94–102
  123. Nutting CM. Preliminary results from clinical trials. Radiother Oncol. 2008;88(S2):S174
  124. Schoenfeld GO, Amdur RJ, Morris CG, Li JG, Hinerman RW, Mendenhall WM. Patterns of failure and toxicity after intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;71(2):377–385
  125. Eisbruch A, Marsh LH, Dawson LA, et al. Recurrences near base of skull after IMRT for head-and-neck cancer: implications for target delineation in high neck and for parotid gland sparing. Int J Radiat Oncol Biol Phys. 2004;59(1):28–42
  126. David MB, Eisbruch A. Delineating neck targets for intensity-modulated radiation therapy of head and neck cancer. What we learned from marginal recurrences?. Front Radiat Ther Oncol. 2007;40:193–207
  127. Sanguineti G, Gunn GB, Endres EJ, Chaljub G, Cheruvu P, Parker B. Patterns of locoregional failure after exclusive IMRT for oropharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2008;72(3):737–746
  128. Yao M, Chang K, Funk GF, et al. The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy—the University of Iowa experience. Int J Radiat Oncol Biol Phys. 2007;67(5):1332–1341
  129. Viani GA, Stefano EJ, Afonso SL. Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials. Int J Radiat Oncol Biol Phys. 2009;74(5):1405–1418
  130. Dearnaley D, Sumo G, Syndikus I, et al. Initial toxicity results of the phase III Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer (CHHiP) trial (ISRCTN97182923). Genitourinary ASCO Proceedings. 2009;(abstract 303)
  131. Brabbins DS, Kestin L, Yan D, et al. Improvement in clinical outcomes with prostate radiotherapy at a single institution in the PSA era. Int J Radiat Oncol Biol Phys. 2008;72(1):S318
  132. Rawlins M. De Testimonio: on the evidence for decisions about the use of therapeutic interventions. Clin Med. 2008;8(6):579–588
  133. Mayles WPM. Survey of the availability and use of advanced radiotherapy technology in the UK. Clin Oncol 2010;22:639–642.
  134. Williams MV, Cooper T, Mackay R, Staffurth J, Routsis D, Bornet N. The implementation of intensity-modulated radiotherapy in the UK. Clin Oncol 2010;22:623–628.
  135. Maughan TS, Illidge TM, Hoskin P, et al. Radiotherapy research priorities for the UK. Clin Oncol 2010;22:707–709.
  136. http://rttrialsqa.dnsalias.org

PII: S0936-6555(10)00221-9

doi: 10.1016/j.clon.2010.06.013

Clinical Oncology
Volume 22, Issue 8 , Pages 643-657 , October 2010

Article Tools