Abstract
Radiotherapy is a cornerstone of the modern treatment of many types of cancer, having both curative and palliative roles. It is estimated that more than half of cancer patients will need radiation therapy in the course of evolution. The goal of radiotherapy is to maximize tumor control, reducing adverse effects on normal tissues in close proximity at the same time. Improving the therapeutic ratio is the main goal of the efforts made to improve the technique and accuracy of the radiotherapy by using the targeting of the tumor volume with the help of the imaging guide and the dose conformation around the target volume. The use of the multi-leaf collimator (MLC) allowed a better coverage of the target volume in the irradiation field, thus reducing the unnecessary irradiation of healthy tissues. The use of radioprotective agents and radiosensitizers is another strategy to maximize the effect of radiotherapy. Recently, interest has focused on the design of irradiation protocols that exploit the differences in biology in terms of the response to irradiation between tumor cells and normal tissues.
Highlights
The transition in the 1990s from conformal 3D radiotherapy to intensity-modulated intensity radiotherapy (IMRT) allowed the high-dose irradiation of volumes with irregular shapes [1, 2]
Interest has focused on the design of irradiation protocols that exploit the differences in biology in terms of the response to irradiation between tumor cells and normal tissues [2, 3]
It is assumed that the use of IGRT can lead to an improvement in tumor control probability (TCP) by increasing the planning target volumes (PTV) dose coverage in daily treatment while decreasing normal tissue complication probability (NTCP) by using low uncertainty CTV-PTV margins in the case of prostate cancer radiotherapy, demonstrating the ability to improve therapeutic for both IMRT and 3D-CRT plans
Summary
The transition in the 1990s from conformal 3D radiotherapy to intensity-modulated intensity radiotherapy (IMRT) allowed the high-dose irradiation of volumes with irregular shapes [1, 2]. The complexity and the large number of factors that influence the response to the irradiation of the tumors and the probability of the complications of the normal tissues have made it necessary to develop predictive models for the clinical complications associated with the radiation therapy.
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