Dose Escalation in Large Anterior Skull-Base Tumors by Means of IMRT

Abstract

SIMRT enables dose escalation to tumors located close to critical organs. Inverse planning for micro-multileaf collimator stereotactic irradiation is practicable in the daily routine irradiation program. SIMRT needs special verification and still, the following parameters have to be standardized: IMRT dose specification, dose maxima, length of radiation delivery time.

Precision of Image-Guided Radiotherapy (IGRT) in Six Degrees of Freedom and Limitations in Clinical Practice

“…In extracranial treatment this accuracy may be beneficial in SBRT [2,13] and intensity-modulated radiotherapy (IMRT) [6] with steep dose gradients between target volume and adjacent organs at risk. Dose-escalated IMRT treatment of paraspinal tumors or reirradiation of spinal metastases has been described with daily imaging and online correction of patient positioning errors [9,24,29].…”

Linearity of the Dose Monitor System at Low Monitor Units

“…Recent developments in accelerator design and computer technology combined with refinements in imaging of tumors have led to the widespread clinical implementation of conformal radiotherapy (CRT). The latest development of this approach has been the intensity-modulated radiotherapy (IMRT) [3,9,19,21,23].…”

Review of photon and proton radiotherapy for skull base tumours

“…14,105 The ability of IMRT to achieve excellent dose distribution for the most complex targets allows moderate dose escalation to the tumour while respecting dose constraints. [106][107][108] Proton radiotherapy results in an even better capability to cover the target while sparing surrounding critical structures, especially in the case of tumours with challenging "L" and "C" shapes, compared to photon IMRT and SRT. Any radiation technique needs to be combined with an optimal surgical resection aiming at tumour debulking to reduce as much of the tumour volume as possible and at achieving the best geometrical configuration to facilitate the adequate target coverage.…”