Journal of Medical Physics
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Year : 1990  |  Volume : 15  |  Issue : 3  |  Page : 190-199

Conformal Treatment Planning


Correspondence Address:
Daniel.L McSahan


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Source of Support: None, Conflict of Interest: None


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The goal of conformal radiation therapy treatment planning is to three dimensionally shape the high dose region to the target anatomy and to minimize the dose to surrounding normal tissue. Conformal treatment design can result in treatments which either 1) significantly reduce complications to normal tissue or 2) increase the probability of tumour control by allowing delivery of higher levels of dose to the tumor without significant increase in normal tissue complications. Conformal treatment planning requires accurate volumetric tumor and normal tissue localization, flexible computerized treatment planning tools for design and evaluation, and ultimately, verifiable setup and treatment delivery. Based on conformal treatment designs, clinical dose escalation studies have been undertaken in the brain, the prostate and the liver. Many other sites have also been treated with conformal treatment design using conventional dose regimes. Treatment to each of these sites currently involves 1) tumor localization through complete CT volume studies and, in the brain, MRI studies, 2) the design and use of multiple fixed (often non-coplanar) fields with focused blocks, 3) the use of Beam's Eye View for block design, and 4) dose volume histograms and three- dimensional displays to assist in treatment plan selection. This paper demonstrates the type of conformal treatment planning which has been achieved clinically for these sites. In addition, new treatment planning tools are described which have been developed explicitly for design of multi-segmental static and dynamic beam delivery using the new generation of computer controlled treatment machines. The author had submitted colour pictures. However, due to the high cost of colour printing, the colour codes have been converted to letter codes. It is hoped that this has not lead to any unacceptable loss in clarity - Editor.


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