2009 Advances in Technology: Practical Aspects on IMRT and Proton Therapy Symposium

Intensity modulated radiation therapy represents high-precision radiation therapy and requires a knowledge of multimodality imaging, set-up uncertainties and internal organ motion, tumor control probabilities, normal tissue complication probabilities, three-dimensional dose calculation and optimization, and dynamic beam delivery of nonuniform beam intensities. This process of planning and treatment delivery shows significant potential for further improving the therapeutic ratio and reducing toxicity. There is a great push to make this technology available for all cancer patients, but it does not come without a price and a risk. The price lies in the fact that IMRT utilizes expensive hardware, complex and voluminous multimodality imaging and planning data, and significant personnel resources. The risk lies in the fact that complex radiation therapy techniques can be misunderstood and misapplied, possibly resulting in excess tumor recurrences or excess complications that will negate the potential benefits of these technologies. Therefore, the task of safely and precisely implementing IMRT in radiation therapy clinics will require innovative and efficient methodologies of quality assurance and image guidance. The IMRT team includes radiation oncologists, physicists, radiation therapists, medical dosimetrists and nurses to effectively and safely administer IMRT treatment. Most IMRT planning and delivery systems are essentially first generation systems and are changing rapidly. These rapid changes require continued learning for members of the IMRT treatment delivery team. A professional faculty of radiation oncologists and physicists will aid both experienced radiation oncologists and newcomers to the field in understanding the nuances of IMRT and its safe implementation in the clinic setting.

Program Objectives

• Apply the most recent IMRT techniques of radiation therapy to improve outcomes for cancer patients.
• Identify appropriate target volumes and learn strategies for target volume and organ-at-risk expansion to account for geometric variations, organ motion and other uncertainties.
• Explain the clinical implication and potential pitfalls of IMRT.
• Acquire the practical information on execution of these optimal plans, their verification and quality assurance.
• Discuss different proton delivery systems.
• Summarize the intricacies of proton treatment planning and uncertainties.
• Discuss proton application to specific clinical sites including pediatric, skull base, thoracic and prostate cancers.