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CA Cancer J Clin 2005; 55:117-134
doi: 10.3322/canjclin.55.2.117
© 2005 American Cancer Society
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 QUIZ 2 WORKSHEET: Advances in Radiation Therapy
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Advances in Radiation Therapy: Conventional to 3D, to IMRT, to 4D, and Beyond

M. Kara Bucci, MD, Alison Bevan, MD, PhD and Mack Roach, III, MD


Dr. Bucci is Clinical Instructor, Department of Radiation Oncology, University of California, San Francisco, CA.
Dr. Bevan is Clinical Instructor, Department of Radiation Oncology, University of California, San Francisco, CA.
Dr. Roach is Professor, Departments of Radiation Oncology, Medical Oncology, and Urology, University of California, San Francisco, CA.

Modern advances in computers have fueled parallel advances in imaging technologies. The improvements in imaging have in turn allowed a higher level of complexity to be incorporated into radiotherapy treatment planning systems. As a result of these changes, the delivery of radiotherapy evolved from therapy designed based primarily on plain (two dimensional) x-ray images and hand calculations to three-dimensional x-ray based images incorporating increasingly complex computer algorithms. More recently, biologic variables based on differences between tumor metabolism, tumor antigens, and normal tissues have been incorporated into the treatment process. In addition, greater awareness of the challenges to the accuracy of the treatment planning process, such as problems with set-error and organ movement, have begun to be systematically addressed, ushering in an era of so-called Four-Dimensional Radiotherapy. This review article discusses how these advances have changed the way the most common neoplasms are treated now and will be treated in the near future.




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