IMRT - External Beam Radiation Therapy
The goal of radiation therapy is to get a high enough dose of radiation into
the body to kill the cancer cells while sparing the surrounding healthy tissue
from damage. Several different radiation therapy techniques have been developed
to accomplish this. Depending on the location, size and type of your tumor or
tumors, you may receive one or a combination of these techniques. Your cancer
treatment team will work with you to determine which treatment and how much
radiation is best for you.
During
external beam radiation therapy, a beam of radiation is directed through the
skin to a tumor and the immediate surrounding area in order to destroy the main
tumor and any nearby cancer cells. To minimize side effects, the treatments
are typically given every day for a number of weeks.
The radiation beam comes from a machine located outside of your body that does
not touch your skin or the tumor. Receiving external beam radiation is similar
to having an X-ray taken. It is a painless, bloodless procedure. The most common
type of machine used to deliver external beam radiation therapy is called a
linear accelerator, sometimes called a "linac." It produces a beam
of high-energy X-rays or electrons. Using sophisticated treatment planning software,
your radiation oncology treatment team plans the size and shape of the beam,
as well as how it is directed at your body, to effectively treat your tumor
while sparing the normal tissue surrounding the cancer cells.
Several special types of external beam therapy are discussed below. These are
used for particular types of cancer, and your radiation oncologist will recommend
one of these treatments if he or she believes it will help you.
Three-Dimensional Conformal Radiation Therapy (3D-CRT)
Tumors usually have an irregular shape. Three-dimensional conformal radiation
therapy (3D-CRT) uses sophisticated computers and computer assisted tomography
scans (CT or CAT scans) and/or magnetic resonance imaging scans (MR or MRI scans)
to create detailed, three-dimensional representations of the tumor and surrounding
organs. Your radiation oncologist can then shape the radiation beams exactly
to the size and shape of your tumor. The tools used to shape the radiation beams
are multileaf collimators or blocks. Because the radiation beams are very precisely
directed, nearby normal tissue receives less radiation exposure.
Intensity Modulated Radiation Therapy (IMRT)
Intensity modulated radiation therapy (IMRT) is a specialized form of 3D-CRT
that allows radiation to be more exactly shaped to fit your tumor. With IMRT,
the radiation beam can be broken up into many "beamlets," and the
intensity of each beamlet can be adjusted individually. Using IMRT, it may be
possible to further limit the exact amount of radiation that is received by
normal tissues that are near the tumor. In some situations, this may also allow
a higher dose of radiation to be delivered to the tumor, increasing the chance
of a cure.
Stereotactic Radiotherapy
Stereotactic radiotherapy is a technique that allows your
radiation oncologist to precisely focus beams of radiation to destroy certain
types of tumors. Since the beam is so precise, your radiation oncologist may be
able to spare more normal tissue than with conventional external beam therapy.
This additional precision is achieved through rigid immobilization, such as with
a head frame as is used in the treatment of brain tumors. Although often performed in a single treatment, fractionated radiotherapy, where patients receive
up to five treatments, is sometimes necessary. Stereotactic radiotherapy may be the only
treatment if a very small area is affected. In addition to
treating tumors, it can also be used to treat malformations in the brain's blood vessels
and certain noncancerous (benign) brain tumors.
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