icru-83-2010-调强.doc

JournaloftheICRUVol10No1(2010)Report83 OxfordUniversityPress doi:10.1093/jicru/ndq002 Prescribing,Recording,andReportingPhoton-Beam Intensity-ModulatedRadiationTherapy(IMRT) Contents Preface............................................................................ Abstract........................................................................... ExecutiveSummary ................................................................ 1 3 5 7 7 1 Introduction .................................................................... 1.1 OverviewofIntensity-ModulatedRadiationTherapy(IMRT)..................... 1.1.1 FromThree-DimensionalConformal(3D-CRT)toIntensity-ModulatedRadiation Therapy............................................................................. DeliveryofIMRT...................................................... ClinicalExperiencewithIMRT ......................................... 8 8 9 1.1.2 1.1.3 1.2 1.3 IssuesCommontoBoth3D-CRTandIMRT..................................... 11 11 13 14 15 1.2.1 1.2.2 1.2.3 Imagingand4DAdaptiveTreatment .................................... MarginsandUncertainties............................................. Radiation-InducedSecondaryCancers .................................. AimofthePresentReportandRelationtoExistingICRUReports ................ 2 OptimizedTreatmentPlanningForIMRT........................................... 17 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Introduction ............................................................... Comparisonof3D-ConformalandIMRTTreatmentPlanning..................... OverviewoftheOptimizationProcess......................................... ExamplesofanObjectiveFunctionandtheIterativeOptimizationProcess ........ IterativeSearchforanImprovedAbsorbed-DoseDistribution.................... BeamletOptimizationandAperture-BasedOptimization ........................ OptimizationIncorporatingBiologicalInformation............................. 17 17 18 20 22 24 25 3 SpecialConsiderationsRegardi