The Role of Three-Dimensional Conformal Radiotherapy in the Treatment of Mediastinal Tumors
Although considerable clinical experience has been accumulated in applying three-dimensional (3-D) technology to the treatment of prostatic carcinoma, the potential value of this technology in the management of thoracic neoplasms has only recently been recognized [1–10]. A variety of factors have contributed to this “lag” in the routine use of 3-D based technology for the management of thoracic neoplasms. First, the routine implementation of 3-D conformal radiotherapy (3-DCRT) has been hampered by the lack of widespread availability of FDA-approved 3-D software. The labor-intensive nature of 3-DCRT and the failure of many radiation oncologists to recognize the shortcomings of standard treatment techniques have also contributed to the slow diffusion of 3-D technology. Most investigators who have access to 3-D based treatment planning are convinced that the potential benefits associated with its routine use will ultimately result in its widespread adoption. To test the hypothesis that this technology will result in improved local control and possibly survival, phase I/II dose escalation studies sponsored by the Radiation Therapy Oncology Group (RTOG) are underway. In this review we discuss how this “tool” may allow us to improve the treatment of mediastinal tumors.
KeywordsRadiation Therapy Oncology Group Mediastinal Tumor Thoracic Irradiation Oblique Beam Inferior Oblique
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