A shift from simple to sophisticated: using intensity-modulated radiation therapy in conventional nonstereotactic palliative radiotherapy.
Journal
Current opinion in supportive and palliative care
ISSN: 1751-4266
Titre abrégé: Curr Opin Support Palliat Care
Pays: United States
ID NLM: 101297402
Informations de publication
Date de publication:
01 03 2023
01 03 2023
Historique:
entrez:
25
1
2023
pubmed:
26
1
2023
medline:
28
1
2023
Statut:
ppublish
Résumé
The authors aimed to highlight trends in, and evidence underlying the use of highly conformal radiotherapy (RT) techniques in conventional nonstereotactic palliative RT. The authors reviewed palliative-intent and curative-intent studies relevant to the use of intensity-modulated radiation therapy (IMRT) for the delivery of nonstereotactic conventional regimens to the brain, head and neck, thorax, abdomen and pelvis, and bone metastases. The use of IMRT has become standard with certain indications for brain metastases such as hippocampus-avoiding/limiting whole brain RT. IMRT in the treatment of bone metastases is increasing at many institutions despite limited data comparing its effectiveness with that of fluoroscopy-based and three-dimensional conformal radiation therapy techniques. There is scant data describing the use of IMRT for palliation in other extracranial anatomic sites; guidance for its use in these settings must be gleaned almost exclusively from curative-intent randomized trials, consensus recommendations and contouring atlases. Consistent with historical technology shifts in RT practice, the uptake of highly conformal techniques such as IMRT for conventional palliative RT will likely outpace rigorous evaluations of their advantages and disadvantages relative to simpler techniques. Opportunities exist in virtually all anatomic sites for observational and randomized studies to evaluate the clinical impacts of these modern techniques in the palliative setting.
Identifiants
pubmed: 36695868
doi: 10.1097/SPC.0000000000000639
pii: 01263393-202303000-00011
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-76Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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