Radioterapia de intensidade modulada do feixe (IMRT) - ilustração da técnica, suas indicações e vantagens
DOI:
https://doi.org/10.34631/sporl.236Palavras-chave:
Radioterapia de intensidade modulada, vantagensResumo
A Radioterapia de Intensidade Modulada, conhecida pela sigla IMRT, é um estado-da-arte no tratamento do cancro. É um método que permite debitar altas doses de radiação directamente ao volume-alvo tumoral, de uma forma extremamente orientada e muito mais precisa do que é possível com radioterapia convencional. Com esta técnica é possível efectuar doses de radiação superiores às estruturas tumorais e conseguir poupar mais e melhor as estruturas normais circundantes, muitas vezes limitantes de dose. Apesar de apresentar inúmeras indicações, esta técnica adquire particular vantagem nos tumores da cabeça e pescoço, quer a nível de efeitos secundários agudos, quer tardios
O objectivo deste artigo é descrever a técnica de IMRT, a sua aplicação clínica e os seus potenciais benefícios, quando comparada à Radioterapia convencional.
Referências
APISARNTHANARAX S, ELLIOTT DD, EL-NAGGAR AK ET AL. DETERMINING OPTIMAL CLINICAL TARGET VOLUME MARGINS IN HEAD-AND-NECK CANCER BASED ON MICROSCOPIC EXTRACAPSULAR EXTENSION OF METASTATIC NECK NODES. INT J RADIAT ONCOL BIOL PHYS, 2006; 64: 678-683
BLANCO AI, CHAO KSC. INTENSITY-MODULATED RADIATION THERAPY AND PROTECTION OF NORMAL TISSUE FUNCTION IN HEAD AND NECK CANCER. IN PRINCIPLES AND PRACTICE OF RADIATION ONCOLOGY: UPDATES. NEW YORK: LIPPINCOTT WILLIAMS & WILKINS HEALTHCARE, 2002;3
CHAO KS, LOW DA, PEREZ CA, PURDY JA. INTENSITY-MODULATED RADIATION THERAPY IN HEAD AND NECK CANCERS. THE MALLINCKRODT EXPERIENCE. INT J CANCER, 2001; 90: 92-103
CHAO KS, DEASY JO, MARKMAN J, HAYNIE J ET AL. A PROSPECTIVE STUDY OF SALIVARY FUNCTION SPARING IN PATIENTS WITH HEAD-AND-NECK CANCERS RECEIVING INTENSITY-MODULATED OR THREE-DIMENSIONAL RADIATION THERAPY. INITIAL RESULTS. INT J RADIAT ONCOL BIOL PHYS, 2001; 49: 907-916
CHAO KS, WIPPOLD FJ, OZYGIT G, TRAN BN ET AL. DETERMINATION AND DELINEATION OF NODAL TARGET VOLUMES FOR HEAD-AND-NECK CANCER BASED ON PATTERNS OF FAILURE IN PATIENTS RECEIVING DEFINITIVE AND POSTOPERATIVE IMRT. INT J RADIAT ONCOL BIOL PHYS, 2002; 53(5): 1174-1184
CHAO KS, OZYIGIT G, TRAN BN ET AL. PATTERNS OF FAILURE IN PATIENTS RECEIVING DEFINITIVE AND POSTOPERATIVE IMRT FOR HEAD-AND-NECK CANCER. INT J RADIAT ONCOL BIOL PHYS, 2003; 55: 312-321
EISBRUCH A, KIM HM, TERRELL JE, MARSH LH ET AL. XEROSTOMIA AND ITS PREDICTORS FOLLOWING PAROTID-SPARING IRRADIATION OF HEAD- AND-NECK CANCER. INT J RADIAT ONCOL BIOL PHYS, 2001; 50: 695-704
EISBRUCH A, MARSH LH, DAWSON LA ET AL. RECURRENCES NEAR BASE OF SKULL AFTER IMRT FOR HEAD-AND-NECK CANCER: IMPLICATIONS FOR TARGET DELINEATION IN HIGH NECK AND FOR PAROTID GLAND SPARING. INT J RADIAT ONCOL BIOL PHYS, 2004; 59: 28-42
FRANK SJ, CHAO KS, SCHWARTZ DL ET AL. TECHNOLOGY INSIGHT: PET AND PET/CT IN HEAD AND NECK TUMOR STAGING AND RADIATION THERAPY PLANNING. NAT CLIN PRACT ONCOL, 2005; 2: 526-533
GRÉGOIRE V, DE NEVE W, EISBRUCH A, LEE N ET AL. INTENSITY-MO- DULATED RADIATION THERAPY FOR HEAD AND NECK CARCINOMA. THE ONCOLOGIST, 2007; 12: 555-564
HUNT MA, ZELEFSKY MJ, WOLDEN S, CHUI CS ET AL. TREATMENT PLAN- NING AND DELIVERY OF INTENSITY-MODULATED RADIATION THERAPY FOR PRIMARY NASOPHARYNX CANCER. INT J RADIAT ONCOL BIOL PHYS, 2002; 49: 623-632
PAULINO AC, KOSHY M, HOWELL R ET AL. COMPARISON OF CT- AND FDG-PET-DEFINED GROSS TUMOR VOLUME IN INTENSITY-MODULATED RADIOTHERAPY FOR HEAD-AND-NECK CANCER. INT J RADIAT ONCOL BIOL PHYS, 2005; 61: 1385-1392
POW EH, KWONG DL, MCMILLAN AS ET AL. XEROSTOMIA AND QUALITY OF LIFE AFTER INTENSITY-MODULATED RADIOTHERAPY VS. CONVENTIONAL RADIOTHERAPY FOR EARLY-STAGE NASOPHARYNGEAL CARCINOMA: INITIAL REPORT ON A RANDOMIZED CONTROLLED CLINICAL TRIAL. INT J RADIAT ONCOL BIOL PHYS, 2006; 66: 981-991
TEH BS, WOO SY, BUTLER EB. INTENSITY MODULATED RADIATION THE- RAPY (IMRT): A NEW PROMISING TECHNOLOGY IN RADIATION ONCOLOGY. THE ONCOLOGIST, 1999; 4: 433-442
WITHERS HR, TAYLOR JM, MACIEJEWSKI B. THE HAZARD OF ACCELERA- TED TUMOR CLONOGEN REPOPULATION DURING RADIOTHERAPY. ACTA ONCOL, 1988; 27: 131-146
WU QM, MANNING M, SCHMIDT-ULLRICH R, MOHAN R. THE POTENTIAL FOR SPARING OF PAROTIDS AND ESCALATION OF BIOLOGICALLY EFFECTIVE DOSE WITH INTENSITY-MODULATED RADIATION TREATMENTS OF HEAD AND NECK CANCERS: A TREATMENT DESIGN STUDY. INT J RADIAT ONCOL BIOL PHYS, 2000; 46: 195-205
