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Treatment Planning and Techniques

Advances in computer technology have enabled the possibility of transitioning from basic 2-dimensional treatment planning and delivery (2-D radiotherapy) to a more sophisticated approach with 3-dimensional conformal radiotherapy (3-D CRT). Whereas 2-D radiotherapy can be applied with simple equipment, infrastructure and training, transfer to 3-D conformal treatments requires more resources in technology, equipment, staff and training. A novel radiation treatment approach using Intensity Modulated Radiation Therapy (IMRT) that optimizes the delivery of radiation to irregularly shaped tumour volumes demands even more sophisticated equipment and seamless teamwork, and consequentially more resources, advanced training and more time for treatment planning and verification of dose delivery than 3-D CRT.

Whereas 3-D CRT can be considered as a standard, IMRT is still evolving. Due to the increased interest of Member States to the modern application of radiotherapy the IAEA has received a number of requests for guidance coming from radiotherapy departments that wish to upgrade their facilities to 3-D CRT and IMRT through Technical Cooperation programme. These requests are expected to increase in number in the near future. Since these treatment techniques are perceived as the cuttingedge of development in the field, there is a concern that centres and countries need orientation as to the preparatory conditions and resources involved. In addition the current status of the evidence supporting the use of IMRT in terms of patient outcomes has to be kept in mind when planning to invest in these technologies.