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Clinical use of intensity-modulated radiotherapy: part II

Radiotherapy Department and Head and Neck Unit, Institute of Cancer Research and Royal Marsden NHS Trust, London and Surrey, UK

Correspondence: Dr C Nutting, Head and Neck Unit, Royal Marsden NHS Trust, Fulham Road, London SW3 6JJ, UK

Intensity-modulated radiotherapy (IMRT) is a novel conformal radiotherapy technique which is gaining increasingly widespread use. This second clinical article aims to summarize the published data pertaining to prostate cancer, pelvic irradiation, gynaecological and breast cancer. Prostate cancer patients represent the largest group treated to date. The main indication has been radiation dose escalation within acceptable normal tissue late toxicity. Phase II data are promising, but no randomized clinical trial data are available to support its use. Pelvic IMRT aims to deliver radical radiation doses to pelvic lymph nodes while sparing the bowel and bladder. Indications for breast IMRT data are reviewed, and current data presented. Further data from randomized trials are required to confirm the anticipated benefits of IMRT in patients.

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