The University Hospitals Department of Radiation Oncology is at the forefront in the constantly changing battle to treat malignancies with ionizing radiation. As computer technology evolves and improves, so do the treatment planning capabilities that are available in the Radiation Oncologist’s arsenal. Three-Dimensional Conformal Radiation Therapy (3DCRT) is a technology-driven treatment planning technique that utilizes diagnostic quality Computed Axial Tomography (CAT or CT scans) to create a customized treatment plan for the patient. This planning method allows for more precise delivery of the external beam radiation from high-energy linear accelerators and has forced a rethinking of the traditional planning techniques. By utilizing a full CT dataset, three-dimensional localization and visualization of the target and its relation to the adjacent normal structures is now an integral part of the planning process. 3DCRT can also account for changes in the patient contour and the density variations within the body
The goal of a course of radiation therapy is to deliver higher total doses to the target volume with relatively lower doses to the normal tissues. 3D Conformal Radiation Therapy techniques utilize multiple beams to focus the high dose on the volume of interest identified by the physician. At the same time, the plans aim to reduce the dose to the normal structures in the area of the target volume. 3DCRT plans can consist of 6-8 beams, or more, and these treatment portals are customized in their energy selection and relative contribution and are highly conformal. By accurately shaping the fields with much smaller margins, usually 0.5-1.5cm on the target volume, the treatment plan is designed to exclude as much normal tissue as possible in order to keep these structures below their tolerance levels. This is done in an effort to reduce side effects and make the treatment more tolerable for the patient. The tighter margins also allow for higher doses to be delivered to the target volume on each fraction. An additional benefit is that higher overall doses are now attainable and these higher doses should improve cure rates. Other imaging modalities such as MR (Magnetic Resonance), PET (Positron Emission Tomography), SPECT (Single Photon Emission Tomography) can be used in conjunction with CT to guided the planning process to accurately deliver more dose to the target region while sparing normal organs.
At University Hospitals, the entire treatment planning and delivery process is completely automated. From the treatment planning CT to the treatment planning computer and on to the treatment machine, a seamless transfer of information is in place. 3DCRT and other complex radiation treatments are planned and implemented for patients treated at University Hospitals Seidman Cancer Center and at the satellite locations.