Safety considerations for IGRT: Executive summary

David A Jaffray; Katja M Langen; Gikas Mageras; Laura A Dawson; Di Yan; Robert Adams EdD; Arno J Mundt; Benedick Fraass

doi:10.1016/j.prro.2013.01.004

Safety considerations for IGRT: Executive summary

Pract Radiat Oncol. 2013 Jul-Sep;3(3):167-170. doi: 10.1016/j.prro.2013.01.004. Epub 2013 Apr 15.

Authors

David A Jaffray¹, Katja M Langen², Gikas Mageras³, Laura A Dawson⁴, Di Yan⁵, Robert Adams EdD⁶, Arno J Mundt⁷, Benedick Fraass⁸

Affiliations

¹ Radiation Medicine Program, Princess Margaret Cancer Centre/UHN, Toronto, Ontario, Canada. Electronic address: david.jaffray@rmp.uhn.on.ca.
² Department of Radiation Oncology, MD Anderson Cancer Center, Orlando, Florida.
³ Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York.
⁴ Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada.
⁵ Department of Radiation Oncology, Beaumont Health System, Detroit, Michigan.
⁶ Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina.
⁷ Department of Radiation Medicine and Applied Sciences, University of California - San Diego, La Jolla, California.
⁸ Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.

Abstract

Radiation therapy is an effective cancer treatment that is constantly being transformed by technological innovation. Dedicated devices for fraction-by-fraction imaging and guidance within the treatment room have enabled image guided radiation therapy (IGRT) allowing clinicians to pursue highly conformal dose distributions, higher dose prescriptions, and shorter fractionation schedules. Capitalizing on IGRT-enabled accuracy and precision requires a strong link between IGRT practices and planning target volume (PTV) design. This is clearly central to high quality, safe radiation therapy. Failure to properly apply IGRT methods or to coordinate their use with an appropriate PTV margin can result in a treatment that is 'precisely wrong'. The white paper summarized in this executive summary recommends foundational elements and specific activities to maximize the safety and effectiveness of IGRT.