Intenzitetno modulirano obsevanje (IMRT) zdaj tudi na Onkološkem inštitutu v Ljubljani Intensity modulated radiotherapy – IMRT

now available also at the Institute of Oncology in Ljubljana

Abstract

Intenzitetno modulirano obsevanje (angl. Intensity Modulated RadioTherapy, IMRT) je sodobna obsevalna tehnika, ki nadvse domiselno združuje dosežke sodobne računalniške tehnologije in industrijske rešitve s področja radioterapevtskih naprav. V primerjavi s konvencionalnimi obsevalnimi tehnikami lahko z IMRT dosežemo pomembno izboljšanje razporeditve doze v obsevanem tkivu. Ta se kaže v večji konformnosti, ki jo hkrati dopolnjuje strm gradient doze na robu tarčnega volumna. To omogoča bolj usmerjeno obsevanje tarče in manjšo sevalno obremenitev zdravih tkiv v njeni okolici, kar zmanjšuje verjetnost pojavljanja in resnost neželenih stranskih učinkov obsevanja. V prispevku so opisane osnovne značilnosti tehnike IMRT in razlike glede na konvencionalne obsevalne tehnike, slabosti oz. nevarnosti, ki spremljajo IMRT in na katere je treba biti pozoren pri njeni implementaciji, postopek priprave in izvedbe IMRT ter indikacije in potencialni domet pričakovanih kliničnih rezultatov. Uvedbo tehnike IMRT na Onkološkem inštitutu v Ljubljani lahko obravnavamo kot eno najpomembnejših prelomnic v sodobni zgodovini slovenske radioterapije. Glede na poročila tujih ustanov, kjer je IMRT del klinične rutine že dlje časa, je z IMRT zdravstveni tim dobil novo in učinkovito orožje v boju z zahrbtno in smrtonosno boleznijo, bolniki pa novo upanje na uspešen konec zdravljenja.

Abstract (Eng)

Intensity Modulated Radiotherapy (IMRT) is a modern radiation technique that most cunningly combines the achievements in computer technology and innovations in the industrial production of radiotherapeutic devices. In comparison to conventional radiation techniques, IMRT yields a significant improvement in dose distribution in irradiated tissue. The latter is reflected in higher conformity which is supplemented with steep dose gradient at the edge of target volume. Thereby, these characteristics allow better adjustment of the radiation beam to the target and lower radiation load to the healthy tissue surrounding the target, which in turn reduces the risk of serious radiation side effects. This review presents the basic features of IMRT, the distinctions between IMRT and conventional radiation techniques, the drawbacks or risks of IMRT that require special attention, the procedures during the IMRT preparation and implementation, as well as the indications and the scope of estimated clinical results. With launching IMRT at the Institute of Oncology Ljubljana, a new era has dawned in the development of radiotherapy in Slovenia. Having considered the reports from the worldwide institutions, where IMRT has longer been a part of clinical routine, we may conclude that medical team gained a new and effective weapon against this malicious and lethal disease and the patients new hope for successful completion of treatment.