Novel Technologies for Improved Treatment Outcome and Patient Safety in Cancer Radiotherapy.

Copyright © 2016 Jun Deng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cancer radiotherapy has been largely driven by technological development in the past thirty years, resulting in improved local tumor control for a variety of lesion sites [1]. Yet the paradigm has shifted more recently toward a patient-centered healthcare model and value-based medicine where success is measured by improved treatment outcome, enhanced patient safety, and increased patient satisfaction [2]. Clinically, local tumor control should be optimized simultaneously with treatment outcome and patient safety in order to maximize the therapeutic ratio while maintaining a high standard of patient care. This special issue aims to present some of the novel technological developments in recent years and discuss their potentials in improving treatment outcome and patient safety in the radiotherapeutic management of cancers worldwide. The research work entitled " An IMRT/VMAT Technique for Non-Small Cell Lung Cancer " investigated a novel approach in treating non-small cell lung cancer (NSCLC) with radiation, that is, a hybrid intensity-modulated radio-therapy (IMRT) and volumetric modulated arc therapy (VMAT) technique, in order to achieve the delivery efficiency from VMAT and the critical structure sparing with IMRT. The proposed hybrid approach involved an initial IMRT plan delivering the first half of the total prescription dose, followed by a VMAT plan delivering the second half of the total dose, which was optimized based on the initially optimized IMRT plan. With the dosimetric evaluation of 15 NSCLC patients, the hybrid technique has been shown to reduce í µí±‰ 5 , í µí±‰ 10 , í µí±‰ 30 , and the mean lung dose (MLD) of normal lungs compared with VMAT and better protect the organs-at-risk (OARs) with fewer monitor units (MUs) at the cost of slightly higher dosimetric indexes as compared to IMRT. The proposed hybrid approach demonstrated its promise in improving the treatment outcome and reducing normal tissue toxicity in the radiotherapy of lung cancers, which is one of the most deadly cancers in the modern era. The clinical study entitled " Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes " addressed a controversial issue in the clinic, the treatment of pelvic lymph nodes (PLNs) in higher risk prostate carcinoma, by …