TA26-Technology in Use at The University of Texas M. D. Anderson Cancer Center

Almon S. Shiu, Ph.D.

Associate Professor

Department of Radiation Physics,

The University of Texas M. D. Anderson Cancer Center,

Houston, TX,

The current external-beam treatment technology used at the Division of Radiation Oncology, at the University of Texas M. D. Anderson Cancer Center is the main focus for this section’s presentation. The Division of Radiation Oncology at UTMDACC is the largest single radiation treatment facility in the world. The treatment facilities consist of fourteen linear accelerators, one isocentric Cobalt-60 tele-therapy unit, one 50 KVp and one 250 KVp x-ray therapy units, three CT-simulators and one conventional simulator, more than 50 treatment planning workstations, the QA dosimetry labs and mold room, manual and remote Brachytherapy units, machine shop, and multiple computer resources. Six linear accelerators and one cone-beam CT simulator will be delivered in July, 2004 to our new facility site, Ambulatory Clinic building (across street from our main facilities). In addition, a dedicated image-guided treatment delivery unit will also be delivered to the main facilities in July. At the main campus, we are currently treating more than 400 external-beam patients per day. More than 95% of all external-beam cases are planned based on CT images. The MRI images and PET/CT images are also used in some of the anatomic sites for target and critical structures delineation. Currently, about 35% of our patients have received IMRT (Intensity Modulated Radiotherapy) treatment. The most of the remaining patients are treated with 3D conformal technique except a few palliative treatments delivered with a single or the opposed fields approach. The step and shoot IMRT technique for the brain, head and neck (H&N), and prostate tumors will be discussed and the filed-in-field technique used for H&N and breast treatment will also be discussed. The advantages and disadvantages of the current technology versus the conventional treatment will be evaluated. The respiratory gating for acquired Thoracic CT images and treatment delivery will be presented. In addition, the 4D CT images used to determine the internal target volume (ITV) will be addressed. The current practice of intracranial and extracranial stereotactic radiosurgery and radiotherapy will also be presented. One of the major benefits of the current technology is the reduction of the acute side effects in H&N, breast and prostate. This also allows the radiation oncologists to prescribe a higher target dose and spare the critical structures, which should lead to better tumor control and the increase of survival rate.