Clinical aspects of intensity-modulated radiotherapy in the treatment of breast cancer

In recent years, interest has grown throughout the radiotherapy community in investigation and clinical application of intensity-modulated radiation therapy (IMRT) for adjuvant treatment of breast cancer. IMRT removes the usual reliance on flat (or uniform-intensity) radiation fields, and instead replaces that simple paradigm with a variable-intensity pattern that is usually determined with the aid of a computerized optimization algorithm. The main goal of much IMRT and optimization work is the delivery of more conformal plans to the patient. Thus, IMRT has the potential to improve target coverage and reduce inhomogeneities observed within the breast (and regional lymph nodes) that are obtained with standard plans. Furthermore, IMRT may be able to reduce doses delivered to the heart and lungs, and may potentially minimize further the probability of complications from radiotherapy.