IMRT, thin-beam radiation?


Question from Friday: When are the new thin-beam radiation techniques going to be the standard?
Answers - Lydia Komarnicky, M.D. I assume you're talking about IMRT (Intensity Modulated Radiation Therapy) by thin-beams. These specialized beams—which may be 4, 5, or 6 beams of radiation—treat the breast and provide a very accurate beam of radiation to the breast. Not all centers are using these types of beams for the treatment of breast cancer. These beams may be considered controversial still.
Marisa Weiss, M.D. Just because it's new does not mean it's better. In my practice, we have the ability to use IMRT as well as another state-of-the-art treatment approach. Most of the time, the non-IMRT plan looks better.
Lydia Komarnicky, M.D. One thing people need to realize, and don't hear on the advertising, is that sometimes when you use these IMRT beams, you are actually by necessity having to treat normal breast tissue on the other side.
Marisa Weiss, M.D. That is a significant concern. We don't know if that is safe or dangerous. There are some IMRT approaches that do not involve exposure to the other side. All these new techniques need to be carefully studied further before they are commonly used.
Lydia Komarnicky, M.D. We're still in uncharted territory with IMRT for breast. IMRT is being used a lot for prostate cancer and brain tumors, but I think this still has to be evaluated for the treatment of breast cancer a little more.
Marisa Weiss, M.D. IMRT is best suited for treating cancers that are deep inside the body where it is very challenging to limit the dose only to the area at risk and spare normal tissue. But when it comes to treating women with breast cancer, the breast is on the surface. The challenge of restricting the dose to normal tissue is not the same. It is easier.
Lydia Komarnicky, M.D. There are some that would use IMRT especially for left-sided breast cancers to try to spare the heart and even the lungs, but there is a tradeoff for treating normal tissues like breast tissue on the other side.

On Wednesday, March 17, 2004, our Ask-the-Expert Online Conference was called Radiation Therapy UpdatesLydia T. Komarnicky, M.D. and Marisa Weiss, M.D. answered your questions about advances in radiation therapy: the newest and best techniques, combining radiation therapy with other treatments, ways to manage, reduce or eliminate side effects, and more.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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