Radiation treatment of malignancies with curative intent requires maximizing the chance of tumor eradication while minimizing the risk of normal tissue injury, the so-called collateral damage of radiotherapy. There has been a gradual evolution in radiotherapy approaches over time in an effort to achieve this goal. Much of this evolution has centered on advances in the technological aspects of radiotherapy treatment planning and delivery. Appropriate delineation of clinical target volumes through improvements in imaging technology (CT, MRI, PET) is one example. Another example is in the development of three-dimensional conformal radiotherapy planning and the introduction of intensity-modulated radiotherapy (IMRT), discussed in the previous chapter.
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