Treatment Planning Comparison Of Conventional Radiation Therapy, 3-Dimensional Conformal Radiation Therapy, And Intensity-Modulated Radiation Therapy Of Vertebral Tumors

Objective: Bone metastases are common, esp. in the advanced breast cancer, lung cancer and prostate cancer patients. The primary symptom is local pain. Radiation therapy may inhibit or kill tumor cells, reduce the invasion of tumor to the adjacent bones and soft tissues, and increase the production of collagen protein. Then, a great quantity of vascular fibrous matrix is produced, activities of osteoblasts rise and new bones are formed, thus pain is relieved. However, vertebral bone metastases lie very close to spinal cord, so the dose to the planning target volume (PTV) sometimes has to be compromised. 3-dimensional conformal radiation therapy (3DCRT) could provide improved dose homogeneity and highly conformal dose distributions. This allows not only increase of local control but also improved sparing of normal tissues in many tumor sites. In this study, we compare the difference of treatment plans using conventional, classical conformal and intensity-modulated radiation therapy for vertebral bone metastases. The aim is to find out the best technique to achieve improved dose homogeneity and sparing of normal tissues for vertebral bone tumors. We expect IMRT also allows the radiation therapy of adjacent vertebral bone tumors.Material and Methods: From October 2005 to March 2006, 4 patients with vertebral bone metastases were selected, and conventional, 3D-CRT, and 3, 5, 7,...