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Intensity Modulated Radiation Therapy (IMRT)

High doses of radiation have been proven to kill cancer cells and to shrink tumors. Intensity Modulated Radiation Therapy (IMRT), uses x-rays of varying intensities along with computer generated images to plan and deliver highly targeted radiation directly to cancer cells while significantly reducing the amount of radiation to surrounding healthy tissue. This technique is the most precise form of radiation therapy available today, and can increase the rate of tumor control by conforming to the shape of the tumor while minimizing adverse side effects. Because of its extreme accuracy, tumors which were formerly considered untreatable because of their proximity to vital organs can now be controlled.

A computer program optimizes the treatment plan based on the physician's instructions as relates to dose, and tumor size, shape, and location. The radiation is then delivered by a machine called a medical linear accelerator, equipped with a special device called a multileaf collimater which shapes the radiation beam, and delivers it in accordance with the treatment plan. This equipment can be rotated around the patient sending beams as small as the size of a pencil tip and of varying intensities to the tumor at preferential angles.

In a treatment planning session, semi-permanent ink is often used to mark the patient's skin, to assist in aligning the radiation equipment with the targeted area. A CT scan may be used to generate three-dimensional diagnostic images of the patient and to determine the dose of radiation the tumor will receive. On the day of the treatment, the patient is positioned on a treatment table, and the process begins. Since external radiation is essentially like having an x-ray taken, the patient will not see or hear the radiation being administered, and the procedure will be painless.

Review an exclusive interview with Dr. Smythe on Current Therapeutical Approaches for Mesothelioma, particularly his trial of extrapleural pneumonectomy in conjunction with intensity modulated radiation therapy.

Journal article on IMRT for malignant mesothelioma