ABSTRACT
The major accelerator manufacturers were each offering intensity modulated radiation therapy (IMRT) delivery packages. Most of the treatment-planning system manufacturers were also offering IMRT planning facilities, usually by inverse planning. Focus began to shift from fundamental concerns about how to perform IMRT into the embryonic stages of clinical delivery. There are also those who are orchestrating campaigns to challenge the clinical significance of implementing IMRT. Geographical widening of IMRT availability is an issue. Possibly the multivane intensity-modulating collimator-type IMRT may be overtaken by dynamic multileaf collimators techniques. Donaldson then counters that IMRT adversely impacts the current working practices of the radiotherapy department. In Colorado Springs, in June 2003, the American Association of Physicists in Medicine held its annual Summer School on the theme of IMRT. A climate of reasonable expectation of benefit is often all one can ‘put upfront’ and ultimately the proof of the worth of IMRT will lie in the outcome of randomized phase-3 clinical trials.
