Organisational Standards for the Delivery of Intensity-modulated Radiation Therapy in Ontario

Clinical Oncology

Volumn 21, Issue 3, 2009, Pages 192-203

  Whitton, A ^a   Warde, P ^b   Sharpe, M ^b   Oliver, T K ^c,d   Bak, K ^a   Leszczynski, K ^f   Etheridge, S ^e   Fleming, K ^g   Gutierrez, E ^a   Favell, L ^h   Green, E ⁱ  

^a Radiation Treatment Program   (Canada)

^b PRINCESS MARGARET HOSPITAL   (Canada)

^c Program in Evidence based Care   (Canada)

^d MCMASTER UNIVERSITY   (Canada)

^e SUDBURY REGIONAL HOSPITAL   (Canada)

^f Radiation Therapy   (Canada)

^g Grand River Regional Cancer Centre   (Canada)

^h Capital Projects   (Canada)

ⁱ Cancer Care Ontario   (Canada)

Author keywords

Implementation; intensity modulated radiation therapy; organisational standards; systematic review

Indexed keywords

ARTICLE; AUSTRALIA; CANADA; CANCER CONTROL; CANCER LOCALIZATION; CLINICAL EFFECTIVENESS; COCHRANE LIBRARY; CONSENSUS DEVELOPMENT; EMBASE; EUROPE; EVIDENCE BASED MEDICINE; HEALTH CARE ACCESS; HEALTH CARE PLANNING; INFORMATION RETRIEVAL; INTENSITY MODULATED RADIATION THERAPY; INTERNET; MEDLINE; MORBIDITY; PATIENT CARE; PATIENT SAFETY; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROFESSIONAL STANDARD; QUALITY CONTROL; RADIATION DOSE; RISK REDUCTION; STAFF TRAINING; STANDARDIZATION; TREATMENT PLANNING; UNITED STATES;

HUMANS; NEOPLASMS; ONTARIO; PRACTICE GUIDELINES AS TOPIC; RADIOTHERAPY, INTENSITY-MODULATED;

EID: 61849107351     PISSN: 09366555     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.clon.2008.10.005     Document Type: Article

References (46)

1. Xia P., Fu K.K., Wong G.W., et al. Comparison of treatment plans involving intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 48 (2000) 329-337
2. Kestin L.L., Sharpe M.B., Frazier R.C., et al. Intensity modulation to improve dose uniformity with tangential breast radiotherapy: initial clinical experience. Int J Radiat Oncol Biol Phys 48 (2000) 1559-1568
3. Liu H.H., Wang X., Dong L., et al. Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 58 (2004) 1268-1279
4. Roeske J.C., Lujan A., Rotmensch J., et al. Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies. Int J Radiat Oncol Biol Phys 48 (2000) 1613-1621
5. Lujan A.E., Mundt A.J., Yamada S.D., et al. Intensity-modulated radiotherapy as a means of reducing dose to bone marrow in gynecologic patients receiving whole pelvic radiotherapy. Int J Radiat Oncol Biol Phys 57 (2003) 516-521
6. Murshed H., Liu H.H., Liao Z., et al. Dose and volume reduction for normal lung using intensity-modulated radiotherapy for advanced-stage non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 58 (2004) 1258-1267
7. Ahmed R.S., Kim R.Y., Duan J., et al. IMRT dose escalation for positive para-aortic lymph nodes in patients with locally advanced cervical cancer while reducing dose to bone marrow and other organs at risk. Int J Radiat Oncol Biol Phys 60 (2004) 505-512
8. Nutting C.M., Corbishley C.M., Sanchez-Nieto B., et al. Potential improvements in the therapeutic ratio for prostate cancer irradiation: dose escalation of pathologically identified tumor nodules using intensity modulated radiotherapy. Br J Radiol 75 (2002) 151-161
9. Pow E.H., Kwong D.L., McMillan A.S., et al. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66 4 (2006) 981-991
10. McMillan A.S., Pow E.H., Kwong D.L., et al. Preservation of quality of life after intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: results of a prospective longitudinal study. Head Neck 28 8 (2006) 712-722
11. Jabbari S., Kim H.M., Feng M., et al. Matched case-control study of quality of life and xerostomia after intensity-modulated radiotherapy or standard radiotherapy for head-and-neck cancer: initial report. Int J Radiat Oncol Biol Phys 63 3 (2005) 725-731
12. Parliament M.B., Scrimger R.A., Anderson S.G., et al. Preservation of oral health-related quality of life and salivary flow rates after inverse-planned intensity-modulated radiotherapy (IMRT) for head-and-neck cancer. Int J Radiat Oncol Biol Phys 58 3 (2004) 663-673
13. Fang F.M., Tsai W.L., Chen H.C., et al. Intensity-modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma: comparisons of four radiotherapy techniques. Cancer 109 2 (2007) 313-321
14. Lin A., Kim H.M., Terrell J.E., et al. Quality of life after parotid-sparing IMRT for head-and-neck cancer: a prospective longitudinal study. Int J Radiat Oncol Biol Phys 57 1 (2003) 61-70
15. Cozzarini C., Fiorino C., Di Muzio N., et al. Significant reduction of acute toxicity following pelvic irradiation with helical tomotherapy in patients with localized prostate cancer. Radiother Oncol 84 2 (2007) 164-170
16. Arcangeli S., Saracino B., Petrongari M.G., et al. Analysis of toxicity in patients with high risk prostate cancer treated with intensity-modulated pelvic radiation therapy and simultaneous integrated dose escalation to prostate area. Radiother Oncol 84 2 (2007) 148-155
17. Zelefsky M.J., Fuks Z., Hunt M., et al. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys 53 5 (2002) 1111-1116
18. De Meerleer G., Vakaet L., Meersschout S., et al. Intensity-modulated radiotherapy as primary treatment for prostate cancer: acute toxicity in 114 patients. Int J Radiat Oncol Biol Phys 60 3 (2004) 777-787
19. Lee N., Puri D.R., Blanco A.I., et al. Intensity-modulated radiation therapy in head and neck cancers: an update. Head Neck 29 4 (2007) 387-400
20. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Breast cancer. V.2.2008 (2008), National Comprehensive Cancer Network, Fort Washington. http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf Available from:
21. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Prostate cancer. V.1.2008 (2008), National Comprehensive Cancer Network, Fort Washington. http://www.nccn.org/professionals/physician_gls/PDF/prostate.pdf Available from:
22. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Head and neck cancer. V.1.2007 (2008), National Comprehensive Cancer Network, Fort Washington. http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf Available from:
23. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Rectal cancer. V.1.2008 (2008), National Comprehensive Cancer Network, Fort Washington. http://www.nccn.org/professionals/physician_gls/PDF/rectal.pdf Available from:
24. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Colon cancer. V.1.2008 (2008), National Comprehensive Cancer Network, Fort Washington. http://www.nccn.org/professionals/physician_gls/PDF/colon.pdf Available from:
25. Ting J.Y., and Scarbrough T.J. Intensity modulated radiation therapy and image-guided radiation therapy: small clinic implementation. Hematol Oncol Clin North Am 20 1 (2006) 63-86
26. Miles E.A., Clark C.H., Urbano M.T., et al. The impact of introducing intensity modulated radiotherapy into routine clinical practice. Radiother Oncol 77 3 (2005) 241-246
27. Hulick P.R., and Ascoli F.A. Quality assurance in radiation oncology. J Am Coll Radiol 2 7 (2005) 613-616
28. Eudaldo T., Huizenga H., Lamm I.L., et al. Guidelines for education and training of medical physicists in radiotherapy: recommendations from an ESTRO/EFOMP working group. Radiother Oncol 70 2 (2004) 125-135
29. Boehmer D., Bohsung J., Eichwurzel I., et al. Clinical and physical quality assurance for intensity modulated radiotherapy of prostate cancer. Radiother Oncol 71 (2004) 319-325
30. Galvin J.M., Ezzell G., Eisbrauch A., et al. Implementing IMRT in clinical practice: a joint document of the American Society for Therapeutic Radiology and Oncology and the American Association of Physicists in Medicine. Int J Radiat Oncol Biol Phys 58 5 (2004) 1616-1634
31. Baker C.R., and Hardy V. Provision of IMRT in the UK. Part 2: current levels, planned expansion and obstacles to implementation. J Radiother Prac 3 4 (2003) 181-184
32. Ezzell G.A., Galvin J.M., Low D., et al. Guidance document on delivery, treatment planning, and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee. Med Phys 30 8 (2003) 2089-2115
33. Intensity Modulated Radiation Therapy Collaborative Group. Intensity modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys 51 4 (2001) 880-914
34. Grant III W., and Woo S.Y. Clinical and financial issues for intensity modulated radiation therapy delivery. Semin Radiat Oncol 9 1 (1999) 99-107
35. Fraass B., Doppke K., Hunt M., et al. American Association of Physicists in Medicine Radiation Therapy Committee Task Group 53: quality assurance for clinical radiotherapy treatment planning. Med Phys 25 10 (1998) 1773-1829
36. Burman C., Chui C., Kutcher G., et al. Planning, delivery, and quality assurance of intensity modulated radiotherapy using dynamic multi-leaf collimator: a strategy for large-scale implementation for the treatment of carcinoma of the prostate. Int J Radiat Oncol Biol Phys 39 (1997) 863-873
37. The College of Radiographers. Radiotherapy. Radiographic staffing: short term guidance 2005. Benchmark for standard core functions within radiotherapy (2005), The Society of Radiographers, London. http://www.sor.org/public/pdf/rad_staffing.pdf Available from:
38. Canadian Association of Provincial Cancer Agencies. Standards for quality control at Canadian radiation treatment centers: medical linear accelerators. Available from: (2005). http://www.medphys.ca/media.php?mid=134
39. American College of Radiology (ACR). Practice guidelines for communication of diagnostic imaging findings (2004), American College of Radiology, Reston. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines /dx/comm_diag_rad.aspx Available from:
40. Trinity Health. Emerging trends and technologies, intensity modulated radiation therapy (2003), Trinity Health, Novi. Available from: http://72.14.205.104/search?q=cache:fJdKAVqUMhEJ:www.bshsi.com/tews/docs /trinity/IMRT-White-Paper.pdf+emerging+trends+and+technologies,+intensit y-modulated+radiation+therapy&hl=en&ct=clnk&cd=1&gl=ca &client=firefox-a
41. American College of Radiology (ACR). Practice guideline for intensity modulated radiation therapy (IMRT). Available from: (2002). http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines /RadiationOncology/ACRPracticeGuidelineforIntensityModulatedRadiationThe rapy(IMRT)Doc3.aspx
42. Canadian Association of Radiation Oncologists. Draft paper on scope of practice by the Manpower and Standards of Care Committee of the Canadian Association of Radiation Oncologists. Available from: (2003). http://www.caro-acro.ca/caro/new/pdfs/scope_of_practice03-03.pdf
43. North American Scientific. IMRT installation. Available from:. http://www.nomos.com/page?id=1507
44. North American Scientific. IMRT implementation. Available from:. http://www.nomos.com/page?id=1505
45. Huntzinger C. The revolution in radiation therapy. Palo Alto: Varian Medical Systems. Available from: (http://varian.mediaroom.com/file.php/mr_varian/spinsite_docfiles/147/VR M395+IMRT+White+Paper+Final+Jan+2005.pdf).
46. AdminaStar Federal. Radiation oncology - external beam treatment. Indianapolis (IN): AdminaStar Federal. Available from: (http://www.adminastar.com/Providers/Intermediary/MedicalPolicy/OH/files /OH_Radiation_Onc_R12.htm).