Dynamic-arc respiratory-gated stereotactic radiotherapy — technique presentation

Main advancements in radiation treatment in recent years have included the introduction of dynamic techniques and 4D radiotherapy. The treatment of movable tumors relies on two important techniques: gating and tracking. The limitation of the former is the relatively short duration of the respiratory phase during which the radiation can be delivered and the need to teach the patient to breathe in accordance with the correct pattern. At the same time, certain clinical situations require the use of dynamic techniques. Intensity modulated radiotherapy (IMRT), combined with gantry rotation, forms the basis for the VMAT technique. The procedure usually takes a shorter time to complete than other dynamic techniques, which considerably improves patient comfort. The recently introduced True BeamTM accelerator employs all the latest innovations in terms of dose-rate modeling and respiratory gating.