3-D Conformal Therapy and Intensity Modulated Radiation Therapy/Volumetric-Modulated Arc Therapy

Central nervous system treatment planning has been evolving as new technology, and research is being released. Traditional treatment methods, such as three-dimensional conformal radiotherapy (3D-CRT), are slowly being replaced by newer techniques, such as intensity modulated radiation therapy (IMRT) and volumetric-modulated radiation therapy (VMAT). This chapter discusses important planning details to create 3D-CRT, IMRT, and VMAT plans and provides the plan evaluation guidelines to ensure the production of high-quality plans. In addition, helpful tips are available for Varian Eclipse and Philips Pinnacle users to develop plans in a standardized and efficient manner. These planning details are used to develop several planning strategies which explain how to approach gliomas, hippocampal avoidance whole brain radiation therapy, craniospinal irradiation (CSI), craniopharyngioma, and pituitary tumors. By the end of this chapter, the reader should feel confident to treat patients safely and effectively, so that the treatment plans satisfy a clinician’s criteria.