الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The modern technology of radiation oncology continues to progress at an unprecedented rate. The need for these advancements is based on the underlying assumption that the new, complex technologies will improve locoregional control of cancer and therefore cure more patients. Research has shown that improvements in patient setups using image guidance technologies has the potential for dose escalation, with a corresponding increase in predicted local control, while maintaining the same level of normal tissue complications. The new technologies result in new demands on the total QA process for radiation treatment. Additional steps and more accuracy are required in patient setup. QA procedures need to be enhanced because significant components of the treatment process are performed “automatically,” resulting in dose delivery techniques that are no longer intuitively obvious. Thus, the user needs to develop confidence that the class solutions to QA procedures will be sufficient to check the built-in safety devices on modern treatment technologies. (Tepper, 2004)
Predictions over the next decade project an increased use of imaging for therapy planning, an increased use of software tools to register images from multiple imaging sources, and an increased demand for IMRT with the application of image guidance for daily setups. 4-D imaging with breathing-controlled or gated therapy will be applied more frequently to thoracic tumors. There will likely be increased applications of brachytherapy. Particle therapy, especially protons, will also gain in activity, although these will likely be limited to larger academic institutions since the costs are still prohibitive. Ultimately these advances in the technology of radiation oncology will benefit the cancer patient by improving the likelihood of cure with reduced complications, resulting in a better quality of life. (Tepper, 2004).
As a local and organ-preserving method, radiation oncology as a discipline is changing its paradigm to more sophisticated, precise treatments rather than large field irradiations. A radiation beam is more like a scalpel in the era of hypofractionated and ablative doses. It becomes increasingly possible to escalate the fractional and total doses without increasing toxicity; toxicity may even decrease. While early clinical results with these new technologies are very satisfactory, evidence-based long term results are anticipated. (Eur Assoc Neurooncol Mag,2012).