Intensity-modulated radiation therapy for breast and lung Cancer: A review of use, cost, clinical evidence, and safety

August 23, 2012

A patient in an Intensity-Modulated Radiation Therapy machine.Intensity-Modulated Radiation Therapy (IMRT) is a type of radiation therapy that uses inverse-planning tools to derive beamlets with variable intensities within each beam to deliver highly conformal radiation doses to tumors while reducing radiation doses to healthy tissues. Its ability to reduce the radiation dose to surrounding tissue means that higher doses can be given to tumors without increasing the dose to healthy tissue. Further, IMRT treatment relies less on the skills of the technicians by essentially eliminating the effect of their skill levels on treatment. Because of this potential benefit, IMRT has been used to treat many different types of cancer.

However, IMRT also introduces new safety and quality concerns. IMRT is an area of particular concern because it is more complex than previous technologies used to administer radiation therapy. It requires sophisticated equipment and software, and staff must be trained on the systems. For staff performing this treatment, a major difference is a loss of intuitively monitoring the treatment because of the involvement of highly advanced technologies. These complexities introduce opportunities for error that did not exist with older technologies.

This issue brief will summarize available data and literature on the use of IMRT for breast and lung cancer—two cancers for which IMRT is emerging as a treatment option. The brief will discuss: (1) trends in IMRT use overall and for breast and lung cancer, (2) the clinical evidence supporting the use of IMRT for breast and lung cancer and (3) safety regulations in Michigan for radiation therapy and IMRT and (4) a review of the evidence related to improving patient safety in radiation therapy.


Suggested citation: Kofke-Egger, Heather and Udow-Phillips, Marianne. August 2012. Intensity-Modulated Radiation Therapy for Breast and Lung Cancer: A Review of Use, Cost, Clinical Evidence and Safety. Center for Healthcare Research & Transformation. Ann Arbor, MI.

Thanks to Jean Moran, PhD for reviewing this paper. Thanks also to Allison Burlock for help finalizing the paper, and to Kim Harrison at Blue Cross Blue Shield of Michigan for assistance acquiring the data.