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`Page 5 of 132
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`

`
`PATENT APPLICATION SERIAL NO.
`
`
`
`
`
`
`us/609457 /
`
`
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`U.S. DEPARTMENT OF COWMERCE
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`IN THE UNITED STATES PATENT AND TRADEMARK OFFICE
`
`
`
`
`
`
`
`
`
`
`Attorney Docket No. 2873-00019
`
`
`
`
`
`PETI11ON FOR
`
`
`EXPEDITED HANDLING
`
`OF FOREIGN FILING
`
`
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`Examiner:
`
`
`
`inventor:
`
`
`
`Serial No.:
`
`
`
`Filed:
`
`
`
`
`
`Unknown
`
`Unknown
`
`
`
`
`
`Cedric X. Yu
`
`
`
`
`Unknown
`
`
`
`Unknown
`
`
`INTENSITY MODULATED
`
`ARC THERAPY WITH
`
`
`
`DYNAMIC MULTI-LEAF
`
`COLL|MA'|1ON
`
`
`
`
`
`
`Hon. Commissioner of Patents
`
`
`
`and Trademarks
`
`
`Washington, DC 20231
`
`
`
`
`
`
`
`Dear Sir:
`
`
`
`
`The undersigned attorney for Applicant respectfully petitions for a foreign tiling license
`
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`for the present application according to 37 C.F.R. Section 5.12 and further requests expedited
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`handling of this Petition.
`
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`Any fees in connection with this Petition should be charged to Applicant's attorney’s
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`
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`
`
`Deposit Account No. 08-0750. A duplicate copy of this Petition is enclosed.
`
`
`
`Respectfully submitted,
`
`
`
`
`
`
`
`
`
`
`
`Thomas. T. Mo
`
`Registration No. 34,881
`
`
`Attorney tor Applicant
`
`
`
`
`
`
`Harness, Dickey & Pierce, P.L.C.
`
`
`
`
`
`P.O. Box 828
`
`
`
`Bloomfield Hills, MI 48303
`
`
`
`
`(810) 641-1600
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`
`
`
`
`
`
`
`Dated: February 29, 1996
`
`
`
`'lTM/trt
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`Page 7 of 132
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`»-._H,A1\..r«:ss,A D1c_y1_g=.x & PIERCE, .
`ATTORNEYS AND COUNSELOBS
`P__0,__B,OX 825
`
`
`
`B I-._°_D,M._lE,L,D....H_Ij.‘LS, MICH i 0 AN 4 3303
`
`u_'s;A_
`- """
`
`
`
`
`
`
`
`
`
`Date: March 1, 1996
`
`
`
`
`
`
`L_(9.8/6094.57
`
`
`
`TELEPHONE
`(510) 841-1800
`
`
`TELEFAOSIMILE
`(B10) 841-0270
`
`
`
`
`
`
`
`Honscommlssloner of Patents and Trademarks
`
`
`
`
`
`
`
`
`
`
`Washington. D. C. 20231
`/0/_ 5
`
`
`
`
`
`
`Cedric X. Yu
`Fie:
`inventor:
`I
`
`For: mreusrrv MODULATED Ar-tc THERAPY WITH DYNAMIC MUL'i1-
`
`
`
`
`
`
`
`LEAF COLIJMATION
`
`
`
`
`
`
`
`Atty. Docket No.:
`
`2873-00019
`
`Sir:
`
`
`
`Transmitted herewith for filing is the above referenced patent application.
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`1.
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`2.
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`[X]
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`[
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`]
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`as.
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`[X]
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`Nine (9) informal sheets of drawings showing Figures 1-11 are enclosed.
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`A Verified Statement Claiming Small Entity Status is enclosed.
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`A check is enclosed to cover the fees as calculated below. The Commissioner is
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`hereby authorized to charge any additional fees which may be required, or credit
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`any overpayment to Deposit Account No. 08-0750. A duplicate copy of this
`document is enclosed.
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`The fees calculated below will be paid within the time allotted for completion oi
`the filing requirements.
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`The fees calculated below are to be charged to Deposit Account No. 08-0750.
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`The Commissioner is hereby authorized to charge any additional fees which may
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`be required. or credit any overpayment to said Deposit Account. A duplicate copy
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`of this document is enclosed.
`
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`Z
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`1
`
`FILING FEE
`CALCULATION
`
`Total Claims
`
`Independent Claims
`
`Number
`Extra
`
`5
`
`1
`
`x
`
`x
`
`Rate
`
`$22_oo
`
`$78.00
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`Multiple Dependent C|aim(s) Used .
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`$933.00
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`FILING FEE - NON-SMALL ENTITY .
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`FILING FEE - SMALL ENTl'|'Y: Reduction by 1/2
`
`
`
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`] Verified Statement enclosed.
`[
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`] Verified Statement filed in priority application.
`[
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`Assignment Fieccrdal Fee ($40.00) .
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`37 C.F.Fl. §1.17(k) Fee (non-English application)
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`Page 8 of 132
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`Atty. Docket No. 2873-00019
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`Date: March 1, 1996
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`An Assinment of the invention‘ is enclosed. The required cover sheet under 37
`C.F.Fi. §3.11. §3.28 and 53.41 is attached.
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`A signed Oath/Declaration [
`37 C.F.Fi. 1.63.
`
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`]
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`is enclosed [X] will be filed in accordance with
`
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`Foreign Priority: Priority based on
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`
`
`, filed
`No.
`
`
`
`Application
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`
`__ . is claimed.
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`A copy of the above reterenced priority document [
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`filed in due course, pursuant to 35 U.S.C. §119(a)-(d).
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`] is enclosed [
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`1 will be
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`Because the enclosed application is in a non-English language, a verified English
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`translation for examination purposes of same [
`] is enclosed [
`] will be filed as
`soon as it is available.
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`Provisional Application Priority: Priority based on United States Provisional
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`Application No.
`is
`, filed
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`claimed under 35 U.S.C. §119(e).
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`A Preliminary Amendment is enclosed.
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`sheets of PTO Form 1449, and
`An information Disclosure Statement,
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`patent(s)/publications/documents are enclosed.
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`An Establishment of Assignee's Right To Prosecute Application Under 37 C.F.R.
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`§ 3.73(b), and Power Of Attorney is enclosed.
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`An Express Mailing Certificate is enclosed.
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`Other copy of Petition for Expedited Handling of Foreign Filing Receip_t_ filed
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`and rented on Februar 29 1996' cc
`of License for Forel n Filln
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`Attention is directed to the fact that the address of this firm has been designated as the
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`correspondence address for this application.
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`
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`Respectfully,
`
`
`
`
`
`
`Thomas T. Mega '
`
`
`
`Reg. No. 34,881
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`Page 2 of 2
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`Page 9 of 132
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`

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`as/6094.?
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`HARNESS, DICKEY & PIERCE, P.L.C.
`ATTORNEYS AND couusetcns
`P.0. aox an
`
`
`
`mus. MICHIGAN 43303
`
`
`
`
`
`
`UISIA.
`
`BLOOMPIELD
`
`
`
`
`
`
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`
`
`TELEPHONE
`(810) 641-1600
`
`TELEFACSIMILE
`(310) 541-0210
`
`
`
`
`
`
`
`
`Date: March 1, 1996
`
`
`
`
`
`
`Hon. Commissioner of Patents
`
`
`
`and Trademarks
`
`
`Washington, D.C. 20231
`
`
`
`
`
`
`
`Sir:
`
`
`
`EXPRESS MAILING CERTIFICATE
`
`
`
`
`
`
`
`Cedric X. Yu
`
`
`
`INTENSITY MODULATED ARC THERAPY WITH DYNAMIC MULTI-
`
`
`
`
`
`
`LEAF COLLIMATION
`
`
`
`
`
`2873-0001 9
`
`
`Thomas T. Moga
`
`
`
`
`
`
`
`
`
`
`
`
`
`Applicant:
`
`Serial No. (if any):
`
`
`
`
`For:
`
`Docket:
`
`Attorney:
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`
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`‘Express Mail“ Mailing Label Number
`
`
`
`. . . . . . . .
`
`. . . . EF787532980US
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`Date of Depostt .
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`. . .
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`. . . . . . . .
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`. . . Marcl11, 1996
`
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`I hereby certify and verify that the accompanying Patent Application including Specification,
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`Claims and Abstract; Nine (9) sheets informal drawings showing Figures 1-11; copy of
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`unexecuted Declaration and Power of Attorney; copy of Petition for Expedited Handling of
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`Foreign Filing Receipt filed and granted on February 29, 1996; copy of License for Foreign Filing;
`
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`Transmittal Letter (in duplicate); and check for $938.00 ($750.00 filing fee. $110.00 extra claim
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`fee, $78.00 extra independent claim fee) is being deposited with the United States Postal Service
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`"Express Mail Post Office To Addresses“ service under 37 C.F.Fl. 1.10 on the date indicated
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`above and is addressed to the Commissioner of Patents and Trademarks, Washington, D.C.
`20231.
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`I’
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`/ Signaturelgf Person Miling Document(s)
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`Page 10 of 132
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`Imrrzn STATE! DEPARTMENT or emu
`Mill: and Trllnmlrk Oillu
`Mums: cnuulssrouai or mrrarra mnfluoaunxs
`wmwmnaama
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`
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`Tllle:
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`Page 11 of 132
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`éaqé/57
`
`STRACT
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`A method and apparatus for delivering optimized
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`treatment plans to deliver relatively high doses of
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`ionizing radiation to target tissues while minimizing
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`dose to the surrounding healthy tissues. The present
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`invention utilizes continuous gantry motion in which
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`field shape, which is conformed with a multi—leaf
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`collimator, changes during gantry rotation.
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`multiple superimposing arcs, arbitrary two—dimensional
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`Using
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`beam intensity distribution at different beam angles
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`can be delivered, giving arbitrary dose distribution
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`in the patient to maximize the therapeutic ratio.
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`Page 12 of 132
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`00 swam 4 5 7R’
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`Attorney Docket No. 2873-00019
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`NTENSITY xonumgfgn 1u3Vc_;,__z-;_1__31mnz_.w::trr_:_ E
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`It: nUmI—:.“1TKr" oor.LIuM.'IoN
`D
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`*“ wIfififiTiSN '
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`T
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`ni
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`‘e1
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`This
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`invention relates to radiation therapy.
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`Particularly,
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`the present
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`invention relates to a
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`method and apparatus for delivering optimal radiation
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`dose to cancer patients to improve the therapeutic
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`ratio. The apparatus of the present invention relies
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`upon a radiation generating device equipped with a
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`rotatable gantry and a computer controlled multi-leaf
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`collimator.
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`The method of the present
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`invention is
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`referred to as intensity modulated arc therapy.
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`It
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`combines irradiation with gantry rotation and change
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`of
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`such rotation
`radiation field shapes.
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`delivers a focused radiation dose to the tumor site.
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`Each
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`Arbitrary
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`three-dimensional
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`radiation
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`dose
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`distributions
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`can
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`be
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`delivered with multiple
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`superimposing arcs.
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`Di
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`ss'o
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`Radiation therapy is intended to irradiate a
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`tumor to high levels of radiation dose such that the
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`growth of the tumor
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`tumor cells are destroyed. Where it is not possible
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`is halted and, preferably, all
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`to destroy all cells of a tumor, radiation therapy is
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`employed to reduce the size of the tumor so that it
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`Page 13 of 132
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`may be surgically removed.
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`Radiation therapy also
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`complements surgical removal of a tumor by irradiating
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`microscopic extensions of the tumor.
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`In certain situations,
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`chemotherapy
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`is used
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`instead of surgical
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`removal with radiation therapy.
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`This combination minimizes the toxicity on healthy
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`cells normally effected by high doses of chemotherapy
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`drugs administered alone.
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`The delivery of radiation in radiation therapy is
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`a
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`skilled art
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`in that,
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`in cancer
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`therapy,
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`the
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`objective is to er destroy a tumor without causing
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`irreparable radiation damage
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`in normal body tissue
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`which is adjacent
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`to the target.
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`tissue.
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`This
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`is
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`generally made\Fossib1e because of the nature of the
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`cancer‘-cellstahgzh distinguish themselves by being
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`quickly replicating relative to normal cells.
`It is
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`during the reproduction stage that cancer cells are
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`sensitive to ionizing radiation. Accordingly,
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`tumor
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`cells are more readily destroyed by ionizing radiation
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`than are normal cells because of this sensitivity.
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`It is the ionizing radiation which causes the
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`ionization of
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`the cell's chemical components.
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`As
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`photons or electrons enter body tissue,
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`some of the
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`energy disrupts cellular function.
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`(Most energy is
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`converted
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`into heat which
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`carries
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`no
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`damaging
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`biological effect.)
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`As ionizing radiation traverses
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`the tissue, it contacts atoms, which causes them to
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`Page 14 of 132
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`become excited. This process results in the breaking
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`of molecular bonds, followed by biological damage and
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`cellular destruction.
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`While the cellular destruction caused by ionizing
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`radiation produces desirable
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`lethal
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`effects
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`on
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`abnormal, quickly dividing cancer cells, this is not
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`desirable for healthy cells.
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`Indeed,
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`the greatest
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`limitation to the
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`broad
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`scale use of
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`ionizing
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`radiation in a therapy of various cancers relates to
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`the fact that in most cases the radiation beam has to
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`traverse healthy tissues in order to reach the tumor,
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`causing damage to the healthy tissues.
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`while an
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`increased dose of radiation would be useful in curing
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`the patient,
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`the dose is limited by the negative
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`effects of radiation on the adjacent, normal healthy
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`tissue. Complicating radiation therapy are the two
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`types of organs, serial and parallel.
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`In the former,
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`radiation tolerance is generally high, but the entire
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`organ (such as viscera) must be preserved to maintain
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`minimum function.
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`In parallel organs
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`(such as the
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`liver or the lungs), while in the latter tolerance is
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`normally low, a substantial portion of the organ may
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`be destroyed and the organ still remains minimally
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`operative. Accordingly, the goal of radiation therapy
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`has been to maximally irradiate the tumor while
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`keeping the dose to adjacent structures under their
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`tolerance or preserve part of the healthy structure
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`Page 15 of 132
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`such that enough of the organ is maintained so as to
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`guarantee a minimal functional reserve.
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`In keeping with the goal of administering maximum
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`amounts of
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`radiation to the target
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`tissue while
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`minimizing the delivery of radiation to healthy organs
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`surrounding the tumor, various techniques and devices
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`have been employed.
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`Two general
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`approaches
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`are
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`taken today
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`to
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`delivering radiation therapy. one is to use multiple
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`fields, and the other is to employ arc therapy.
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`In using multiple fields, each radiationniggiaent
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`is at a different orientation from the next.
`since
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`these radiation beams overlap at the tumor site,
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`a
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`higher dose can be given to the tumor
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`than to the
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`normal
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`structures.
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`To minimize
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`the exposure of
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`healthy structures around the tumor
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`to radiation,
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`masks of lead alloy are employed to shape each field
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`as the two dimensional projection of
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`the treatment
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`least
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`two
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`problems
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`are
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`associated with
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`target.
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`At
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`radiation therapy through the use of multiple fields,
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`both of which are related to the use of only a few
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`one problem is that the dose to
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`fields of exposure.
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`the healthy surrounding structure (which is roughly
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`the tumor dose divided by the number of fields)
`is
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`still too high. The other problem is that the ability
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`to shape the high dose volume
`is limited.
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`(For
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`Page 16 of 132
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`example,
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`if four or
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`fewer fields are used [as
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`is
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`typical],
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`the tumor high-dose area is substantially
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`like a box.) Another problem associated with the use
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`of multiple fields is the length of time it takes to
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`produce the alloy blocks, which is usually a matter of
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`hours or days. Storage of the bulky blocks is also a
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`problem.
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`In arc therapy,
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`irradiation is combined with the
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`rotation of
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`the gantry of
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`the radiation producing
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`apparatus.
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`During gantry rotation,
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`the radiation
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`field is set
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`to a fixed rectangular shape. While
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`delivering radiation to the
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`target
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`tissue,
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`the
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`relatively large field delivers the same amount of
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`radiation to
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`surrounding
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`healthy
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`tissue.
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`The
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`apparatus leaves in its path a cylindrically~shaped
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`swath as it completes its are around the patient.
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`However, arc therapy shares the burden of dose to
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`all
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`structure surrounding the
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`tumor
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`and maximal
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`overlap of beams
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`from all orientations. Again, at
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`least
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`two problems
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`result.
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`First,
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`there is no
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`discrimination between structures. Arc therapy treats
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`all structures around the target tissue the same way,
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`but, as noted above, not all
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`tissue has
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`the same
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`tolerance.
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`Second,
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`the cylindrical
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`shape of
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`the
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`delivered high dose is not the typical shape of the
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`tumor.
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`Page 17 of 132
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`The
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`above-noted
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`problem related
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`to
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`the
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`fabrication and use of blocks
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`in multiple field
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`therapy is generally solved with a device known as a
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`multi-leaf collimator.
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`This device consists of
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`opposing arrays of
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`radiation-impregnable, movable
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`leaves or veins placed in front of the radiation beam.
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`By driving each vein into different positions,
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`virtually any desired field shape can be achieved in
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`radiation therapy.
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`While directed to solving the time and labor
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`expenses related to the use of blocks,
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`
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`the multi-leaf
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`collimator does not solve the problems associated with
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`conventional treatment techniques, as discussed in the
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`
`preview section.
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`Thus, it would be desirable to provide a means
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`for accurately shaping the high dose volume to conform
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`three-dimensional shape of the tumor
`to the actual
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`while keeping the dose to all surrounding structures
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`under their tolerance or keeping the unaffected volume
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`larger than the required functional reserve.
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`Page 18 of 132
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`S
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`Y 0
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`THE I
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`ENTION
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`Pursuant
`
`
`
`
`
`to the present
`
`
`
`invention,
`
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`there is
`
`
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`
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`provided a method and system for improving local tumor
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`control and to provide an increased cure rate for
`
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`cancer patients.
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`The present
`
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`
`invention is coupled
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`with advances
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`in computer
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`technology and
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`linear
`
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`accelerator design. These features allow fo the nrw
`Con orma
`,
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`
`
`method of delivering three—dimens1onalA
`
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`
`
`radiotherapy provided for in the present invention.
`
`
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`
`The present
`
`
`
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`
`
`
`invention delivers high doses of
`
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`
`ionizing radiation to the
`
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`target
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`tissues while
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`minimizing dose to the surrounding healthy tissues.
`
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`In general,
`
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`
`the present
`
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`
`
`invention relates to a
`
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`method for delivering optimized treatment plans to
`
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`improve the therapeutic ratio. The present invention
`
`
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`
`
`utilizes continuous gantry motion as
`
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`
`in known are
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`therapy. However, unlike known arc therapy, the field
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`shape, which
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`is
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`
`
`conformed with
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`the multi-leaf
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`collimator,
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`changes during gantry rotation.
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`
`The
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`three-dimensional
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`shape of
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`the resultant high dose
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`volume, which can only be cylindrical with known arc
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`therapy, can take more complex forms.
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`The apparatus and method for delivering radiation
`
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`therapy according to the present
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`invention takes
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`consideration of the differences in tolerance levels
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`among the various normal body organs surrounding the
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`target area.
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`Page 19 of 132
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`The present
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`invention also compensates
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`for
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`
`
`differences in homogenous overlapping structures. For
`
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`example, if in one direction there is an air space in
`
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`the body,
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`the path to the tumor is less than if that
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`space was filled with tissue.
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`The present invention
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`compensates for such density differences.
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`In addition,
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`by taking consideration of
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`the
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`differences in normal structure tolerances and by
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`compensating
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`for
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`the
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`differences
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`in
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`homogenous
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`overlapping structures, angle preferences are created.
`
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`Furthermore, by again taking consideration of the
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`differences in normal structure tolerances and by
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`compensating
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`for
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`the
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`overlapping structures,
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`homogenous
`differences
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`intensity preference within a
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`in
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`beam angle may be created.
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`The present invention also provides a system of
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`delivering the intensity-modulated arc therapy of the
`
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`present invention.
`
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`
`The
`
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`the
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`conformity
`dose
`the
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`
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`to that achievable with
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`
`
`is
`
`present
`
`schemes,
`
`
`
`
`therapy of
`intensity-modulated arc
`
`,
`fipaifim
`
`
`
`present
`temporal
`invention combines
`-spaeia%A_and
`
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`
`
`-intensity modulation with the movement of the gantry.
`
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`It
`
`can
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`be
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`that
`
`shown
`
`theoretically equivalent
`
`
`The
`techniques.
`slice-based treatment
`
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`
`
`invention also presents advantages over tomotherapy.
`
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`As with tomotherapy or other sliced delivery
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`the intensity modulated arc therapy can
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`Page 20 of 132
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`deliver beams with both spatial and temporal intensity
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`modulations.
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`
`In comparison with the sliced delivery
`
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`
`
`
`schemes,
`
`
`
`intensity modulated arc therapy has many
`
`
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`
`
`advantages.
`
`
`
`It
`
`
`
`is implemented on existing linear
`
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`accelerators equipped with a multi—leaf collimator.
`
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`Therefore, it maintains the flexibility of a linear
`
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`accelerator.
`
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`Electron beam ther py and traditional
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`Cpex l5_
`
`
`
`treatment methods can-co-ex1etAus1ng the same device.
`
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`Non-transaxial arc treatments can be achieved to a
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`
`certain extent and partial
`
`
`Skate. 0
`is a\vLpecialized
`achievable.
`vromfiffiefalmjkmachine
`
`e.n'{'I‘ah
`(
`device,
`thegggfigentionptreatment cannot be delivered.
`
`
`With tomotherapy, a photon beam generated at the
`
`
`
`
`
`
`
`rc to ations are easily
`omo~‘c era»?
`
`
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`x—ray target is collimated into a slit, most of the
`
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`photons generated in the target will be blocked,
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`
`resulting in inefficient
`
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`
`beam delivery and
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`
`long
`
`
`
`delivery time. With intensity modulated arc therapy,
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`most of the target will be in the beam during the
`
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`delivery, maintaining a high efficiency in utilizing
`
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`the photons generated in the X—ray target.
`
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`
`With tomotherapy,
`
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`
`the patient is required to be
`
`
`moved in his length direction to cover
`
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`
`the entire
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`
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`treatment
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`area.
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`
`
`complexity of treatment. With intensity modulated are
`
`
`
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`
`
`This
`
`increases
`
`the
`
`cost
`
`and
`
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`
`
`therapy, no additional patient
`
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`
`transport mechanisms
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`are required to move the patient from slice to slice.
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`Eliminating the slicing also eliminates the problem of
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`Page 21 of 132
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`beam abutment between slices, and the cold and hot
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`spot associated with the abutments. Theoretically,
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`such an abutment problem among slices will be much
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`more severe if patient motion between treatment slices
`
`
`
`is considered.
`
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`
`Finally,
`
`
`
`since
`
`
`
`the
`
`
`
`
`intensity modulation
`
`
`
`in
`
`
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`
`
`tomotherapy relies on a set of leaves to open or close
`
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`
`the slit beam, the resolution of the beam intensities
`
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`
`is the slit width by the leaf width.
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`For practical
`
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`
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`
`
`
`design, such resolution is on the order of lcm by 1cm.
`
`
`
`The
`
`
`
`
`smooth three-dimensional
`
`
`
`target
`
`
`
`
`shape has
`
`
`
`to
`
`
`
`approximated
`
`
`
`by
`
`
`
`a
`
`
`
`
`collection of
`
`
`
`1
`
`
`
`3
`
`cm
`
`
`
`cubes.
`
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`
`
`
`
`
`the dose Conformity is limited.
`Therefore,
`
`
`
`\\ rfl‘ OCHQ;{\
`
`
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`
`
`is most severe for smaller targets, which
`
`Such
`
`
`
`conformal
`
`treatment.
`
`
`
`
`
`For
`
`
`
`
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`
`
`
`are more suitable for
`
`
`
`
`
`
`
`
`
`
`intensity modulated arc therapy treatments,
`
`
`
`the leaf
`
`
`
`travel
`
`
`
`
`
`
`
`
`
`is continuous in the length direction of the
`
`
`
`leaves.
`
`
`
`The
`
`
`
`
`field aperture
`
`
`
`
`in the
`
`
`
`
`leaf width
`
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`
`
`
`direction is collimated by the backup jaws and is,
`
`
`
`therefore,
`
`
`
`
`also continuous.
`
`
`
`Therefore,
`
`
`
`intensity
`
`modulated
`
`
`
`arc
`
`
`
`therapy
`
`
`
`
`
`can deliver higher
`
`
`
`dose
`
`
`
`
`
`
`
`conformity than tomotherapy.
`
`
`
`The
`
`
`
`steps
`
`
`
`for
`
`
`
`
`
`
`employing the therapy of
`
`
`
`the
`
`
`
`_ present
`
`
`
`
`
`invention are as
`
`
`
`follows.
`
`
`
`First
`
`
`
`
`is the
`
`
`
`
`
`
`
`
`
`optimization of a treatment plan that uses a beam
`
`
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`
`
`
`
`
`every 1-5 degrees around the patient. Second, besides
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`
`
`the beam energy and prohibiting angles, describe the
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`Page 22 of 132
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`beams
`
`
`
`at
`
`
`
`all
`
`
`
`angles
`
`
`
`(i.e.,
`
`
`
`having
`
`
`
`intensity
`
`
`
`distribution).
`
`
`
`
`
`
`(Appropriate methods and algorithms
`
`
`
`
`
`
`
`
`
`
`
`are made for these first two steps.) Third, translate
`
`
`
`two-dimensional
`
`
`
`
`
`
`intensity distributions at all beam
`
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`
`
`
`
`
`angles into arcs (i.e., field shape sequences, number
`
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`
`
`
`
`
`
`of beam monitor units per shape, et cet.).
`
`
`
`Fourth,
`
`
`
`
`
`
`
`
`
`
`write the field shape sequences, the number of monitor
`
`
`
`
`
`
`
`
`
`units per shape, et cet.,
`in the format required by
`the multi-leaf collimator controller and transfer the
`
`
`
`
`
`
`
`
`
`
`
`
`
`information to the controller.
`
`
`
`
`
`
`Fifth, deliver the
`
`
`
`dosage.
`
`
`
`
`
`
`
`
`
`
`involved in creating
`one of
`the key
`steps
`using
`optimized
`dose distributions
`the
`present
`
`invention is directed to a method to convert
`the
`
`
`
`
`
`
`
`
`
`
`
`
`
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`
`
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`
`
`
`
`
`
`
`
`
`
`
`intensity distributions at all beam angles required by
`
`
`
`
`
`
`
`
`the treatment plan into multiple arcs. Translation is
`
`
`affected by:
`
`
`
`
`
`
`
`
`(1) Determining the angle of multi-leaf
`
`
`
`
`
`
`
`
`
`
`collimator veins along which the radiation fields are
`
`
`
`
`
`conformed such that
`
`
`
`
`
`
`
`the field shape formed by the
`
`
`
`
`
`
`
`
`
`
`veins best coincides with the preferred field shape
`
`
`
`
`
`
`
`
`for all the various beam angles;
`
`
`(2)
`
`
`
`segmenting the
`
`
`
`
`
`
`
`
`two—dimensional beam intensity distributions of all
`
`
`
`
`
`
`
`
`
`beam angles into multiple, one-dimensional ones, each
`
`
`
`
`
`
`
`
`
`aligned with a pair of multi-leaf collimator veins;
`
`
`
`
`
`
`
`
`
`
`(3) determining the openings of each opposed pair of
`
`
`
`
`
`
`
`
`veins and the sequence of opening such that no large
`
`
`
`
`
`
`is required between two successive beam
`
`movement
`
`
`
`
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`Page 23 of 132
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`
`
`
`
`
`
`
`
`
`
`
`
`
`using
`
`
`
`
`the present
`
`
`
`invention.
`
`
`
`efficient
`
`treatment
`
`
`
`
`
`time
`
`
`
`including
`
`
`irradiation is
`
`
`comparable
`
`
`
`
`
`patient
`
`
`
`set—up
`
`to
`
`
`
`or
`
`
`
`shorter
`
`Total
`
`
`
`
`
`and
`
`than
`
`angles:
`
`
`
`
`
`
`
`
`(4) at every beam angle, constructing from the
`
`
`
`
`
`
`
`
`
`
`sets of vein openings a stack of field shapes; and (5)
`
`
`
`
`
`
`
`
`
`
`constructing arcs from the stacks of field shapes by
`
`
`
`
`
`
`
`picking one shape from each beam angle.
`
`
`
`The
`
`
`
`present
`
`
`
`invention
`
`
`
`also
`
`
`
`provides
`
`
`
`the
`
`simultaneous
`
`
`
`
`synchronizing of
`
`
`
`
`radiation delivery,
`
`
`
`
`
`
`
`
`
`This
`and field shape alter tion.
`gantry rotation,
`
`_
`s_ow':fl
`_
`.
`
`
`
`ation
`synchronizing is accomplished by enslavengfl
`
`
`
`
`
`
`
`and changes
`in field shape to delivered radiation
`
`
`
`
`monitor units so that
`
`
`
`
`
`the delivery is immune
`
`
`to
`
`machine dose rate fluctuations.
`
`
`
`
`
`
`
`
`
`
`
`
`Since there is no need to move the patient during
`
`
`
`
`
`treat