Authors' objectives:

This study aimed to assess the efficacy, safety, availability and economic aspects of intensity-modulated radiotherapy (IMRT).

Authors' results and conclusions: The term 'intensity-modulated radiotherapy' covers different technologies. There is no consensus definition of IMRT. IMRT is significantly more complex than any other radiotherapy technique, and requires rigorous and specific quality assurance. The 8 clinical trials selected were of a low level of evidence: 7 case series, only one of which was a prospective study, and a dose-escalation study. The literature review provided insufficient information to determine a clinical risk/benefit ratio for this emerging technique. Limited clinical data show that IMRT is feasible for the treatment of prostate, head and neck, central nervous system, breast and gynaecological cancers. Investment in IMRT depends very much on the equipment and staff already available within the health care organisation. A cost/efficacy ratio for IMRT could not be determined as no studies of adequate design quality were found. The practice survey reflects the current availability of IMRT in France: 87.7% of centres who responded did not use the technique, but 46.5% planned to introduce it within the next 3 years. A total of 12 centres had treated 159 patients between June 2000 and December 2002, mainly for prostate cancer (79.9%) and head and neck cancer (17%).

Authors' recommendations: IMRT is an emerging external radiotherapy technique. Its clinical applications have yet to be studied. Specific guidelines for this technique need to be drawn up to define the optimum human and equipment resources, quality assurance, and training for care staff.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)