Advances of Dose-painting Radiotherapy

For majority of malignancies, loco-regional failure remains the common pattern after definitive radiation therapy, and the possible reason might be that a homogenous radiation dose was usually delivered to the planning target volume without taking the spatial-temporal radiosensitive heterogeneity into account. The advanced imaging techniques such as positron emission tomography-computed tomography (PET-CT) and functional magnetic resonance imaging (fMRI) make the radiation dose be delivered to the subvolume or voxel in tumor with heterogeneous radio-sensitivity, i.e. dose-painting (DP) radiotherapy. The DP radiotherapy includes DP by contours (DPBC) or numbers (DPBN). It is feasible in technique that DP radiotherapy could be executed in the cancers of head and neck, lung, prostate and anorectum. But the DP radiation therapy is warranted to be improved in technique, software and hardware as well as to be investigated in clinical practice.