摘 要 放射治疗在过去的十年中经历了一系列技术革命，相继出现了三维适形放疗(3DCRT)、调强放疗(IMRT)、质子放疗等技术，这些技术的主要进步是靶区剂量分布适形性的提高。但是，由于呼吸运动等因素的影响，在放疗实施过程中肿瘤及其周围正常组织会发生形状和位置的变化，这种不确定性一定程度阻碍了3DCRT和IMRT技术的发展。图像引导放疗技术(IGRT)的出现，对补偿呼吸运动影响的肿瘤放疗取得了很好的疗效，特别是近年来提出的四维放射治疗(4DRT)技术，进一步丰富了IGRT的实现方式。本文将详细介绍现有的各种放疗技术及其存在的问题，同时讨论一下放疗技术的未来发展方向。

    关键词 图像引导放疗；锥形束CT；四维放疗；呼吸门控系统

    Abstract Radiation therapy has experienced a series of technological revolution in the past decade with the advent of the three-dimensional conformal radiotherapy(3DCRT), Intensity Modulated Radiotherapy(IMRT), proton radiation, and other technologies. The main target of these technologies is to increase the dose distribution. However, due to respiration, and other factors, the tumor and surrounding normal tissue will change in the shape and location in the course of implementing, this uncertainty hindered the 3 DCRT and the development of IMRT technology to some extent. With the emergence of Image guided radiation therapy technology (IGRT) compensation for respiratory movement of cancer radiation therapy achieved a very good effect. especially in recent years the four-dimensional radiation therapy (4DRT) technology, further enriching the IGRT way to achieve this. This paper will detail the various existing radiation therapy technology and the existing problems, and further talk about the future direction of technology. ......