Objective: The current study was designed to review the clinical practice of intensity modulated radiation therapy (IMRT) in department of radiation oncology, Stanford university medical center. Methods: An inverse planning system ( Corvus, NOMOS corporation) was used to optimize IMRT treatment plans for 2 patients. IMRT using 9 coplanar beams was a part of radical irradiation, combined with external beam therapy. An X-knife radiosurgery boost was added to the first case with nasopharyngeal carcinoma. IMRT was the single modality in the treatment of thoracic vertebral metastases in the second patient. Results: The optimized isodose distributions in various plans showed the best compromise between the target volume dose requirements and the dose constraints placed upon the sensitive structures. The statistics of the plan summarized the volume, dose range in the targets and the organs or tissues concerned. Dose volume histograms offered a direct comparison of dose-volume in tumor and sensitive structures. Conclusions: IMRT can yield a sufficiently homogeneous desired dose distribution which results in a high degree of sparing of sensitive structures. It can be implemented to escalate target doses in some cases.