Advanced Techniques For Radiotherapy

For physicians, particularly oncologists, and for specialists involved with the equipment or procedures of nuclear medicine, describes the use of large nuclear installations to treat cancer. Reviews the results obtained with neutrons produced by accelerators of different energies; details the use of nuclear reactors for Boron Neutron Capture Therapy, emphasizing the collaboration between disciplines; surveys the experience of medium- and high- energy accelerators in various laboratories; and the assesses the advantages of Synchrotron light emitted from large electron storage rings in both diagnosis and therapy. No index. Annotation copyright by Book News, Inc., Portland, OR

This new book educates readers about new technologies before they appear in hospitals, enabling medical physicists and clinicians to prepare for new technologies thoroughly and proactively, and provide better patient care once new equipment becomes available. Emerging technologies in imaging, treatment planning, treatment delivery, dosimetry and informatics are all discussed. The book is divided into three parts: recently developed technologies available for practice; technologies under development nearing completion; and technologies in an early stage of development that could have potential radiotherapy applications. Features: Introduces emerging technologies in imaging, treatment planning, treatment delivery, dosimetry and informatics The advantages and limitations of each technology in clinical settings are discussed, and recommendations on how to adopt the technologies are provided Critiques and improvement points are provided for researchers, in addition to suggestions on how to prepare quality assurance are provided as needed

In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop.

This book addresses the day-to-day treatment planning issues that radiation oncologists are likely to encounter during the treatment of breast cancer patients and provides numerous practical “tips” that will assist in navigation of the treatment planning process, from delineation of the tumor boundaries to discrimination of adjacent normal tissues and critical structures at risk of radiation injury. Differences in target delineation and treatment planning according to technique are emphasized, with coverage of conventional radiation therapy and advanced techniques including cardiac-sparing approaches, e.g., using active breathing control, intensity-modulated radiation therapy, proton beam therapy, and electron beam therapy post mastectomy. Individual chapters also focus on radiation setup and verification techniques and radiation treatment planning systems. The book, which is part of the Springer series Practical Guides in Radiation Oncology, is designed for hands-on use by radiation oncology residents/fellows in training and practicing radiation oncologists.

This book concisely reviews important advances in radiation oncology, providing practicing radiation oncologists with a fundamental understanding of each topic and an appreciation of its significance for the future of radiation oncology. It explores in detail the impact of newer imaging modalities, such as multiparametric magnetic resonance imaging (MRI) and positron emission tomography (PET) using fluorodeoxyglucose (FDG) and other novel agents, which deliver improved visualization of the physiologic and phenotypic features of a given cancer, helping oncologists to provide more targeted radiotherapy and assess the response. Due consideration is also given to how advanced technologies for radiation therapy delivery have created new treatment options for patients with localized and metastatic disease, highlighting the increasingly important role of image-guided radiotherapy in treating systemic and oligometastatic disease. Further topics include the potential value of radiotherapy in enhancing immunotherapy thanks to the broader immune-stimulatory effects, how cancer stem cells and the tumor microenvironment influence response, and the application of mathematical and systems biology methods to radiotherapy.

This evidence-based guide on the use of radiotherapy in patients with common malignancies of the lung, esophagus, and thymus will help radiation oncologists to deliver optimal care within a multidisciplinary setting. Detailed information is provided on all aspects, from delineation of tumor volumes and organs at risk based on four-dimensional CT simulation through to the various advanced radiotherapy techniques, including stereotactic ablative radiotherapy (SABR), intensity-modulated radiation therapy (IMRT), tomotherapy, volumetric modulated arc therapy (VMAT), and proton therapy. Contouring, treatment planning, and treatment delivery are documented in a range of everyday cases, with illustrations of slice-by-slice delineations on planning CT images and finalized treatment plans based on detailed acceptance criteria. Numerous practical tips are highlighted, and relevant information is included on surgical techniques and systemic therapies. The book will facilitate decision making in the management of patients with common thoracic malignancies and assist in overcoming the challenges encountered in daily clinical practice.

Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.

This book is a practical guide to the use of modern radiation therapy techniques in women with gynecological cancers. Step-by-step instruction is provided on simulation, contouring, and treatment planning and delivery for cancers of the cervix, endometrium, vagina, and vulva. Beyond external beam radiation delivery, full details are presented on three-dimensional brachytherapy at all sites for which it is applicable. Moreover, in-depth guidance is offered on the various advanced techniques of radiation delivery, including intensity-modulated radiation therapy, image guidance for external beam and brachytherapy, and stereotactic body radiotherapy. Radiation therapy is a critical component of the multidisciplinary management of gynecological tumors. With modern technology, both external beam radiation and brachytherapy can be delivered in a highly conformal way. This requires precise contouring and accurate planning techniques. In clearly describing the indications for and the delivery of quality radiation therapy for gynecological tumors, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists, and radiotherapy residents.

This new book educates readers about new technologies before they appear in hospitals, enabling medical physicists and clinicians to prepare for new technologies thoroughly and proactively, and provide better patient care once new equipment becomes available. Emerging technologies in imaging, treatment planning, treatment delivery, dosimetry and informatics are all discussed. The book is divided into three parts: recently developed technologies available for practice; technologies under development nearing completion; and technologies in an early stage of development that could have potential radiotherapy applications. Features: Introduces emerging technologies in imaging, treatment planning, treatment delivery, dosimetry and informatics The advantages and limitations of each technology in clinical settings are discussed, and recommendations on how to adopt the technologies are provided Critiques and improvement points are provided for researchers, in addition to suggestions on how to prepare quality assurance are provided as needed

Successful clinical use of intensity-modulated radiation therapy (IMRT) represents a significant advance in radiation oncology. Because IMRT can deliver high-dose radiation to a target with a reduced dose to the surrounding organs, it can improve the local control rate and reduce toxicities associated with radiation therapy. Since IMRT began being used in the mid-1990s, a large volume of clinical evidence of the advantages of IMRT has been collected. However, treatment planning and quality assurance (QA) of IMRT are complicated and difficult for the clinician and the medical physicist. This book, by authors renowned for their expertise in their fields, provides cumulative clinical evidence and appropriate techniques for IMRT for the clinician and the physicist. Part I deals with the foundations and techniques, history, principles, QA, treatment planning, radiobiology and related aspects of IMRT. Part II covers clinical applications with several case studies, describing contouring and dose distribution with clinical results along with descriptions of indications and a review of clinical evidence for each tumor site. The information presented in this book serves as a valuable resource for the practicing clinician and physicist.