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Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.
HDR brachytherapy will be in the forefront of radiation oncology in the coming decades. This is the first textbook that offers the much needed information necessary to use this treatment modality. It begins with a discussion of the physics and radiobiology of HDR bracytherapy and continues with its application for specific body sites. Brachytherapy nursing and intraoperative HDR are also discussed
This book reevaluates the health risks of ionizing radiation in light of data that have become available since the 1980 report on this subject was published. The data include new, much more reliable dose estimates for the A-bomb survivors, the results of an additional 14 years of follow-up of the survivors for cancer mortality, recent results of follow-up studies of persons irradiated for medical purposes, and results of relevant experiments with laboratory animals and cultured cells. It analyzes the data in terms of risk estimates for specific organs in relation to dose and time after exposure, and compares radiation effects between Japanese and Western populations.
This book serves as a practical guide for the use of carbon ions in cancer radiotherapy. On the basis of clinical experience with more than 7,000 patients with various types of tumors treated over a period of nearly 20 years at the National Institute of Radiological Sciences, step-by-step procedures and technological development of this modality are highlighted. The book is divided into two sections, the first covering the underlying principles of physics and biology, and the second section is a systematic review by tumor site, concentrating on the role of therapeutic techniques and the pitfalls in treatment planning. Readers will learn of the superior outcomes obtained with carbon-ion therapy for various types of tumors in terms of local control and toxicities. It is essential to understand that the carbon-ion beam is like a two-edged sword: unless it is used properly, it can increase the risk of severe injury to critical organs. In early series of dose-escalation studies, some patients experienced serious adverse effects such as skin ulcers, pneumonitis, intestinal ulcers, and bone necrosis, for which salvage surgery or hospitalization was required. To preclude such detrimental results, the adequacy of therapeutic techniques and dose fractionations was carefully examined in each case. In this way, significant improvements in treatment results have been achieved and major toxicities are no longer observed. With that knowledge, experts in relevant fields expand upon techniques for treatment delivery at each anatomical site, covering indications and optimal treatment planning. With its practical focus, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists, and senior nurses whose work involves radiation therapy, as well as medical oncologists and others who are interested in radiation therapy.
This book is the seventh in a series of titles from the National Research Council that addresses the effects of exposure to low dose LET (Linear Energy Transfer) ionizing radiation and human health. Updating information previously presented in the 1990 publication, Health Effects of Exposure to Low Levels of Ionizing Radiation: BEIR V, this book draws upon new data in both epidemiologic and experimental research. Ionizing radiation arises from both natural and man-made sources and at very high doses can produce damaging effects in human tissue that can be evident within days after exposure. However, it is the low-dose exposures that are the focus of this book. So-called “late” effects, such as cancer, are produced many years after the initial exposure. This book is among the first of its kind to include detailed risk estimates for cancer incidence in addition to cancer mortality. BEIR VII offers a full review of the available biological, biophysical, and epidemiological literature since the last BEIR report on the subject and develops the most up-to-date and comprehensive risk estimates for cancer and other health effects from exposure to low-level ionizing radiation.
This book, written by a team of international experts, concisely reviews the rationale and clinical application of image-guided total marrow irradiation, a rapidly emerging area in radiation oncology and hematopoietic cell transplantation. The aim is to provide the practicing radiation oncologist, hematologist, medical physicist, and bone marrow transplant researcher with a fundamental understanding of key aspects and an appreciation of the increasing significance of total marrow irradiation as conditioning for bone marrow transplantation. Detailed attention is paid to the impacts of recent advances in radiation therapy technology, functional PET and MRI, and understanding of the response of bone marrow to radiation. Full consideration is also given to the ways in which technological advances in image-guided radiation therapy have created new opportunities to treat bone marrow transplant patients with limited transplant options due to advanced disease, age, or co-morbidities. Further topics covered include the ways in which cancer stem cells and the marrow microenvironment influence response to radiation therapy and the implementation of new-generation predictive radiobiologic factors in the clinic.
Accelerated partial breast irradiation (APBI) is being rapidly introduced into the clinical management of early breast cancer. APBI, in fact, encompasses a number of different techniques and approaches that include brachytherapy, intraoperative, and external beam techniques. There is currently no single source that describes these techniques and their clinical implementation. This text is a concise handbook designed to assist the clinician in the implementation of APBI. This includes a review of the principles that underlie APBI, a practical and detailed description of each technique for APBI, a review of current clinical results of APBI, and a review of the incidence and management of treatment related complications.
Joint FAO/IAEA/WHO Study Group on High-Dose Irradiation (Wholesomeness of Food Irradiated with Doses Above 10 kGy), Geneva, 15-20 September 1997
Does radiation medicine need more regulation or simply better-coordinated regulation? This book addresses this and other questions of critical importance to public health and safety. The issues involved are high on the nation's agenda: the impact of radiation on public safety, the balance between federal and state authority, and the cost-benefit ratio of regulation. Although incidents of misadministration are rare, a case in Pennsylvania resulting in the death of a patient and the inadvertent exposure of others to a high dose of radiation drew attention to issues concerning the regulation of ionizing radiation in medicine and the need to examine current regulatory practices. Written at the request from the Nuclear Regulatory Commission (NRC), Radiation in Medicine reviews the regulation of ionizing radiation in medicine, focusing on the NRC's Medical Use Program, which governs the use of reactor-generated byproduct materials. The committee recommends immediate action on enforcement and provides longer term proposals for reform of the regulatory system. The volume covers: Sources of radiation and their use in medicine. Levels of risk to patients, workers, and the public. Current roles of the Nuclear Regulatory Commission, other federal agencies, and states. Criticisms from the regulated community. The committee explores alternative regulatory structures for radiation medicine and explains the rationale for the option it recommends in this volume. Based on extensive research, input from the regulated community, and the collaborative efforts of experts from a range of disciplines, Radiation in Medicine will be an important resource for federal and state policymakers and regulators, health professionals involved in radiation treatment, developers and producers of radiation equipment, insurance providers, and concerned laypersons.
An intuitive, ingenious and powerful technique, sentinel lymph node biopsy has entered clinical practice with astonishing rapidity and now represents a new standard of care for melanoma and breast cancer patients, while showing great promise for the treatment of urologic, colorectal, gynecologic, and head and neck cancers. This text, written by international experts in the technique, provides a clear and comprehensive guide, presenting a detailed overview and discussing the various mapping techniques available and how these are applied in a number of leading institutions. This essential resource for surgical onocologists, pathologists, and specialists in nuclear medicine will also provide key information for those planning to start a sentinel lymph node program.