Proton beam therapy is an emerging technology with promise of revolutionizing the treatment of cancer. While nearly half of all patients diagnosed with cancer in the US receive radiation therapy, the majority is delivered via electron accelerators, where photons are used to irradiate cancerous tissue. Because of the physical properties of photon beams, photons may deposit energy along their entire path length through the body. On the other hand, a protonbeamdirected ata tumor travels in a straight trajectory towards its target, gives off most of its energy at a defined depth called the Bragg peak, and then stops. While photons often deposit more energy within the healthy tissues of the body than within the cancer itself, protons can deposit most of their cancer-killing energy within the area of the tumor. As a result, in the properly selected patients, proton beam therapy has the ability to improve cure rates by increasing the dose delivered to the tumor and simultaneously reduce side-effects by decreasing the dose to surrounding tissue. The benefits of proton beam therapy in delivering a lethal hit to the target while sparing surrounding normal tissues from radiation are becoming applicable to an increasing number of patients and a growing list of conditions. In this book, the author will guide the reader through existing evidence supporting proton beam therapy for pediatric cancer, prostate cancer, lung cancer, brain tumors, spinal tumors, and several other conditions. The book will discuss which conditions are suitable for treatment with proton beam therapy, how the treatment is delivered, and the current data supporting its use."

This book describes the molecular mechanisms of lung cancer development and progression that determine therapeutic interventions in the era of genomics, when the rapid evolution in lung cancer diagnosis and treatment necessitates critical review of new results to integrate advances into practice. The text opens with background and emerging information regarding the molecular biology of lung cancer pathogenesis. Updated results regarding lung cancer prevention and screening are discussed, followed by chapters on diagnostic techniques and pathological evaluation. This leads on to a detailed presentation of treatment modalities, from surgery and radiation therapy to standard chemotherapy and targeted agents. The coverage includes resistance to therapy and the emergence of immunotherapy for lung cancer; in addition, the current evidence in respect of small cell lung cancer is summarized. The book presents insights from experts across disciplines to emphasize the importance of collaborative care. Advances in our understanding of issues in geriatric oncology and palliative care complete the comprehensive discussion of lung cancer.

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.

Prostate brachytherapy has been the subject of heated debate among surgeons and the proponents of the various brachytherapy methods. This very first interdisciplinary book on the subject provides a comprehensive overview of innovations in low dose rate (LDR), high dose rate (HDR), and pulsed dose rate (PDR) interstitial brachytherapy for the management of local or locally advanced prostate cancer. In addition to detailed chapters on patient selection and the use of imaging in diagnostics, treatment guidance, and implantation control, background chapters are included on related medical physics issues such as treatment planning and quality assurance. The results obtained with the different treatment options and the difficult task of salvage treatment are fully discussed. All chapters have been written by internationally recognized experts who for more than a decade have formed the teaching staff responsible for the successful GEC-ESTRO/EAU Prostate Brachytherapy Teaching Course.

Dating Neurological Injury: A Forensic Guide for Radiologists, Other Expert Medical Witnesses, and Attorneys presents a unique way to approach the dating of neurological injury as imaged by modern computed tomography (CT), magnetic resonance (MR) and ultrasound (US). Chapters are presented in a logical progression beginning with the general appearance of normal brain and progressing to the way abnormalities manifest themselves. The emphasis in these discussions is on the appearance of edema and of hemorrhage, as these two findings are the brain's most common response to injury. This volume presents in a systematic fashion the principles involved in the interpretation of images of the central nervous system specifically in a medical-legal setting where concern exists about the occurrence and timing of an injury. Dating Neurological Injury: A Forensic Guide for Radiologists, Other Expert Medical Witnesses, and Attorneys is a welcome addition to institutional, medical, and legal libraries, and to the personal libraries of malpractice defense and plaintiff lawyers and physicians in the neurosciences (neurosurgery, neurology, neuropathology, and neuroradiology) involved in medical-legal issues.

Photon Radiation Therapy for Skin Malignancies is a vital resource for dermatologists interested in radiation therapy, including the physics and biology behind treatment of skin cancers, as well as useful and pragmatic formulas and algorithms for evaluating and treating them. Dermatology has always been a field that overlaps multiple medical specialties and this book is no exception, with its focus on both dermatologists and radiation oncologists. It is estimated that between 2010 and 2020, the demand for radiation therapy will exceed the number of radiation oncologists practicing in the U.S. tenfold, which could profoundly affect the ability to provide patients with sufficient access to treatment. Photon Radiation Therapy for Skin Malignancies enhances the knowledge of dermatologists and radiation oncologists and presents them with the most up-to-date information regarding detection, delineation and depth determination of skin cancers, and appropriate biopsy techniques. In addition, the book also addresses radiation therapy of the skin and the skin's reactions to radiation therapy.

This book reports the majority of lectures given during the NATO Advanced Study Institute ASI-982996, which was held at the European Scientific Institute of Archamps (ESI, Archamps - France) from November 15 to November 27, 2007. The ASI course was structured in two parts: the first was dedicated to what is often called "teletherapy", i. e. radiotherapy with external beams, while the second focused on internal radiotherapy, also called "brachytherapy" or "curietherapy" in honour of Madame Curie who initiated the technique about a century ago. This ASI took place after the European School of Medical Physics, which devoted a 3 week period to medical imaging, a subject complementary to the topics of this book. Courses devoted to nuclear medicine and digital imaging techniques are collected in two volumes of the NATO Science Series entitled "Physics for Medical Imaging Applications" (ISBN 978-1-4020-5650-5) and "Molecular imaging: computer reconstruction and practice" (ISBN 978-1-4020- 8751-6). Every year in autumn ESI organises the European School of Medical Physics, which covers a large spectrum of topics ranging from Medical Imaging to Radiotherapy, over a period of 5 weeks. Thanks to the Cooperative Science and Technology sub-programme of the NATO Science Division, weeks four and five were replaced this year by the ASI course dedicated to "Physics of Modern Radiotherapy & Brachytherapy". This allowed the participation of experts and students from 20 different countries, with diverse cultural background and p- fessional experience.

Cancer is one of the leading killers in the world and the incidence is increasing, but most cancer patients and cancer survivors suffer much from the disease and its conventional treatments' side effects. In the past, clinical data showed that some complementary and alternative medicine (CAM) possessed anticancer abilities, but some clinicians and scientists have queried about the scientific validity of CAM due to the lack of scientific evidence. There is great demand in the knowledge gap to explore the scientific and evidence-based knowledge of CAM in the anticancer field. With this aim, a book series is needed to structurally deliver the knowledge to readers. There have been a number of publications on materia medica for various cancers in recent years, the scientific and medical community are thrust for up-to-date information that are supported by concrete laboratory evidences or clinical trials. This volume is a specialised book presenting the experimental and clinical evidences of anticancer materia medica for various cancers. This book consists of sixteen chapters, providing concise reviews and expert opinions on the recent progress of materia medica research in fourteen particular cancers from bench to bedside application. In addition, the book also includes a chapter with an overview of evidence-based materia medica for cancer chemoprevention, as well as a chapter discussing on the pharmacokinetics of anticancer materia medica. Gathering international opinion leaders' views, this volume will contribute great to the cancer, academic, and clinical community by providing evidence-based information on the anticancer effects of materia medica for various cancers. Readership Oncologists, cancer researchers, pharmacologists, pharmaceutical specialists, Chinese medicine practitioners, medical educators, postgraduates and advanced undergraduates in biomedical disciplines, cancer caregivers, cancer patients.

Current cancer therapies are focused on three general strategies: modifying intrinsic radiosensitivity via molecular targeting, manipulating microenvironmental factors to enhance tumor susceptibility to radiation, and improving delivery of radiation to critical tumor locations while sparing normal tissues. The goal of this volume is to describe a number of promising approaches corresponding to each strategy. In general, research in radiation oncology tends to be siloed into fundamental biology, physics or treatment delivery. The strategies for improving therapeutic ratio encompassed in this book will involve each of these components of radiation oncology. Thus, they will illustrate the variety of disparate approaches available for potentially improving the efficacy of radiotherapy, which may then stimulate discussion across disciplines and foster further translational investigations. Although a goal of each chapter will be to highlight advances within an approach, of equal importance will be the delineation of barriers to successful clinical application and how to overcome or minimize such impediments. Along these lines, because therapeutic ratio incorporates both tumor and normal tissue radio response, a point of emphasis will be the mechanistic rationale for selectively modifying tumor (sensitization) or normal cells (protection). Finally, whereas the literature is replete with studies describing potential targets/strategies for increasing the therapeutic ratio for radiotherapy, this book will focus on those supported by in vivo data consistent with impending translational application along with those that are already being evaluated in the clinic.

The last three decades have provided opportunities to explore the potential of treating malignant diseases with antibodies or other targeting molecules labelled with nuclides. While considerable advances have been reported, there is still a signi- cant amount of work left to accomplish before our ambitions can be achieved. It now seems timely to review the accomplishments achieved to date and to clarify the challenges that remain. The choice of radionuclide, the conjugation p- cedure employed, and the selection of suitable targets were early issues that were faced by our field that still persist, however we can now tackle these obstacles with significantly better insight. The expanding array of new targeting molecules (recombinant antibodies, peptides and agents based upon alternate scaffolds) may increase the therapeutic efficacy or even modify the radiation sensitivity of the targeted tumor cell. The title of this book "Targeted Radionuclide Tumour Therapy - Biological Aspects" was selected to reinforce the concept that a major focus of this volume was devoted to understanding the biological effects of targeting and radiation. These important issues have not previously been the primary focus in this context. Furthermore, our rapidly expanding knowledge of different types of cell death and the increasingly likely existence of cancer stem cells suggests to us that even more efficient approaches in targeting might be possible in the future.

This book concisely reviews our current understanding of hypoxia, molecular targeting, DNA repair, cancer stem cells, and tumor pathophysiology, while also discussing novel strategies for putting these findings into practice in daily clinical routine. Radiotherapy is an important part of modern multimodal cancer treatment, and the past several years have witnessed not only substantial improvements in radiation techniques and the use of new beam qualities, but also major strides in our understanding of molecular tumor biology and tumor radiation response. Against this backdrop, the book highlights recent efforts to identify reasonable and clinically applicable biomarkers using broad-spectrum tissue microarrays and high-throughput systems biology approaches like genomics and epigenomics. In particular, it describes in detail how such molecular information is now being exploited for diagnostic imaging and imaging throughout treatment using the example of positron emission tomography. By discussing all these issues in the context of modern radiation oncology, the book provides a broad, up-to-date overview of the molecular aspects of radiation oncology that will hopefully foster its further optimization.

At the time of the first edition of Principles of Cancer Biotherapy in 1987, this book represented the first comprehensive textbook on biological therapy. In 1991, when the second edition was published, there was still some doubt on the part of many oncologists and cancer researchers as to the therapeutic value of these new approaches. By 2003 and the fourth edition, it was generally agreed that biopharmaceuticals were producing major opportunities for new cancer therapies. Cancer biotherapy has now truly matured into the fourth modality of cancer treatment. This fifth revised edition describes the tremendous progress that has been made in recent years using biologicals in cancer treatment.

This book summarizes an evolving science and a rapidly changing medical practice in biotherapy. In this new millennium, it is now possible to envision a much more diversified system of cancer research and treatment that will afford greater opportunities for a patient s personalized cancer treatment. This was first envisioned in the 1987 initial edition of this textbook and is now a new and popular approach to cancer treatment. Some forms of cancer biotherapy use the strategy of tumor stabilization and control through continued biological therapy, akin to the use of insulin in the treatment of diabetes.

This textbook illustrates new methods of thinking and new strategies for control of cancer. It is always difficult to move from past dogma to future opportunity, but this fifth edition of Principles of Cancer Biotherapy illustrates why it is so important to the patients for researchers and clinicians to explore and quickly apply these new opportunities in cancer biotherapy."

This book presents a systematic survey of different local treatments in inflammatory joint diseases and their potential side effects and complications. Both surgical therapies and pharmaceutical strategies involving local or systemic application of anti-inflammatory and immunomodulating drugs are addressed. Special emphasis is placed on nuclear medicine therapy by intra-articular instillation of beta radiation emitters, known as radiosynoviorthesis or radiation synovectomy. Possible complications, in particular radionecrosis, infection, and thromboembolism, are described and available treatment strategies are examined in detail. In addition, radiation safety considerations are critically reviewed and relevant clinical questions are discussed. While radiosynoviorthesis is an effective and safe treatment if a proper indication is secured and if the application is performed by an experienced nuclear medicine physician, local complications can never be excluded with certainty. This book will support physicians who are engaged in the care and treatment of patients with inflammatory joint disease, approximately 30,000 of whom undergo radiosynoviorthesis in Europe each year.

This book reviews the significant advances in our understanding of glioma biology that have been achieved during the past decade and describes in detail the resultant new approaches to treatment. Improvements in surgical techniques, radiation therapy, and chemotherapy are comprehensively covered, with discussion of their impact in decreasing patient morbidity and increasing survival. In addition, individual chapters are devoted specifically to current treatment for low-grade gliomas, anaplastic gliomas, and glioblastoma multiforme. Other topics addressed include treatment of the elderly patient, investigating emerging therapies from small molecules to immunotherapy and palliative care. This timely book will be a valuable source of up-to-date information for practitioners and will also be of interest to researchers.

This text is designed to present a comprehensive and state-of the-art approach to the management of breast cancer within the fields of surgery, medical oncology, and radiation oncology. Sections address changes in these fields. These areas include breast imaging, management of the axilla, atypical breast lesions, surgical margins, new techniques in breast reconstruction, and nipple sparing and contralateral mastectomies. Subsequent chapters focus on issues in medical oncology including, triple negative breast cancer and metastatic breast disease. New paradigms in radiation oncology are examined. Breast cancer treatment in the elderly and in young women, and genetic risk in breast cancer management is also be discussed. Written by experts in their field, each of these sections addresses advances and changes in the field. A brief review of the existing literature addressing the particular topic follows in each section. The text concludes with chapters on pathological issues and advances in radiation oncology. As access to a comprehensive multidisciplinary resource such as this is currently limited in the literature, Changing Paradigms in the Management of Breast Cancer represents the first single source to provide information on advances and outcomes for the physician caring for breast cancer patients in a multidisciplinary setting.

Oncological imaging has thoroughly changed in the past decade, especially due to the introduction of PET and 18FDG. In "Positron Emission Tomography," expert referring specialists and professional imagers seek to help bridge some of the knowledge gaps in several oncological domains. The book s goal is to aid in the improvement of communicative competences: to communicate scan findings so that the referring specialist receives proper advice from the imager, and that, alternatively, the referring one provides the imager with appropriate clinical details to allow for a proper interpretation, and that the referring specialist is aware of the possibilities and limitations of the requested technology. While it focuses on FDG PET, other radiopharmaceuticals are covered as well, where appropriate. Written for the highly respected "Methods in Molecular Biology " series, this volume provides the kind of detailed description and implementation advice that is crucial for getting optimal results.

Authoritative and convenient, "Positron Emission Tomography" serves as an excellent reference for oncologists, surgeons, radiotherapists, radiologists, nuclear medicine physicians, and pathologists desiring a stronger synergy within their vital efforts."

Multiple myeloma is the second most common hematologic malignancy and c- rently affects approximately 50,000 people in the United States. Each year about 20,000 people are diagnosed with myeloma. Although new treatments have been developed, which signi?cantly prolong the survival of patients, myeloma bone d- ease still remains a major cause of severe morbidity and increased mortality in patients with myeloma. Myeloma bone disease is characterized by "punched out" lytic lesions caused by increased osteoclastic bone destruction accompanied by suppressed or even absent osteoblast activity. Advances in our understanding of both the pathophysiology of myeloma bone disease and the development of novel agents that target speci?c pathways involved in both the increased osteoclast f- mation and the suppressed osteoblast activity in myeloma provide new hope for these patients. The treatment of myeloma bone disease was revolutionized by cl- ical trials that demonstrated the signi?cant bene?t of intravenous bisphosphonate therapy in patients with myeloma bone disease. With the identi?cation of many of the cytokines and chemokines involved in myeloma bone disease, novel th- apies such as denosumab that blocks RANKL activity, anti-DKK1, which targets the inhibition of osteoblast activity by blocking Wnt signaling inhibition, and the potential anabolic effects of agents such as bortezomib and activin have greatly improved our potential to block the progression or reverse myeloma bone disease.

Recent advances in radiation oncology have depended upon and are intertwined with subsequent scientific discoveries and the development of new techniques in the fields of radiation and molecular biology, physics, electrical engineering, surgery, and medical oncology. This volume describes how some of the recent discoveries in the radiological sciences have influenced the way radiation oncology is practised. As there are many advances in this field, the Editors have chosen to concentrate on selected topics in clinical radiotherapy, radiation physics and biology, and technical innovations that have had a major impact on radiation oncology in the past twenty years. It is hoped that the techniques described in this volume will increase tumor control and prolong patient survival and at the same time decrease radiation-induced side effects and complications.

Radiation Toxicity: A Practical Guide provides insight into the management of day-to-day aspects of radiotherapy. Most radiation oncologists and radiation oncology nurses spend a large percentage of their time dealing with the effects of radiotherapy. This book describes the biology behind each sites acute and long-term responses to radiotherapy, including the best current knowledge regarding radiation tolerance, and fills a needed void in the literature that is available on radiation oncology.

This book describes radionanomedicine as an integrated medicine using exogenous and endogenous This book describes radionanomedicine as an integrated approach that uses exogenous and endogenous nanomaterials for in vivo and human applications. It comprehensively explains radionanomedicine comprising nuclear and nanomedicine, demonstrating that it is more than radionanodrugs and that radionanomedicine also takes advantage of nuclear medicine using trace technology, in which miniscule amounts of materials and tracer kinetic elucidate in vivo biodistribution. It also discusses exogenous nanomaterials such as inorganic silica, iron oxide, upconversion nanoparticles and quantum dots or organic liposomes labelled with radioisotopes, and radionanomaterials used for targeted delivery and imaging for theranostic purposes. Further, it examines endogenous nanomaterials i.e. extracellular vesicles labelled with radioisotopes, known as radiolabelled extracellular vesicles, as well as positron emission tomography (PET) and single photon emission computed tomography (SPECT), which elucidate the biodistribution and potential for therapeutic success.

"Decision Making in Radiation Oncology" is a reference book designed to enable radiation oncologists, including those in training, to make diagnostic and treatment decisions effectively and efficiently. The design is based on the belief that a picture is worth a thousand words. Knowledge is conveyed through an illustrative approach using algorithms, schemas, graphics, and tables. Detailed guidelines are provided for multidisciplinary cancer management and radiation therapy techniques. In addition to the attention-riveting algorithms for diagnosis and treatment, strategies for the management of disease at individual stages are detailed for all the commonly diagnosed malignancies. Clinical trials that have yielded gold standard treatment and their results are documented in the schemas. Moreover, radiation techniques, including treatment planning and delivery, are presented in an illustrative way. This groundbreaking publication is an essential tool for physicians in their daily clinical practice."

This book acts as a primer for radiographers upon performing computed tomography (CT) examinations. The focus resides in radiation physics, radiobiology, anatomy, imaging protocols and image evaluation. It seeks to provide readers insight into the practical and innovative approaches within CT, backed up with key literature and examples in practice. Recent innovations and the importance of new technology to acquire enhanced quality remain a focal point. These are essential in understanding the importance of dose optimization, patient anatomy and common pathology observed. Patient care will remain central in this book, supported with a dedicated chapter discussing effective communication, patient education, informed consent, coupled with the assessment of laboratory results and vital signs. The editors draw from recent publications and clinical expertise, supported with the growing trend of technological advances utilized within the CT environment. Critically, this volume focuses on the role of CT for an array of audiences but, more specifically, undergraduate and postgraduate radiographers worldwide.

Following an introductory overview, Hyperthermia In Cancer Treatment: A Primer comprehensively describes the biological reasons for associating hyperthermia with radiation and chemotherapy and the biological and clinical effects of hyperthermia on cancerous and normal tissues. The volume 's 20 chapters are arranged in three principal parts: physical and methodological studies, biologic principles, and clinical studies.