Radiotherapy using fast electrons, whether alone or in combination with high-voltage, has met with increasing interest in the last few years. This book provides a useful account of the present state of knowledge and critically discusses where an improvement of results is certain or prob able - in contrast to results with radiotherapy using photons alone. The work also considers additional improvements which might be expected to accrue from past experience and particular attention is paid to the nature and possible dangers of electron therapy. Bern, August 1980 A. Zuppinger Contents Opening Address A. Zuppinger . . . . . . . . . . . . . . . . . . . . . . ........... . . . . . . . . . . Physical Section Introduction J .L. Minchole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Computer Treatment Planning of Lung Radiation by Means of High Energy Electrons G. Poretti, F. Ionesco-Farca, and P. Veraguth. . . . . . . . . . . . . . . . . . . . . . 6 Electron Beam Quality Parameters and Absorbed Dose Distributions from Therapy Accelerators A. Brahme and H. Svensson. . . . . . . . . . . . . . . . . . . . . . . . . . . 12 . . . . . . . Surface Dose in Electron Beams and Association with High Energy X-Ray Beams J.C. Ro senwald. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 . . . . . . . . . . Electronic Wedge Filter for the Asklepitron 45 R. Hilnig, A.v.Arx, and A. Scholz. . . . . . . . . . . . . . . . . . . . . . . . 25 . . . . . . Magnetic Field Modification of Electron Beam Dose Distributions in Inhomogeneous Media B.R. Paliwal and A.L. Wiley, Jr. . . . . . . . . . . . . . . . . . . . . . . . . 28 . . . . . . . Conclusions of the Physical Section J.C. Rosenwald. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 . . . . . . . . . . Clinical Section Clinical Radiobiology A. Zuppinger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 . . . . . . . . . . Indications for Electron Beam Therapy J.P.Bataini ............................................ 37 Contents VIII The Electron Beam Therapy for Malignant Tumors: Indications and Limitations E. Scherer and M. Bamberg. . . . . . . . . . . . . . . . . . . . . . . . . . . 39 . . . . . . . Electron Therapy for Cutaneous Epitheliomas H. Pourquier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 . . . . . . . . . ."

Good and effective treatment in radiotherapy requires careful consideration of the complex variables involved as well as critical assessment of the techniques. This new edition of an established classic takes into account advances in imaging and treatment delivery and reflects the current state of the art in the practice of radiotherapy, emphasizing the underlying principles of treatment that can be applied for conventional, conformal, and novel treatments.

The Third Edition of Handbook of Evidence-Based Radiation Oncology updates and revises the previous successful editions and serves as a key reference for radiation oncology professionals. Organized by body site, concise clinical chapters provide easy access to critical information. Important "pearls" of epidemiology, anatomy, pathology, and clinical presentation are highlighted. The key elements of the work-up are listed, followed by staging and/or risk classification systems. Treatment recommendations are discussed based on stage, histology, and/or risk classification. Brief summaries of key trials and studies provide the rationale for the recommendations. Practical guidelines for radiation techniques are described and complications and follow-up guidelines are outlined. The Third Edition incorporates new key studies and trials to reflect current radiation oncology practice; includes the most recent staging systems; and features new color illustrations and anatomic atlases to aid in treatment planning. This book is a valuable resource for students, resident physicians, fellows, and other practitioners of radiation oncology.

An ideal text for radiation oncologists, hematologist-oncologists, and radiologists, Image-Guided Radiotherapy and Functional Imaging in Modern Lymphoma Management is the foremost source for information on the increasingly important subject of image guided radiation therapy (IGRT) and its crucial role in the clinical evolution of high-precision ionizing beam therapy. An understanding of IGRT allows clinicians to improve targeting accuracy and safely increase dosage administration without increasing toxicity in normal, healthy tissue areas, resulting in better lymphoma patient outcomes.

This easy-to-understand pocketbook in the highly respected Clark's stable of diagnostic imaging texts is an invaluable tool for students, sonographers and other ultrasound practitioners, providing practical guidance on clinical ultrasound procedures, summarising current relevant literature and professional body guidelines. The content is arranged by anatomical system and organ for ease of reference, with each section comprising a short introduction, the indications for the procedure, patient preparation, the imaging procedure itself, along with an image analysis, supported throughout by positioning photographs and clinical images. Clark's Essential Guide to Clinical Ultrasound is ideal for all users of clinical ultrasound at both undergraduate and postgraduate level and will also provide a convenient distillation of the latest best practice and guidelines for sonographers, midwives, vascular technologists, ECG technologists, medical doctors, sports injury specialists, paramedics, and other health professionals.

This book explores outcome modeling in cancer from a data-centric perspective to enable a better understanding of complex treatment response, to guide the design of advanced clinical trials, and to aid personalized patient care and improve their quality of life. It contains coverage of the relevant data sources available for model construction (panomics), ranging from clinical or preclinical resources to basic patient and treatment characteristics, medical imaging (radiomics), and molecular biological markers such as those involved in genomics, proteomics and metabolomics. It also includes discussions on the varying methodologies for predictive model building with analytical and data-driven approaches. This book is primarily intended to act as a tutorial for newcomers to the field of outcome modeling, as it includes in-depth how-to recipes on modeling artistry while providing sufficient instruction on how such models can approximate the physical and biological realities of clinical treatment. The book will also be of value to seasoned practitioners as a reference on the varying aspects of outcome modeling and their current applications. Features: Covers top-down approaches applying statistical, machine learning, and big data analytics and bottom-up approaches using first principles and multi-scale techniques, including numerical simulations based on Monte Carlo and automata techniques Provides an overview of the available software tools and resources for outcome model development and evaluation, and includes hands-on detailed examples throughout Presents a diverse selection of the common applications of outcome modeling in a wide variety of areas: treatment planning in radiotherapy, chemotherapy and immunotherapy, utility-based and biomarker applications, particle therapy modeling, oncological surgery, and the design of adaptive and SMART clinical trials

This book is designed to convey as much information as possible in a concise and simple way to make it suitable for students, researchers and clinical medical physicists. Better meanings, codes and examples are included. Most of the basics are also covered for easy reference along with a glossary of objective-type questions. Upon completion of this textbook, the readers will gather knowledge about the physics, chemistry and biology of the human body towards cancer treatment using radiation.

Because radiation is a central curative and palliative therapy for many patients, it is essential to have safe and efficient systems for planning and delivering radiation therapy. Factors such as rapid technological advances, financial reorganization, an aging population, and evolving societal expectations, however, may be compromising our ability to deliver highly reliable and efficient care. Engineering Patient Safety in Radiation Oncology describes proven concepts and examples, borrowed from organizations known for high reliability and value creation, to guide radiation oncology centers towards achieving patient safety and quality goals. It portrays the authors' efforts at the University of North Carolina to address the challenges of keeping patients safe while continuously improving care delivery processes. Reviews past and current challenges of patient safety issues within radiation oncology Provides an overview of best practices from high reliability organizations Explains how to optimize workplaces and work processes to minimize human error Offers methods for engaging and respecting people during their transition to safety mindfulness Requiring no prior knowledge of high reliability and value creation, the book is divided into two parts. Part one introduces the basic concepts, methods, and tools that underlie the authors' approach to high reliability and value creation. In addition, it provides an overview of key safety challenges within radiation oncology. In part two, the authors supply an in-depth account of their journey to high reliability and value creation at the University of North Carolina.

This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In this volume the Editors bring together first-rate palliative care with oncological treatment for patients with head and neck cancer. Head and neck cancer is one of the most frightening and distressing cancers for patients and their families as it affects appearance, the ability to speak, and the ability to eat. Pain which is difficult to treat, infection, and disfiguring surgery with wounds that often do not heal, are common accompaniments of advanced disease. In addition, psychological distress, loneliness, and isolation are often experienced by patients. Head and neck cancer is not that common but, when it does occur, it very often needs specialist help from palliative care and hospice clinicians. There is little written on this subject and this book provides a comprehensive, practical guide that draws together all the information in an easily accessible format. It is an essential reference for on the ward, or before going to a home visit. The Palliative Care Consultations series is primarily aimed at those individuals working in an acute hospital cancer centre and/or tertiary referral centre. Books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common, but difficult. The volumes are site specific and each volume encompasses a review of the current oncological or haemato-oncological management of advanced disease with symptom control advice. These volumes give clinicians excellent advice on symptom control in the context of palliative care. The books are also of use and interest to other professions working in acute hospitals.

Malignant pleural mesothelioma, a malignancy due largely to asbestos exposure, represents an increasingly common challenge to clinical and medical oncologists, respiratory physicians, and cardiothoracic surgeons, as well as researchers in the field. The disease has yet to reach its peak and is expected to kill over 100,000 people worldwide. As malignant pleural mesothelioma gains in profile, Kenneth O'Byrne and Valerie Rusch present a comprehensive overview of the subject, aimed at all health care professionals who come into contact with patients with the disease. The book includes chapters on epidemiology, diagnosis, histopathology, radiology, surgery, chemotherapy, immune therapy, radiotherapy, and palliative medicine, written by an international team of contributors. A molecular biology section focuses on the carcinogenic effects of asbestos fibres and simian virus 40, angiogenesis and angiogenic growth factors, the immune response, and genetic abnormalities detected in the disease. Future therapies are also covered, as is a perspective on the distinct legal issues related to the disease. This highly-illustrated, full colour book provides the ultimate, timely resource on this devastating disease.

This book provides a practical, comprehensive, state-of-the-art review of bladder cancer. A valuable resource for anyone with an interest in urothelial tumors, this text brings together a multidisciplinary team of experts who have distilled their vast years of experience and knowledge into a concise, easy to digest format. Topics covered range from importance of a pattern recognition in diagnosis and pathologic evaluation to 'how I do it' tips on patient selection for appropriate therapies such as chemotherapy, immunotherapy, surgery and radiation. Bridging the gap between a traditional textbook and hands-on experience, this book provides a practical guide to managing day-to-day issues and challenges and brings an algorithmic approach to avoid common pitfalls. Bladder Cancer: A Practical Guide provides a concise yet comprehensive summary of the current status of the field of bladder cancer treatment, guiding patient management and stimulating investigative efforts.

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

This book provides a radiotherapy perspective on the management of brain metastases with case-based discussion. This management has been rapidly evolving in the face of changing technology, progressing systemic therapy, and paradigm changes that all impact practice. These changes can be difficult, and this text gives a practical approach to help practitioners and trainees understand these changes and incorporate them into their practices. The work has two main sections: Clinical and Technical. The clinical section has chapters that address all aspects of radiation therapy for brain metastases, including integrating advances in surgery and drug treatments. The technical section focuses on the "how to" aspects of treatment, including treatment planning and delivery. This is an ideal guide for practicing radiation oncologists and trainees.

Molecular Targeted Radiosensitizers: Opportunities and Challenges provides the reader with a comprehensive review of key pre-clinical research components required to identify effective radiosensitizing drugs. The book features discussions on the mechanisms and markers of clinical radioresistance, pre-clinical screening of targeted radiosensitizers, 3D radiation biology for studying radiosensitizers, in vivo determinations of local tumor control, genetically engineered mouse models for studying radiosensitizers, targeting the DNA damage response for radiosensitization, targeting tumor metabolism to overcome radioresistance, radiosensitizers in the era of immuno-oncology, and more. Additionally, the book features discussions on high-throughput drug screening, predictive biomarkers, pre-clinical tumor models, and the influence of the tumor microenvironment and the immune system, with a specific focus on the challenges radiation oncologists and medical oncologists currently face in testing radiosensitizers in human cancers. Edited by two acclaimed experts in radiation biology and radiosensitizers, with thirteen chapters contributed by experts, this new volume presents an in-depth look at current developments within a rapidly moving field, with a look at where the field will be heading and providing comprehensive insight into the framework of targeted radiosensitzer development. Essential reading for investigators in cancer research and radiation biology.

This book, written by leading international experts, describes alternate fractionation strategies in which technology-driven precise targeting and dosing allow for improved conformance and decreased volumes, with concordant lessening of toxicity, reduction in treatment time, and lower overall health care expense. The aim is to provide the advanced clinician with an up-to-date evidence-based reference that will assist in the delivery of enhanced patient care in daily practice. Traditional multi-week fractionation schedules were established at a time when the inclusion of relatively large amounts of normal tissue was unavoidable owing to the lack of accurate target localization during treatment. Such schedules are time and resource consuming, difficult for patients, and expensive. Nevertheless, acceptance of alternate fractionation strategies has been slow in some countries. The paradigm is, however, changing as evidence accumulates to demonstrate improved local control, equivalence of tolerance, or both. In documenting these alternate strategies, this book will be of value for radiation oncologists, medical physicists, and oncologists worldwide.

This book analyzes all aspects of modern multimodal treatment of locally recurrent rectal cancer in the pelvis in order to offer a panoramic overview of the different therapeutic options and enable the reader to balance their benefits and drawbacks. Indications for surgery and the surgical techniques themselves, including reconstruction techniques after major exenterative surgery, are clearly described and evaluated. The role of new imaging tools, such as MRI and PET-CT, in staging recurrences and guiding therapy is assessed and detailed consideration is given to the use of neoadjuvant and iterative radiotherapy and the indications for systemic chemotherapy. Morbidity, mortality, oncologic outcomes, and quality of life issues are carefully analyzed and options for pain control and palliation are examined. Finally, a national survey is presented on the state of the art in the surgical treatment of locally recurrent rectal cancer in Italy. While there has been a dramatic fall in the incidence of local pelvic recurrences, their treatment remains a major clinical challenge which requires a multidisciplinary approach and careful selection of the most appropriate strategy in each case. This book will aid practitioners in making the correct decisions in individual patients.

The first text to focus solely on quality and safety in radiotherapy, this work encompasses not only traditional, more technically oriented, quality assurance activities, but also general approaches of quality and safety. It includes contributions from experts both inside and outside the field to present a global view. The task of assuring quality is no longer viewed solely as a technical, equipment-dependent endeavor. Instead, it is now recognized as depending on both the processes and the people delivering the service. Divided into seven broad categories, the text covers:

• Quality Management and Improvement includes discussions about lean thinking, process control, and access to services.
• Patient Safety and Managing Error looks at reactive and prospective error management techniques.
• Methods to Assure and Improve Quality deals broadly with techniques to monitor, assure, and improve quality.
• People and Quality focuses on human factors, changing roles, staffing, and training.
• Quality Assurance in Radiotherapy addresses the general issues of quality assurance with descriptions of the key systems used to plan and treat patients and includes specific recommendations on the types and frequencies of certain tests.
• Quality Control: Equipment and Quality Control: Patient-Specific provides explicit details of quality control relating to equipment and patient-specific issues.

Recently, a transformation of quality and safety in radiotherapy has begun to take place. Among the key drivers of this transformation have been new industrial and systems engineering approaches that have come to the forefront in recent years following revelations of system failures. This book provides an approach to quality that is long needed, one that deals with both human and technical aspects that must be the part of any overall quality improvement program.

This book provides a comprehensive overview of the approach to retroperitoneal sarcomas, rare and challenging tumors requiring highly specialized, multidisciplinary management. Based on an updated review of the literature and drawing on the expertise of respected authors, it analyzes key topics - such as pre-operative work-up and staging, multimodal therapy, multi-organ resection, surgical complications and management of local recurrence and advanced disease - as well as several other debated issues. Presenting surgery as the cornerstone in the treatment of this disease, the book serves both as a guide for non-expert physicians wishing to understand the best management of RPS patients, including the need to refer them to specialized centers, and as a state-of-the-art overview for surgeons with interest in sarcoma surgery.

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 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.

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.

This well-received book, now in its fifth edition, is unique in providing a detailed examination of the technological basis of radiation therapy. Another unique feature is that the chapters are jointly written by North American and European authors. This considerably broadens the book's contents and increases its applicability in daily practice throughout the world. The book is divided into two sections. The first section covers basic concepts in treatment planning and explains the various approaches to radiation therapy, such as intensity-modulated radiation therapy, tomotherapy, stereotactic radiotherapy, and high and low dose rate brachytherapy. The second discusses in depth the practical clinical applications of the different radiation therapy techniques in a wide range of cancer sites. All chapters have been written by leaders in the field. This book will serve to instruct and acquaint teachers, students, and practitioners with the basic technological factors and approaches in radiation therapy.

The average physician and even cancer care-givers are not knowledgeable about the effects of cancer treatment on sex and reproductive life. They are even less aware of the options available for treatment of such patients. Cancer and Sexual Health fills a great need for a reference work devoted to the link between cancer and human sexuality. The volume is designed to give a comprehensive and state-of-the-art review of the sexual and reproductive consequences of cancer diagnosis and treatment. It will prove an invaluable resource for those clinicians caring for cancer patients as well as acting as a reference text for the sexual medicine clinician who may not see a large number of cancer patients.

Recent advances in the treatment of gynecologic malignancies led to a new worldwide consensus to introduce image guidance to gynecologic radiation therapy, particularly to brachytherapy. The book summarizes the changed practice of management: treatment planning for cervical cancer, not modified for over 60 years, has been shifted to an image-based approach, endometrial cancer management with an increase in the use of chemotherapy and vaginal brachytherapy, and vaginal cancer therapy including image guidance and high-dose delivery with IMRT.

Anemia, a frequent complication of cancer and its treatments, produces unwanted symptoms and significantly impairs metabolic and physiologic functions, as well as patients' activity, quality of life and even life expectancy. In its new Second Edition, this book presents current knowledge on anemia in cancer and its treatment with Recombinant Human Erythropoietin (rhEPO). Expanded, updated and newly added chapters describe scientific and clinical aspects of anemia, and give diagnostic and therapeutic recommendations on use of rhEPO. This is an essential source of information for radiotherapists, medical oncologists, hematologists, internists, pediatricians, surgeons, specialists in transfusion and laboratory medicine, and pharmacologists.