As the definition of palliative-intent radiation therapy (RT) continues to evolve, the application of advanced radiotherapeutic technologies, such as intensity-modulated RT, and techniques, such as image-guidance, are no longer the provision solely of the curative realm. Treatment options previously considered strictly palliative are expanding, with conventional RT being delivered in conjunction with other modalities such as highly conformal radiation, surgery or systemic therapy, or being bypassed entirely. Additionally, as the median survival rate for many primary cancer histologies improve, more and more patients are outliving the palliative benefit of their first course of RT, making re-irradiation a commonly encountered scenario. Many factors should be taken into account when making RT treatment decisions, including those incorporating advanced technologies, such as individualised considerations of symptom burden, extent of disease, life expectancy, performance status, comorbidities, toxicity, prior treatment, and patient wishes. However, while palliative RT should be appropriately customised for each patient, it should also have a convincing evidence base. To date, research investigating the optimal use of palliative RT has been strikingly underrepresented, especially considering it comprises up to 50% of a department's workload. This book reviews state of the art in palliative radiation therapy across all disease sites, discussing available evidence supporting the use of advanced technologies and related clinical and dosimetric outcomes. Areas in which practice diverges from available evidence, as well as those in which no supporting evidence exists, are described. Many chapters include a historical overview highlighting lessons learned from past experience and techniques. Additionally, where specific palliative literature does not exist, generalisable excerpts from the curative setting are examined as well. Also, key practice points pertinent to management approaches and decisions, treatment planning and other clinical pearls are summarised by over 60 international experts from three continents, often incorporating a multinational and/or multi-institutional perspective. A foundational chapter reviewing these technologies is complimented by sections on their use in each primary cancer site, along with chapters focusing on emerging techniques such as stereotactic radiation, clinical settings such as oligometastases, and patient-reported outcomes including quality of life and toxicity. Clinical trial methodology applicable to palliative RT, prognostication, health services research, and the interface of radiation oncology with palliative care in the 21st century are highlighted. Finally, a concluding chapter provides an overview of clinical contexts in which conventional radiation therapy or best supportive care may be favoured.

This is the second edition of a very well received book devoted specifically to the treatment of liver tumors by radioembolization with 90Y microspheres. The success of the first edition was based on the provision of all the fundamental information required for successful use of this therapeutic modality in clinical practice. The new edition has been fully updated to cover the most recent advances and includes additional chapters on regulations and emerging trends. Detailed information is provided on the full range of relevant topics, including hepatic vascular anatomy (including variants), dosimetry, assessment of tumor response, and the results achieved using radioembolization alone and in combination with other treatments in patients with primary or metastatic disease. Complications and side-effects are also fully discussed. This book will prove immensely valuable for both beginners and practitioners.

This is a comprehensive learning tool for medical students, residents, and junior attending physicians in radiation oncology. Organised in chapters and sections by site, the book covers in detail all the sites and cancer types currently treated with radiotherapy. Emphasis is on treatment recommendations and the evidence behind them. Moreover, this book provides easily accessible information for residents and practitioners in radiation oncology. It presents the most essential information that is immediately required in the clinical setting. Important data of epidemiology, anatomy, pathology, and clinical presentation are highlighted. Key facets 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 rationale for the recommendations.

Brachytherapy, also known as internal radiotherapy, is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment. Brachytherapy is commonly used as an effective treatment for cervical, prostate, breast, and skin cancer and can also be used to treat tumours in many other body sites. Brachytherapy can be used alone or in combination with other therapies such as surgery and chemotherapy. This book presents current research from around the globe in the study of brachytherapy including High Dose Rate (HDR) Intracavitary Brachytherapy for cervical, breast and prostate cancer, as well as nanobrachytherapy and Brachytherapy for soft tissue sarcomas.

This concise but comprehensive textbook sets out the essentials of the science and clinical application of radiobiology for those seeking accreditation in radiation oncology, clinical radiation physics and radiation technology. Fully revised and updated to keep abreast of current developments in radiation biology and radiation oncology, the fourth edition continues to present in an interesting way the biological basis of radiation therapy, discussing the basic principles and significant developments that underlie the latest attempts to improve the radiotherapeutic management of cancer. New topics for the fourth edition include chapters on the mechanisms of cell death, biological response modifiers, and biological image guided radiotherapy, with major revisions to sections on the molecular basis of the radiation response, tumour hypoxia and the dose-rate effect. A variety of new authors have contributed to this revision, who, together with the new Editorial team, have used their significant international teaching experience to ensure the content remains clear and comprehensive, and as valuable to the trainee as it is to the established radiation oncologist. With the fourth edition we will see the most radical change so far - as Professor Gordon Steel has retired as Editor and has been replaced by Bert van der Kogel, the current current course director for the above-mentioned course, plus Michael Joiner, who is the head of the Radiation Biology Program at the Wayne State University and is the Associate Editor of the International Journal of Radiation Biology.

This issue of Radiologic Clinics of North America focuses on Vascular Imaging, and is edited by Dr. Christopher J. Francois. Articles will include: Pre-operative planning for structural heart disease; Updates in vascular CT; Imaging patients with mesenteric ischemia; Imaging patients with pulmonary vascular disease; Peripheral vascular imaging focusing on non-atherosclerotic disease; Imaging thoracic aorta aneurysms; Recent innovations in renal vascular imaging; Radiological imaging in large and medium vessel vasculitis; MR lymphangiography; Recent innovations in vascular ultrasound; Imaging vascular malformations; 4D Flow MRI; and more!

This issue of MRI Clinics of North America focuses on MR Imaging of the Shoulder, and is edited by Drs. Naveen Subhas and Soterios Gyftopoulos. Articles will include: Shoulder MRI & MRA Techniques (New Advances): How I do it; Rotator Cuff Disease (New Concepts and Challenges): How do I read it; The Postoperative Rotator Cuff: How I read it; Anterior Instability: What to look for; Posterior Instability: What to look for; SLAP/biceps/thrower's shoulder: How I read it; Postoperative Labrum and Instability: What to look for; Capsular injury and inflammation: How I read it; AC Joint: What to look for; Nerve and muscle abnormalities: How I read it; Tumor/tumor like lesions: What to look for; Shoulder MRI and US: How do I choose; and more!

This textbook is designed to help the busy radiation oncologist to accurately and confidently delineate tumor volumes for conformal radiation therapy (including IMRT). The book provides an atlas of clinical target volumes (CTVs) for commonly encountered cancers, with each chapter illustrating CTV delineation on a slice-by-slice basis, on planning CT images. Common anatomic variants for each tumor are represented in individual illustrations, with annotations highlighting differences in coverage. The anatomy of each site and patterns of lymphatic drainage are discussed, and their influence on the design of CTVs is explained in detail. Utilization of other imaging modalities, including MRI, to delineate volumes is highlighted. Key details of simulation and planning are briefly reviewed. Although the emphasis is on target volume delineation for conformal techniques, information is also provided on conventional radiation field setup and design when IMRT is not suitable.

In spite of years of clinical research and trials of a variety of new and promising therapies, cancer remains as a major cause of morbidity and mortality. Use of ionizing radiation in treatment of cancer quickly followed the discovery of X-rays and radioactivity at the dawn of the last century. The limited success of radiotherapy has been attributed to several factors if which the intrinsic radioresistance of tumor cells, their fast reproduction, and tumor hypoxia are the major causes.

Radiation Sensitizers: A Contemporary Audit presents data on newer hypoxic cell sensitizers like senazole and deal with old molecules such as chlorpromazine in a new role of sensitization. Bringing together information scattered throughout published and unpublished literature, the book contains contributions from an international panel that examines new therapies and new uses of old therapies. It contains tables and diagrams that illustrate the concepts and make the information easy to find.