Accelerated Partial Breast Irradiation PDF Download

Author: David E. Wazer
Publisher: Springer Science & Business Media
ISBN: 3540880062
Category : Medical
Languages : en
Pages : 447

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Book Description
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.

Author: Adam P. Dicker
Publisher: CRC Press
ISBN: 9781841842981
Category : Medical
Languages : en
Pages : 488

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Book Description
Prostate brachytherapy (transperineal interstitial implantation of the prostate with either permanent or temporary radioactive sources) has evolved into a sophisticated and definitive treatment modality, used either as monotherapy or in combination with external beam radiation therapy for the treatment of prostate cancer. This popular form of therapy is frequently integrated with neoadjuvant and/or concurrent androgen suppression therapy in the intermediate and advanced risk patient. This book covers both basic and advanced techniques for prostate brachytherapy and is appropriate for the practitioner who is anticipating or currently performing permanent radioactive seed implants. A partial list of topics includes: patient selection, equipment decisions, treatment planning, operative technique, post-implant evaluation, management of acute/long term treatment and follow-up after implant. The accompanying CD-ROM, with video clips, is an invaluable teaching tool. Basic and Advanced Techniques in Prostate Brachytherapy is for practitioners of prostate brachytherapy-urologists, radiation oncologists, medical oncologists and medical physicists.

Author: Bruce Thomadsen
Publisher: Medical Physics Publishing Corporation
ISBN: 9781930524248
Category : Science
Languages : en
Pages : 965

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Book Description
This text is organized into 6 sections: Fundamentals; Dosimetry; Interstitial Fundamentals; Interstitial Applications; Intercavitary Applications for Gynecological Cancer, and Unconventiional Delivery Systems. The book includes a CD-ROM containing an electronic version of the book (with many illustrations in full color) plus a compiled list of references.

Author: Yasuo Yoshioka
Publisher: Springer
ISBN: 9811304904
Category : Medical
Languages : en
Pages : 300

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Book Description
This book provides a comprehensive and up-to-date overview of major technical advances and research findings in the field of brachytherapy. Especially research conducted on brachytherapy in Japan has made tremendous strides, offering readers valuable insights into new treatment outcomes, evidence and techniques. In the respective chapters, each author elucidates cutting-edge findings, addressing both the basic and clinical aspects including the application to various cancers, and especially focusing on highly valuable data gleaned in Japan. As such, the book will benefit not only radiation oncologists but also basic researchers, radiation technologists, medical physicists and members of medical staff who are involved in the development and utilization of this advanced therapy.

Author: Phillip M. Devlin
Publisher: Lippincott Williams & Wilkins
ISBN: 9780781762779
Category : Medical
Languages : en
Pages : 460

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Book Description
Written by the foremost experts in the field, this volume is a comprehensive text and practical reference on contemporary brachytherapy. The book provides detailed, site-specific information on applications and techniques of brachytherapy in the head and neck, central nervous system, breast, thorax, gastrointestinal tract, and genitourinary tract, as well as on gynecologic brachytherapy, low dose rate and high dose rate sarcoma brachytherapy, vascular brachytherapy, and pediatric applications. The book thoroughly describes and compares the four major techniques used in brachytherapy—intracavity, interstitial, surface-dose or mold therapy, and transluminal. Chapters detail particular techniques that are appropriate in specific clinical situations.

Author: Björn Morén
Publisher: Linköping University Electronic Press
ISBN: 9179297382
Category : Electronic books
Languages : sv
Pages : 53

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Book Description
Cancer is a widespread class of diseases that each year affects millions of people. It is mostly treated with chemotherapy, surgery, radiation therapy, or combinations thereof. High doserate (HDR) brachytherapy (BT) is one modality of radiation therapy, which is used to treat for example prostate cancer and gynecologic cancer. In BT, catheters (i.e., hollow needles) or applicators are used to place a single, small, but highly radioactive source of ionizing radiation close to or within a tumour, at dwell positions. An emerging technique for HDR BT treatment is intensity modulated brachytherapy (IMBT), in which static or dynamic shields are used to further shape the dose distribution, by hindering the radiation in certain directions. The topic of this thesis is the application of mathematical optimization to model and solve the treatment planning problem. The treatment planning includes decisions on catheter placement, that is, how many catheters to use and where to place them, as well as decisions for dwell times. Our focus is on the latter decisions. The primary treatment goals are to give the tumour a sufficiently high radiation dose while limiting the dose to the surrounding healthy organs, to avoid severe side effects. Because these aims are typically in conflict, optimization models of the treatment planning problem are inherently multiobjective. Compared to manual treatment planning, there are several advantages of using mathematical optimization for treatment planning. First, the optimization of treatment plans requires less time, compared to the time-consuming manual planning. Secondly, treatment plan quality can be improved by using optimization models and algorithms. Finally, with the use of sophisticated optimization models and algorithms the requirements of experience and skill level for the planners are lower. The use of optimization for treatment planning of IMBT is especially important because the degrees of freedom are too many for manual planning. The contributions of this thesis include the study of properties of treatment planning models, suggestions for extensions and improvements of proposed models, and the development of new optimization models that take clinically relevant, but uncustomary aspects, into account in the treatment planning. A common theme is the modelling of constraints on dosimetric indices, each of which is a restriction on the portion of a volume that receives at least a specified dose, or on the lowest dose that is received by a portion of a volume. Modelling dosimetric indices explicitly yields mixed-integer programs which are computationally demanding to solve. We have therefore investigated approximations of dosimetric indices, for example using smooth non-linear functions or convex functions. Contributions of this thesis are also a literature review of proposed treatment planning models for HDR BT, including mathematical analyses and comparisons of models, and a study of treatment planning for IMBT, which shows how robust optimization can be used to mitigate the risks from rotational errors in the shield placement. Cancer är en grupp av sjukdomar som varje år drabbar miljontals människor. De vanligaste behandlingsformerna är cellgifter, kirurgi, strålbehandling eller en kombination av dessa. I denna avhandling studeras högdosrat brachyterapi (HDR BT), vilket är en form av strålbehandling som till exempel används vid behandling av prostatacancer och gynekologisk cancer. Vid brachyterapibehandling används ihåliga nålar eller applikatorer för att placera en millimeterstor strålkälla antingen inuti eller intill en tumör. I varje nål finns det ett antal så kallade dröjpositioner där strålkällan kan stanna en viss tid för att bestråla den omkringliggande vävnaden, i alla riktningar. Genom att välja lämpliga tider för dröjpositionerna kan dosfördelningen formas efter patientens anatomi. Utöver HDR BT studeras också den nya tekniken intensitetsmodulerad brachyterapi (IMBT) vilket är en variation på HDR BT där skärmning används för att minska strålningen i vissa riktningar vilket gör det möjligt att forma dosfördelningen bättre. Planeringen av en behandling med HDR BT omfattar hur många nålar som ska användas, var de ska placeras samt hur länge strålkällan ska stanna i de olika dröjpositionerna. För HDR BT kan dessa vara flera hundra stycken medan det för IMBT snarare handlar om tusentals möjliga kombinationer av dröjpositioner och inställningar av skärmarna. Planeringen resulterar i en dosplan som beskriver hur hög stråldos som tumören och intilliggande frisk vävnad och riskorgan utsätts för. Dosplaneringen kan formuleras som ett matematiskt optimeringsproblem vilket är ämnet för avhandlingen. De övergripande målsättningarna för behandlingen är att ge en tillräckligt hög stråldos till tumören, för att döda alla cancerceller, samt att undvika att bestråla riskorgan eftersom det kan ge allvarliga biverkningar. Då alla målsättningarna inte samtidigt kan uppnås fullt ut så fås optimeringsproblem där flera målsättningar behöver prioriteras mot varandra. Utöver att dosplanen uppfyller kliniska behandlingsriktlinjer så är också tidsaspekten av planeringen viktig eftersom det är vanligt att den görs medan patienten är bedövad eller sövd. Vid utvärdering av en dosplan används dos-volymmått. För en tumör anger ett dosvolymmått hur stor andel av tumören som får en stråldos som är högre än en specificerad nivå. Dos-volymmått utgör en viktig del av målen för dosplaner som tas upp i kliniska behandlingsriktlinjer och ett exempel på ett sådant mål vid behandling av prostatacancer är att 95% av prostatans volym ska få en stråldos som är minst den föreskrivna dosen. Dos-volymmått utläses ur de kliniskt betydelsefulla dos-volym histogrammen som för varje stråldosnivå anger motsvarande volym som erhåller den dosen. En fördel med att använda matematisk optimering för dosplanering är att det kan spara tid jämfört med manuell planering. Med väl utvecklade modeller så finns det också möjlighet att skapa bättre dosplaner, till exempel genom att riskorganen nås av en lägre dos men med bibehållen dos till tumören. Vidare så finns det även fördelar med en process som inte är lika personberoende och som inte kräver erfarenhet i lika stor utsträckning som manuell dosplanering i dagsläget gör. Vid IMBT är det dessutom så många frihetsgrader att manuell planering i stort sett blir omöjligt. I avhandlingen ligger fokus på hur dos-volymmått kan användas och modelleras explicit i optimeringsmodeller, så kallade dos-volymmodeller. Detta omfattar såväl analys av egenskaper hos befintliga modeller, utvidgningar av tidigare använda modeller samt utveckling av nya optimeringsmodeller. Eftersom dos-volymmodeller modelleras som heltalsproblem, vilka är beräkningskrävande att lösa, så är det också viktigt att utveckla algoritmer som kan lösa dem tillräckligt snabbt för klinisk användning. Ett annat mål för modellutvecklingen är att kunna ta hänsyn till fler kriterier som är kliniskt relevanta men som inte ingår i dos-volymmodeller. En sådan kategori av mått är hur dosen är fördelad rumsligt, exempelvis att volymen av sammanhängande områden som får en alldeles för hög dos ska vara liten. Sådana områden går dock inte att undvika helt eftersom det är typiskt för dosplaner för brachyterapi att stråldosen fördelar sig ojämnt, med väldigt höga doser till små volymer precis intill strålkällorna. Vidare studeras hur små fel i inställningarna av skärmningen i IMBT påverkar dosplanens kvalitet och de olika utvärderingsmått som används kliniskt. Robust optimering har använts för att säkerställa att en dosplan tas fram som är robust sett till dessa möjliga fel i hur skärmningen är placerad. Slutligen ges en omfattande översikt över optimeringsmodeller för dosplanering av HDR BT och speciellt hur optimeringsmodellerna hanterar de motstridiga målsättningarna.

Author: Akila N. Viswanathan
Publisher: Springer Science & Business Media
ISBN: 3540689583
Category : Medical
Languages : en
Pages : 301

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Book Description
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.

Author: William Small, Jr.
Publisher: John Wiley & Sons
ISBN: 0470905522
Category : Medical
Languages : en
Pages : 940

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Book Description
This fully updated and enhanced third edition offers a highly practical, application-based review of the biological basis of radiation oncology and the clinical efficacy of radiation therapy. Revised edition of the classic reference in radiation oncology from Dr. C.C. Wang, whose practical approach to clinical application was legendary Includes the latest developments in the field: intensity modulated radiation therapy (IMRT), image guided radiation therapy, and particle beam therapy Includes two brand new chapters Palliative Radiotherapy, and Statistics in Radiation Oncology Features a vibrant and extremely comprehensive head and neck section Provides immediately applicable treatment algorithms for each tumor

Author: Subir Nag
Publisher: Wiley-Blackwell
ISBN: 9780879935887
Category : Medical
Languages : en
Pages : 462

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Book Description
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

Author: David G. Bragg
Publisher: Saunders
ISBN: 9780721674940
Category : Cancer
Languages : en
Pages : 0

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Book Description
Completely updated to reflect the latest developments in science and technology, the second edition of this reference presents the diagnostic imaging tools essential to the detection, diagnosis, staging, treatment planning, and post-treatment management of cancer in both adults and children. Organized by major organs and body systems, the text offers comprehensive, abundantly illustrated guidance to enable both the radiologist and clinical oncologist to better appreciate and overcome the challenges of tumor imaging. Features 12 brand-new chapters that examine new imaging techniques, molecular imaging, minimally invasive approaches, 3D and conformal treatment planning, interventional techniques in radiation oncology, interventional breast techniques, and more. Emphasizes practical interactions between oncologists and radiologists. Includes expanded coverage of paediatric tumours as well as thorax, gastrointestinal tract, genitourinary, and musculoskeletal cancers. Offers reorganized and increased content on the brain and spinal cord. Nearly 1,400 illustrations enable both the radiologist and clinical oncologist to better appreciate and overcome the challenges of tumour imaging. - Outstanding Features! Presents internationally renowned authors' insights on recent technological breakthroughs in imaging for each anatomical region, and offers their views on future advances in the field. Discusses the latest advances in treatment planning. Devotes four chapters to the critical role of imaging in radiation treatment planning and delivery. Makes reference easy with a body-system organisation.