The rationale for using intraoperative irradiation (IORT) is based on the realization that tolerable doses of eternal beam radiation are often insufficient to achieve control of locally advanced malignancies. In these instances, the IORT component of treatment becomes the optimal conformal technique of irradiation, since dose-limiting organs or structures can either be surgically displaced or protected by placement of lead shielding. This fully revised and expanded second edition is of interest to those with intraoperative electron (IOERT) capabilities, high-dose-rate brachytherapy (HDR-IORT) capabilities, or both. Techniques, indications, and results are discussed by disease site. Each chapter is dual authored by a radiation oncologist and a surgeon, giving a balanced presentation of clinical scenarios. Issues of basic science and physics are also covered, and a notable chapter on normal tissue tolerance is included. Intraoperative Irradiation: Techniques and Results, Second Edition is a superb compilation, providing essential cutting-edge knowledge. It is a foundation for physicians as IORT develops and becomes more widely available.
This book addresses the most relevant aspects of radiation oncology in terms of technical integrity, dose parameters, machine and software specifications, as well as regulatory requirements. Radiation oncology is a unique field that combines physics and biology. As a result, it has not only a clinical aspect, but also a physics aspect and biology aspect, all three of which are inter-related and critical to optimal radiation treatment planning. In addition, radiation oncology involves a host of machines/software. One needs to have a firm command of these machines and their specifications to deliver comprehensive treatment. However, this information is not readily available, which poses serious challenges for students learning the planning aspect of radiation therapy. In response, this book compiles these relevant aspects in a single source. Radiation oncology is a dynamic field, and is continuously evolving. However, tracking down the latest findings is both difficult and time-consuming. Consequently, the book also comprehensively covers the most important trials. Offering an essential ready reference work, it represents a value asset for all radiation oncology practitioners, trainees and students.
The development of the capacity to use electron beams at various energies stimulated the development of the new technology of intraoperative radiation therapy. The visual ization of the primary tumor, definition of the site to be irradiated, and knowledge of the size of tumor to be irradiated, including adequate margins for microscopic extent along with debulking of the tumor, have allowed intraoperative radiation therapy to be pur sued in a wide variety of disease processes. Not only is it possible to treat tumors that were highly resistant, but it is also possible to specifically localize the tumor with a mar gin adequate to encompass potential microscopic extensions and to choose the appro priate electron beam energy to treat the potential residual tumor and spare the adjacent normal structures. It is, furthermore, possible to treat patients with unresectable tumors. Central to this entire development is the fact that normal structures can be removed from the field of treatment. In the beginning, the emphasis was on single fractions of electron beam radiation without subsequent supplementation by external photon beam radiation therapy. How ever, more recently it has become necessary to use not only a single electron beam frac tion during the course of the operation, but to supplement it with external beam treat ment. The encouraging results obtained with intraoperative radiation therapy have led to clinical trials at a large number of institutions throughout the world.
Over the past two decades, intraoperative radiotherapy (IORT) has been used for a variety of malignant tumors and has contributed significantly to improve local tumor control. Based on the 31st San Francisco Cancer Symposium and the 6th International Intraoperative Radiation Therapy Symposium in 1996, this book presents the most recent information available on the use of IORT in cancer treatment. A brief historical overview of the development of IORT is followed by discussions of its biological, physical and technical aspects. The main part of the book is devoted to the clinical applications of IORT and the results of its use in the management of cancers of the brain, head and neck, gastrointestinal tract, breast, bone, lung, urinary tract and gynecological region, and of sarcomas. A further topic considered is the quality of life patients undergoing IORT. The findings presented indicate that IORT provides a major contribution to the control of locally advanced cancer and, in many instances, can improve long-term survival. This book is recommended reading for all clinical practitioners of oncology - surgeons, radiation oncologists and medical oncologists - as well as for radiobiologists, physicists and engineers interested in the technical development of this form of treatment.
A comprehensive review of intraoperative radiation therapy, beginning with the rationale for innovative treatment and the radiobiology of single doses. Problems encountered in modifying a linear accelerator and a radiation therapy suite are reviewed in detail along with special problems relating to technology, nursing, anesthesiology, and various surgical subspecialties. Intraoperative radiation therapy applicators and dosimetric considerations are also reviewed. This text is a valuable reference tool for institutions planning to develop or construct intraoperative radiation therapy facilities.
Intraoperative radiotherapy (IORT) is a treatment delivery technique with reports starting in the early 20th century. There are numerous advantages of IORT in oncology including delivery of a tumoricidal radiation dose in a single treatment, direct visualization of the treatment area of interest, decreasing dose to surrounding tissues, among others. In this series we focus on the clinical application, radiobiology and physics of IORT with an emphasis on the Intrabeam system. As medicine and health care continue to evolve the new frontier of personalized medicine must continue to rigorously evaluate and implement technologies that limit costs and provide meaningful therapeutic benefit.
Targeted intraoperative radiotherapy is a major advance in the management of cancer patients and has been attracting massive interest worldwide following publication of the results of an important randomized controlled trial in The Lancet. This textbook is designed to introduce this innovative technology in a comprehensive manner to clinicians dealing with cancer patients. Throughout, the emphasis is on practical aspects and the text is supported by many excellent illustrations. The editors of the book have extensive experience in targeted intraoperative radiotherapy and include co-directors of the TARGIT Academy, which runs international training courses on the technology in the United Kingdom and Germany. They have brought together multidisciplinary contributors from different centers across the world who have wide experience in the field and whose work has been recognized internationally. It is the editors’ hope that this book will succeed in ensuring that targeted intraoperative radiotherapy is used effectively worldwide.
Perfect for radiation oncology physicians and residents needing a multidisciplinary, treatment-focused resource, this updated edition continues to provide the latest knowledge in this consistently growing field. Not only will you broaden your understanding of the basic biology of disease processes, you'll also access updated treatment algorithms, information on techniques, and state-of-the-art modalities. The consistent and concise format provides just the right amount of information, making Clinical Radiation Oncology a welcome resource for use by the entire radiation oncology team. Content is templated and divided into three sections -- Scientific Foundations of Radiation Oncology, Techniques and Modalities, and Disease Sites - for quick access to information. Disease Sites chapters summarize the most important issues on the opening page and include a full-color format, liberal use of tables and figures, a closing section with a discussion of controversies and problems, and a treatment algorithm that reflects the treatment approach of the authors. Chapters have been edited for scientific accuracy, organization, format, and adequacy of outcome data (such as disease control, survival, and treatment tolerance). Allows you to examine the therapeutic management of specific disease sites based on single-modality and combined-modality approaches. Features an emphasis on providing workup and treatment algorithms for each major disease process, as well as the coverage of molecular biology and its relevance to individual diseases. Two new chapters provide an increased emphasis on stereotactic radiosurgery (SRS) and stereotactic body irradiation (SBRT). New Associate Editor, Dr. Andrea Ng, offers her unique perspectives to the Lymphoma and Hematologic Malignancies section. Key Points are summarized at the beginning of each disease-site chapter, mirroring the template headings and highlighting essential information and outcomes. Treatment algorithms and techniques, together with discussions of controversies and problems, reflect the treatment approaches employed by the authors. Disease Site Overviews allow each section editor to give a unique perspective on important issues, while online updates to Disease Site chapters ensure your knowledge is current. Disease Site chapters feature updated information on disease management and outcomes. Four videos accessible on Expert Consult include Intraoperative Irradiation, Prostate Brachytherapy, Penile Brachytherapy, and Ocular Melanoma. Thirty all-new anatomy drawings increase your visual understanding. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Thoroughly revised and updated, the 2nd Edition presents all of the latest advances in the field, including the most recent technologies and techniques. For each tumor site discussed, readers will find unparalleled coverage of multiple treatment plans, histology and biology of the tumor, its anatomic location and routes of spread, and utilization of specialized techniques. This convenient source also reviews all of the basic principles that underlie the selection and application of radiation as a treatment modality, including radiobiology, radiation physics, immobilization and simulation, high dose rate, intraoperative irradation, and more. Comprehensively reviews each topic, with a distinct clinical orientation throughout. Serves as a foundation for the basic principles that underlie the selection and application of radiation as a treatment modality, including radiobiology, radiation physics, immobilization and simulation, high dose rate, intraoperative irradation, and more. Guides readers through all stages of treatment application with step-by-step techniques for the assessment and implementation of radiotherapeutic options. Presents latest information on brachytherapy * 3-dimensional conformal treatment planning * sterotactic radiosurgery * and radiolabeled antibodies. Discusses the recent use of radiotherapy in the treatment of primary lymphoma, leukemia, multiple myeloma, and cancers of the prostate and central nervous system. Includes the latest AJCC staging system guidelines. Offers the latest advances in techniques, allowing you to deliver doses precisely to areas affected by malignancy and spare healthy tissue. Presents new chapters on the hottest topics including Three Dimensional Conformal Radiotherapy * Intensity Modulated Radiotherapy * Breathing Synchronized Radiotherapy * Plasma Cell Tumors: Multiple Myeloma and Solitary Plasmacytoma * Extracranial Stereotactic Radioablation * and [Imaging of the] Head and Neck * Thorax * Abdomen * and Pelvis.
