Proton Therapy


Book Description

Over the past twenty-five years, proton therapy has become more prominent worldwide. It is an important component of clinical radiation therapy for both adult and pediatric clinical care. Due to the inherent ability of protons to spare normal tissue, protons will continue to develop and become increasingly important in radiation oncology. As such, Proton Therapy - Current Status and Future Directions reviews many aspects of proton care including the application of protons in modern clinical trials. It also reviews problems associated with the migration of proton care worldwide and examines the future direction of proton care. This project was created by colleagues at IntechOpen and was carefully managed by Romina Rovan. It has been a privilege to help coordinate the text and chapters designed to acknowledge the history, footprint, and growing interest of proton care worldwide. Proton management is now embedded in the clinical trials process. In pediatric care, proton delivery is embedded with photons for the management of pediatric malignancies and adult groups have initiated proton-specific clinical trials. A proton registry has been established and outcomes are under evaluation. Due to the inherent ability of protons to spare normal tissue, protons will continue to develop and become increasingly important in radiation oncology.




Stereotactic Body Radiation Therapy


Book Description

Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.




Prostate Cancer Treatment


Book Description

A growing controversy in medical circles concerns the treatment of prostate cancer with proton beam radiation therapy. This relatively new treatment, used on a variety of cancers, is provided in specially constructed facilities costing hundreds of millions of dollars. In order to recoup these hefty construction costs, proton therapy centers aggressively promote their services for a broad array of cancers, especially the relatively common prostate cancer. However, there is currently zero evidence that proton radiation therapy is more effective for treating prostate cancer than the alternative standard treatment, which is half the cost. With the number of proton therapy centers in the United States expected to double in the next few years, Medicare and seniors face the prospect of rapidly increasing prices for prostate cancer treatment, with no proven benefits for beneficiaries.




Proton Therapy Physics


Book Description

Proton Therapy Physics goes beyond current books on proton therapy to provide an in-depth overview of the physics aspects of this radiation therapy modality, eliminating the need to dig through information scattered in the medical physics literature. After tracing the history of proton therapy, the book summarizes the atomic and nuclear physics background necessary for understanding proton interactions with tissue. It describes the physics of proton accelerators, the parameters of clinical proton beams, and the mechanisms to generate a conformal dose distribution in a patient. The text then covers detector systems and measuring techniques for reference dosimetry, outlines basic quality assurance and commissioning guidelines, and gives examples of Monte Carlo simulations in proton therapy. The book moves on to discussions of treatment planning for single- and multiple-field uniform doses, dose calculation concepts and algorithms, and precision and uncertainties for nonmoving and moving targets. It also examines computerized treatment plan optimization, methods for in vivo dose or beam range verification, the safety of patients and operating personnel, and the biological implications of using protons from a physics perspective. The final chapter illustrates the use of risk models for common tissue complications in treatment optimization. Along with exploring quality assurance issues and biological considerations, this practical guide collects the latest clinical studies on the use of protons in treatment planning and radiation monitoring. Suitable for both newcomers in medical physics and more seasoned specialists in radiation oncology, the book helps readers understand the uncertainties and limitations of precisely shaped dose distribution.




Radiotherapy in Prostate Cancer


Book Description

Today, the arsenal of “high-precision” or “targeted” radiotherapy includes a variety of techniques and approaches that, like the pieces of a puzzle, need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of these innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.




Proton and Carbon Ion Therapy


Book Description

Proton and Carbon Ion Therapy is an up-to-date guide to using proton and carbon ion therapy in modern cancer treatment. The book covers the physics and radiobiology basics of proton and ion beams, dosimetry methods and radiation measurements, and treatment delivery systems. It gives practical guidance on patient setup, target localization, and treatment planning for clinical proton and carbon ion therapy. The text also offers detailed reports on the treatment of pediatric cancers, lymphomas, and various other cancers. After an overview, the book focuses on the fundamental aspects of proton and carbon ion therapy equipment, including accelerators, gantries, and delivery systems. It then discusses dosimetry, biology, imaging, and treatment planning basics and provides clinical guidelines on the use of proton and carbon ion therapy for the treatment of specific cancers. Suitable for anyone involved with medical physics and radiation therapy, this book offers a balanced and critical assessment of state-of-the-art technologies, major challenges, and the future outlook of proton and carbon ion therapy. It presents a thorough introduction for those new to the field while providing a helpful, up-to-date reference for readers already using the therapy in clinical settings.




Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology


Book Description

In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop.




Delivering Affordable Cancer Care in the 21st Century


Book Description

Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.