Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.

The third edition of Intensity Modulated Radiation Therapy was written to enhance the reader’s understanding of the cutting-edge technology of Intensity Modulated Radiation Therapy. It is designed to both update old readers and inform new readers about the complexities and details of clinical management. This completely updated edition provides a step-by-step, practical approach to the use of IMRT in the evaluation and treatment of cancer patients. Because of IMRT’s ability to employ individually controlled beamlets, it is an extremely promising technique, especially when paired with CT, PET, and/or MRI. With these improved procedures, doctors and clinicians will be able to take high resolution images of tumors while minimizing dosages to surrounding tissue. In order to focus on the most up to date IMRT techniques, the introductory chapters have been condensed to provide a brief overview of IMRT physics, mechanics and quality assurance, and also CT and MR imaging. To help assist in clinical decision-making it provides the reader with more than 700 full-color illustrations, IMRT tables and clear, straightforward descriptions that address a range of tumor types and sites including head and neck, urinary, and gynecologic cancers.

Clinical conformal radiotherapy is the holy grail of radiation treatment and is now becoming a reality through the combined efforts of physical scientists and engineers, who have improved the physical basis of radiotherapy, and the interest and concern of imaginative radiotherapists and radiographers. Intensity-Modulated Radiation Therapy de

Successful clinical use of intensity-modulated radiation therapy (IMRT) represents a significant advance in radiation oncology. Because IMRT can deliver high-dose radiation to a target with a reduced dose to the surrounding organs, it can improve the local control rate and reduce toxicities associated with radiation therapy. Since IMRT began being used in the mid-1990s, a large volume of clinical evidence of the advantages of IMRT has been collected. However, treatment planning and quality assurance (QA) of IMRT are complicated and difficult for the clinician and the medical physicist. This book, by authors renowned for their expertise in their fields, provides cumulative clinical evidence and appropriate techniques for IMRT for the clinician and the physicist. Part I deals with the foundations and techniques, history, principles, QA, treatment planning, radiobiology and related aspects of IMRT. Part II covers clinical applications with several case studies, describing contouring and dose distribution with clinical results along with descriptions of indications and a review of clinical evidence for each tumor site. The information presented in this book serves as a valuable resource for the practicing clinician and physicist.

Provides an account of the perspective, methodology, and experience in the physical and medical aspects of IMRT at Memorial Sloan-Kettering Cancer Center (MSKCC).

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.

Conformal radiation therapy represents a new challenge. It offers the prospect of either increasing the radiation dose to target tissues while delivering a similar dose to organs at risk, or reducing the dose to organs at risk while maintaining the dose to target tissues. First, lymph node areas at risk are established using the available data from pathological examination. Then, based on a three-dimensional description of the anatomical regions, guidelines for the delineation of the clinical target volumes are proposed. The data presented should enable the reader to make appropriate decisions regarding the selection and delineation of the target volumes when confronted with the most frequent tumor types and sites.

Intensity modulated radiation therapy (IMRT) has become standard of care for most cancer sites that are managed by radiation therapy. This book documents the evolution of this technology over 35 years to the current level of volumetric arc modulated therapy (VMAT). It covers every aspect of this radiation treatment technology, including the fundamentals of IMRT/VMAT, basic principles and advanced processes for implementation. The physics of IMRT is followed by the clinical application in major disease sites such as central nervous system, head and neck, breast, lung, prostate and cervix. It also provides updated references on each component of IMRT/VMAT. This book is written by leading experts in the field with extensive clinical experience in the practice and implementation of this technology. Key Features Provides comprehensive coverage of IMRT for radiation therapy students, dosimetrists, physicists, medical residents and radiation professionals Includes up-to-date descriptions of current instrumentation and practises Diagrams and images are included throughout to illustrate fundamental concepts and aid understanding Provides extensive references for further reading

The first clinical book on the hottest topic in radiation oncology, this timely teaching text offers step-by-step guidance in use of IMRT for cancers at each subsite of the head and neck. The book's high-end content gives readers the clinical decision-making expertise and technical proficiency to incorporate this state-of-the-art radiation treatment technique into practice. Unique to this text is the site-specific instruction on target determination and delineation, to ensure adequate treatment of the tumor target while sparing adjacent normal tissue. More than 250 detailed full-color and black-and-white illustrations clarify each step in clinical implementations of head and neck cancer treatment, especially IMRT. The book provides a concise, pertinent overview of the natural course, lymph node spread, diagnostic criteria, and therapeutic options for each head and neck cancer subsite. Numerous tables provide extensive summaries of the IMRT literature. Figures with succinct explanatory text demonstrate the patterns of direct tumor extension and nodal metastasis with which target volumes are determined and delineated. Clinical outcomes for patients treated with IMRT and with conventional techniques are also included.

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.