Feasibility of Applying a Single Treatment Plan for Fractions in HDR Image Guided Brachytherapy in Cervix Cancer PDF Download
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Author: 何鎵浠
Publisher:
ISBN:
Category : Cervix uteri
Languages : en
Pages : 71
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Book Description
Author: 何鎵浠
Publisher:
ISBN:
Category : Cervix uteri
Languages : en
Pages : 71
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Book Description
Author: Jack Venselaar
Publisher: CRC Press
ISBN: 1439844984
Category : Science
Languages : en
Pages : 539
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Book Description
Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, it discusses major advances in imaging, robotics, dosimetry, Monte Carlo-based dose calculation, and optimization.
Author: Mark Trombetta
Publisher: Springer
ISBN: 331951198X
Category : Medical
Languages : en
Pages : 413
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Book Description
This book, written by leading international experts, describes alternate fractionation strategies in which technology-driven precise targeting and dosing allow for improved conformance and decreased volumes, with concordant lessening of toxicity, reduction in treatment time, and lower overall health care expense. The aim is to provide the advanced clinician with an up-to-date evidence-based reference that will assist in the delivery of enhanced patient care in daily practice. Traditional multi-week fractionation schedules were established at a time when the inclusion of relatively large amounts of normal tissue was unavoidable owing to the lack of accurate target localization during treatment. Such schedules are time and resource consuming, difficult for patients, and expensive. Nevertheless, acceptance of alternate fractionation strategies has been slow in some countries. The paradigm is, however, changing as evidence accumulates to demonstrate improved local control, equivalence of tolerance, or both. In documenting these alternate strategies, this book will be of value for radiation oncologists, medical physicists, and oncologists worldwide.
Author: David J. Kerr
Publisher: Oxford University Press
ISBN: 0191065102
Category : Medical
Languages : en
Pages : 1041
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Book Description
Now in paperback, the Oxford Textbook of Oncology reflects current best practice in the multidisciplinary management of cancer, written and edited by internationally recognised leaders in the field. Structured in six sections, the book provides an accessible scientific basis to the key topics of oncology, examining how cancer cells grow and function, as well as discussing the aetiology of cancer, and the general principles governing modern approaches to oncology treatment. The book examines the challenges presented by the treatment of cancer on a larger scale within population groups, and the importance of recognising and supporting the needs of individual patients, both during and after treatment. A series of disease-oriented, case-based chapters, ranging from acute leukaemia to colon cancer, highlight the various approaches available for managing the cancer patient, including the translational application of cancer science in order to personalise treatment. The advice imparted in these cases has relevance worldwide, and reflects a modern approach to cancer care. The Oxford Textbook of Oncology provides a comprehensive account of the multiple aspects of best practice in the discipline, making it an indispensable resource for oncologists of all grades and subspecialty interests.
Author: Dae Yup Han
Publisher:
ISBN: 9781321891836
Category :
Languages : en
Pages : 72
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Book Description
To achieve most effective cervical cancer breachytherapy treatment quality with image guided brachytherapy (IGBT), we propose a directional intensity modulate-available applicator. The direction modulate brachytherapy (DMBT) cervical cancer tandem applicator was designed to create non-isotropic dose distribution using tungsten alloy shielding in a tandem for an isotropic 192-Ir HDR radiation source. Conventional tandem has 6 mm in outer diameter with 1 channel, however, the DMBT tandem has 6 channels, which is 1.3 mm in diameter, on a surface of the tungsten alloy shield. Prototypes of the DMBT tandem was manufactured to prove of compatibilities with conventional clinical treatment systems such as MR image test, 192-Ir afterloader source delivering test, and so on. The Monte Calro code was used to calculate the non-isotropic 192-Ir dose distributions and in-house developed brachytherapy planning platform were used for plan re-optimizaiton. To evaluate a potential of the DMBT tandem, 3 different clinical treated patients group were re-optimized with DMBT tandem. The conventional tandem was replaced to the DMBT tandem for comparing differences while the ovoid or ring was kept in the same position. For comparing plan quality, HRCTV coverage was matched to each the clinical treated plans. The D2cc to OARs such as bladder, rectum, and sigmoid was recorded and compared. The first group was 75 clinical cases, which treated with the conventional tandem and ovoids (T&O) applicator. In the second group, a patient case with 5 brachytherapy fractions course was evaluated. From the 3rd to 5th fraction, supplementary free loaded needles were used. To evaluate the DMBT tandem potential of covering irregular HRCTV growth patters, the clinical plans were compared with DMBT and ovoid (without supplement needles) plans. The last group was clinical treated patient cases treated with T&R with combined intracavitary- interstitial applicator with PDR brachytherapy afterloader. The free loaded needles and the attached to ring applicator needles were modified to investigate the DMBT tandem covering availability of an irregular growth pattern of the HRCTV.
Author: Yasuo Yoshioka
Publisher: Springer
ISBN: 9811304904
Category : Medical
Languages : en
Pages : 304
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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: Edward C. Halperin
Publisher: Lippincott Williams & Wilkins
ISBN: 9780781763691
Category : Medical
Languages : en
Pages : 2152
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Book Description
The thoroughly updated fifth edition of this landmark work has been extensively revised to better represent the rapidly changing field of radiation oncology and to provide an understanding of the many aspects of radiation oncology. This edition places greater emphasis on use of radiation treatment in palliative and supportive care as well as therapy.
Author: Björn Morén
Publisher: Linköping University Electronic Press
ISBN: 9179297382
Category : Electronic books
Languages : en
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: Edward C Halperin
Publisher: Lippincott Williams & Wilkins
ISBN: 1451116489
Category : Medical
Languages : en
Pages : 432
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Book Description
Inside the Sixth Edition of this now-reference, you will discover encyclopedic coverage of topics ranging from basic science to sophisticated computer-based radiation therapy treatment planning and supportive care. The book's comprehensive scope and abundantly illustrated format provide you with better understanding of the natural history of cancer, the physical methods of radiation application, the effects of radiation on normal tissues, and the most judicious ways in which you can employ radiation therapy in patient care. Including epidemiology, pathology, diagnostic work-up, prognostic factors, treatment techniques, applications of surgery and chemotherapy, end results, and more. Increased emphasis on new approaches and technologies improve your understanding of three-dimensional treatment planning, intensity-modulated radiotherapy, combined modality therapy, and particle therapy. Digital version includes the complete text, index-based search, note sharing, regular content updates integrated into the text, and much more.
Author: Interstitial Collaborative Working Group
Publisher: Lippincott Williams & Wilkins
ISBN:
Category : Medical
Languages : en
Pages : 392
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Book Description
