Adaptive Radiation Therapy PDF

Preface

Adaptive radiation therapy (ART) is a state-of-the-art approach that uses a feedback process to account for patient-specific anatomic and/or biological changes, thus delivering highly individualized radiation therapy for cancer patients. Basic components of ART include (1) detection of anatomic and biological changes, often facilitated by multimodality images, (2) treatment plan optimization to account for the patient-specific spatial morphological and biological changes with consideration of radiation responses, and (3) technologies to precisely deliver the optimized plan to the patient. Interventions of ART may consist of both online and offline approaches. Accumulated clinical data have demonstrated the need for ART in clinical settings, assisted by the wide application of intensity modulated RT (IMRT) and image-guided RT (IGRT). The technology and methodology for ART have advanced significantly in the last few years and are moving rapidly into the clinic. This book describes these technological and methodological advances as well as initial clinical experiences using ART for selected anatomic sites.

The contents have been divided into three main sections. Section I begins with the radiobiological basis for ART (Chapter 1), followed by a detailed discussion dealing with the use of morphological (Chapter 2) and biological (Chapter 3) images and biomarkers (Chapter 4) to detect patient-specific anatomic and biological information for ART planning. The methodology and technology to design and optimize treatment plans in light of available radiation response relationships are discussed in Chapters 5 through 7.

Section II looks at the technologies and methodologies used to accurately deliver the planned treatment to the patient. These technologies and methodologies include the delivery of IMRT and IGRT (Chapters 8 through 10), intervention methodologies of ART (Chapters 11 and 12), management of intrafraction variations with respiratory motion in particular (Chapters 13 and 14), and the quality assurance needed to ensure the safe delivery of ART (Chapter 15).

Section III presents clinical examples of ART applications in several common cancer types or anatomic sites including central nervous system (Chapter 16), head and neck (Chapter 17), breast (Chapter 18), lung (Chapter 19), liver (Chapter 20), prostate (Chapter 21), gynecological cancers (Chapter 22), and softtissue sarcoma (Chapter 23).

This book is intended primarily for medical physicists and radiation oncologists although it should also benefit dosimetrists and radiation therapists. It is meant to serve as both a reference for those who have been working in the field for some years and an educational text for those who are entering the field.