Image-Guided Radiation Therapy of Prostate Cancer PDF

Preface

Safe and effective radiation dose escalation to the whole or partial prostate target volume is now possible. Because of compelling clinical evidence from large multiinstitutional databases as well as multiple clinical trials, this therapeutic approach with a variety of radiation therapy (RT) delivery systems is now part of routine practice for the treatment of localized prostate cancer.

To assure accurate radiation dose delivery with the greatest prospect of maximizing tumor control and minimizing toxicity, image-guided radiation therapy (IGRT) has been developed in both external beam RT and prostate brachytherapy (PBT). Successful execution of prostate IGRT depends on a thorough understanding of a multiplicity of imaging modalities, the criteria for target and normal tissue volume definition, methods of real-time monitoring of prostate gland motion, and the potential of on-line radiation dose verification. There is an increasing demand from the radiation oncology community to have a compilation of this information in the form of a single textbook to assist in the practical issues of implementing IGRT into clinical practice.

This book meets this demand by focusing primarily on new techniques of IGRT and provides detailed treatment guidelines for prostate cancer. It is also intended as an overview and offers a guide for radiation oncologists and other professionals in the field to implement new techniques of IGRT. At the same time, it may serve to highlight areas that need advancement and define a roadmap for future research and development. Many of the contributing authors constantly receive requests from their radiation oncology colleagues all over the world to provide treatment guidelines for IGRT for prostate cancer.

Image-guided radiation therapy opens a new era of RT delivery systems for prostate cancer. Focused, hypofractionated, high biologically equivalent dose of RT with IMRT, PBT, or proton beam are promising developments in the field and offers new treatment options for men with prostate cancer. These novel approaches have a unique reliance on IGRT technology, are quickly advancing through clinical evaluation at academic centers, and will soon move out into community practice.

In this book, the reader will find disease stage–specific IGRT guidelines and stepby- step description of current techniques. There is an emphasis on novel approaches using IGRT, particularly megavoltage imaging, cone-beam CT, hypofractionated radiation therapy, IMRT, and proton beam RT. We outline recommended RT doses, fractionation schedules, target volume delineation (including recommended margins in the postoperative setting based on our new cone-beam CT study), and IGRT procedures and policies. We think this is an exciting time to be involved in IGRT and hope this book is of use to the multidisciplinary management of prostate cancer.