Proton Therapy In Cancer Treatments Clinical Evidence And Controversies

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.

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.

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 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.

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.

This book offers a comprehensive and inclusive insight into the history of prostate cancer and its sufferers. Until recently, little practical help could be offered for men afflicted with the devastating diseases of the genitourinary organs. This is despite complaints of painful urination from aging men being found in ancient medical manuscripts, despite the anatomical discoveries of the European Renaissance and despite the experimental surgical researches of the eighteen and nineteenth centuries. As diseases of the prostate, including prostate cancer, came to be better understood in the early twentieth century, therapeutic nihilism continued as curative radical surgeries and radiotherapy failed. The therapeutic ‘turn’ came with hormonal therapies, itself a product of the explosive growth of U.S. biomedicine from the 1940s onwards. By the 1990s, prostate cancer screening had become a somewhat ubiquitous but controversial feature of the medical encounter for American men as they aged, which greatly influenced the treatment pathways and identity of the male patient: as victim, as hero, and ultimately, as consumer.

Controversies in Stereotactic Radiosurgery: Best Evidence Recommendations is a comprehensive reference that compiles, synthesizes, and summarizes the most relevant scientific literature on the topic. Each succinct, problem-oriented chapter addresses a different controversy surrounding stereotactic radiosurgery. This book saves physicians significant amounts of time by distilling years of scientific research into sound guidelines that will help them make fully-informed treatment decisions. Key Features: Covers both intracranial and spine radiosurgery, providing complete coverage of this rapidly evolving technology Includes more than 35 chapters on treatment controversies for brain and spine tumors as well as vascular malformations Contains summary tables throughout the text that present the main conclusions of published studies All neurosurgeons, radiation oncologists, and neuro-oncologists, involved in the treatment of patients who may be candidates for stereotactic radiosurgery of the brain and spine will find this book to be an essential decision making guide.