High-energy charged particles represent a cutting-edge technique in radiation oncology. Protons and carbon ions are used in several centers all over the world for the treatment of different solid tumors. Typical indications are ocular malignancies, tumors of the base of the skull, hepatocellular carcinomas and various sarcomas. The physical characteristics of the charged particles (Bragg peak) allow sparing of much more normal tissues than it is possible using conventional X-rays, and for this reason all pediatric tumors are considered eligible for protontherapy. Ions heavier than protons also display special radiobiological characteristics, which make them effective against radioresistant and hypoxic tumors. On the other hand, protons and ions with high charge (Z) and energy (HZE particles) represent a major risk for human space exploration. The main late effect of radiation exposure is cancer induction, and at the moment the dose limits for astronauts are based on cancer mortality risk. The Mars Science Laboratory (MSL) measured the dose on the route to Mars and on the planet’s surface, suggesting that a human exploration missions will exceed the radiation risk limits. Notwithstanding many studies on carcinogenesis induced by protons and heavy ions, the risk uncertainty remains very high. In this research topic we aim at gathering the experiences and opinions of scientists dealing with high-energy charged particles either for cancer treatment or for space radiation protection. Clinical results with protons and heavy ions, as well as research in medical physics and pre-clinical radiobiology are reported. In addition, ground-based and spaceflight studies on the effects of space radiation are included in this book. Particularly relevant for space studies are the clinical results on normal tissue complications and second cancers. The eBook nicely demonstrates that particle therapy in oncology and protection of astronauts from space radiation share many common topics, and can learn from each other.

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.

Perfect for radiation oncologists, medical physicists, and residents in both fields, Practical Radiation Oncology Physics provides a concise and practical summary of the current practice standards in therapeutic medical physics. A companion to the fourth edition of Clinical Radiation Oncology, by Drs. Leonard Gunderson and Joel Tepper, this indispensable guide helps you ensure a current, state-of-the art clinical practice. Covers key topics such as relative and in-vivo dosimetry, imaging and clinical imaging, stereotactic body radiation therapy, and brachytherapy. Describes technical aspects and patient-related aspects of current clinical practice. Offers key practice guideline recommendations from professional societies throughout - including AAPM, ASTRO, ABS, ACR, IAEA, and others. Includes therapeutic applications of x-rays, gamma rays, electron and charged particle beams, neutrons, and radiation from sealed radionuclide sources, plus the equipment associated with their production, use, measurement, and evaluation. Features a "For the Physician" box in each chapter, which summarizes the key points with the most impact on the quality and safety of patient care. Provides a user-friendly appendix with annotated compilations of all relevant recommendation documents. Includes an enhanced Expert Consult eBook with open-ended questions, ideal for self-assessment and highlighting key points from each chapter. Download and search all of the text, figures, and references on any mobile device.

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.

- Summarizes the state of the art in the most relevant areas of medical physics and engineering applied to radiation oncology - Covers all relevant areas of the subject in detail, including 3D imaging and image processing, 3D treatment planning, modern treatment techniques, patient positioning, and aspects of verification and quality assurance - Conveys information in a readily understandable way that will appeal to professionals and students with a medical background as well as to newcomers to radiation oncology from the field of physics

In recent years, interest in the management of anterior skull base tumors has been fostered by the introduction and subsequent rapid expansion of indications of transnasal endoscopic techniques. In parallel, extraordinary progress has been made in all the other disciplines which are involved in the complex process of managing anterior skull base tumors, leading to substantial improvements in diagnosis and treatment. The anterior skull base can be involved in a large variety of tumors of a varying nature and histology, which in the majority of cases originate from adjacent anatomic sites. In fact, primary lesions of the anterior skull base mainly include osteoma and other tumors originating from bone and cartilage. Tumors involving the anterior skull base have their origin prevalently in the sinonasal tract, but lesions developing on the intracranial site, such as meningiomas, may also extend caudally to encroach upon this area. All these lesions are rare, which means that the pertinent literature does not include prospective studies or treatment guidelines based on a high level of evidence. In view of the extreme histological variability of lesions involving the anterior skull base, much emphasis has been placed on addressing the different nuances of treatment in relation to histology, especially for malignant tumors. The chapters focusing on surgery provide divergent views on selection criteria for a specific surgical technique, which is the aim of this publication.

This book serves as a practical guide for the use of carbon ions in cancer radiotherapy. On the basis of clinical experience with more than 7,000 patients with various types of tumors treated over a period of nearly 20 years at the National Institute of Radiological Sciences, step-by-step procedures and technological development of this modality are highlighted. The book is divided into two sections, the first covering the underlying principles of physics and biology, and the second section is a systematic review by tumor site, concentrating on the role of therapeutic techniques and the pitfalls in treatment planning. Readers will learn of the superior outcomes obtained with carbon-ion therapy for various types of tumors in terms of local control and toxicities. It is essential to understand that the carbon-ion beam is like a two-edged sword: unless it is used properly, it can increase the risk of severe injury to critical organs. In early series of dose-escalation studies, some patients experienced serious adverse effects such as skin ulcers, pneumonitis, intestinal ulcers, and bone necrosis, for which salvage surgery or hospitalization was required. To preclude such detrimental results, the adequacy of therapeutic techniques and dose fractionations was carefully examined in each case. In this way, significant improvements in treatment results have been achieved and major toxicities are no longer observed. With that knowledge, experts in relevant fields expand upon techniques for treatment delivery at each anatomical site, covering indications and optimal treatment planning. With its practical focus, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists, and senior nurses whose work involves radiation therapy, as well as medical oncologists and others who are interested in radiation therapy.