The final chapter explains how to use other equipment, such as scanners and simulators, in conjunction with linear accelerators for optimum treatment of cancers. Radiographers, radiotherapists, medical technical offiers, manufacturers and clinical scientists would all benefit from this book. Help Centre. My Wishlist Sign In Join. Be the first to write a review. Add to Wishlist. Ships in 7 to 10 business days. Link Either by signing into your account or linking your membership details before your order is placed. Description Table of Contents Product Details Click on the cover image above to read some pages of this book!
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The Physics of Conformal Radiotherapy: Advances in Technology (PBK)
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Home Contact us Help Free delivery worldwide. Free delivery worldwide. Bestselling Series. Harry Potter. Popular Features. New Releases. Notify me. Description The Physics of Conformal Radiotherapy: Advances in Technology provides a thorough overview of conformal radiotherapy and biological modeling, focusing on the underlying physics and methodology of three-dimensional techniques in radiation therapy. This carefully written, authoritative account evaluates three-dimensional treatment planning, optimization, photon multileaf collimation, proton therapy, transit dosimetry, intensity-modulation techniques, and biological modeling.
Product details Format Paperback pages Dimensions x x Other books in this series. Add to basket. The prescribed doses to the primary tumor were 70— The median follow-up time ranged from 5. Acute GI toxicity was investigated in 12 studies with patients [ 33 , 36 — 41 , 43 , 52 , 56 — 58 ].
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Due to obvious heterogeneity, random effect model was employed. A total of 14 studies with patients assessed the acute GU toxicity [ 33 , 36 — 41 , 43 , 45 , 52 , 53 , 56 — 58 ]. Pooled RR indicated that the incidence of grade 2—4 acute GU toxicity was only 1. No obvious heterogeneity was found, thus fixed effect model was performed. Data regarding acute rectal toxicity were available in 4 studies with patients [ 45 , 47 , 53 , 54 ]. With obvious heterogeneity observed, the random effect model was employed. Late GI toxicity was discussed in 13 studies with patients [ 33 , 37 , 38 , 40 , 41 , 43 , 44 , 46 , 48 , 50 — 52 , 54 ].
For the obvious heterogeneity, the random effect model was performed. A total of 12 studies with patients were included in meta-analysis to evaluate grade 2—4 late GU toxicity [ 33 , 37 , 40 , 41 , 43 , 44 , 46 , 48 , 50 , 52 — 54 ]. Due to the significant heterogeneity, random effect model was used for this analysis. Data regarding late rectal bleeding were available in 5 studies with patients [ 42 , 45 , 47 , 49 , 53 ]. With obvious heterogeneity found, the random effect model was employed. Biochemical control was reported in 6 studies with patients [ 33 , 37 , 41 , 44 , 45 , 50 , 52 ].
X-IMRT | SpringerLink
Random effect model was employed because of the significant heterogeneity. A Biochemical control, B OS. Data regarding overall survival were available in three studies with patients [ 37 , 41 , 44 ]. Random effect model was performed for the obvious heterogeneity. In this meta-analysis, we enrolled 23 eligible studies comparing the clinical outcomes between IMRT and 3DCRT in patients diagnosed with prostate cancer. Moreover, no significant differences were discovered in grade 2—4 acute rectal toxicity and overall survival. However, more high quality studies will be needed to further identify this result.
Compared with 3DCRT, IMRT can deliver radiation with the capability of intensely conforming to cancerous site, which means IMRT can deliver higher dose to the target volume with less damage of normal tissues and with the creation of steep dose gradients and concave dose distribution [ 59 , 60 ]. On the one hand, dose-escalated RT has been demonstrated to generate better biochemical control when compared with lower doses by some randomized trials [ 8 , 61 ]. On the other hand, higher doses were associated with increased RT related side effects. Therefore, IMRT is generally believed to minimize treatment related toxicity and relatively improve survival.
Besides, IMRT can also be performed to increase the homogeneity of dose distribution [ 59 ]. IMRT also has some drawbacks. Compared with 3DCRT, IMRT leads to larger volumes of healthy tissues exposed to low doses of radiation, which may increase the risk of second malignancies.
However, more solid data are needed to clarify the clinical relevance [ 27 , 62 ]. Furthermore, IMRT is a kind of complex RT technique, which needs longer delivery time and has higher requirements for the physicists [ 63 ].
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Nevertheless, there is still a need to understand the cost-effectiveness of IMRT, which may produce more quality-adjusted life-years QALYs with lower total costs [ 64 ]. Hence, it is important to assess the benefits and risks of IMRT. In the published trials of RT, GI and GU toxicities are the most frequently studied and may deeply influence quality of life in patients who are diagnosed with prostate cancer [ 65 — 69 ].
Rectal bleeding is a type of late GI toxicity, but it sometimes is reported as a sole end point due to its objectivity [ 70 — 73 ]. Although meta-analysis is considered the gold standard by some authors, some potential bias cannot be completely eliminated.
However, several aspects which may produce potential biases in this meta-analysis should be discussed. First, only the literatures published in English were included because of the inaccessibility of other languages for reviewers. So the literature published in other languages, such as German, French and Spanish, was excluded in this meta-analysis [ 74 — 76 ]. This selection may cause further approval of the positive results, because positive results usually are published in English, while negative results tend to be published in native languages. Second, some studies were excluded due to the inaccessibility of extractingestimated RR value.
However, no data was available about late GU toxicity for meta-analysis from this study [ 58 ]. Third, the obvious heterogeneity between studies may be derived from different characteristics of study design, including different sample size, tumor stage, combined therapy, previous treatments, follow-up time, dose of the radiation therapy, etc.
For example, two included studies reported that all of their patients had a prostatectomy, while only Besides, the doses of the radiation varied among studies. Most of the studies used prescribed doses of 70 to 78 Gy, while one study performed a median dose up to One limitation of this study is that we ignored the effect of combination treatments, and were not able to stratify patients according to whether they received surgery.
In those studies which contain patients who underwent surgery, only one study analyzed the relationship between surgery and the incidence of late GU toxicity[ 40 , 41 , 45 , 46 , 51 , 56 ]. As for hormone therapy, only 3 studies discussed the influence of hormone therapy on late toxicity [ 46 , 47 , 50 ]. Data regarding late GU toxicity was available in the other two studies [ 46 , 50 ].vmfas.com/includes/forks/arama-kayd-doekueman.html
Intensity-Modulated Radiation Therapy
Another limitation is that we did not stratify the patients according to recurrence risk. Only two studies separated their patients into low, intermediate and high risk groups, which was not enough for us to perform a subgroups analysis with such small numbers of studies[ 41 , 44 ]. More researches investigating the associations of risk group and radiotherapy are needed.
In general, based on the above results, IMRT should be considered as a better choice for the treatment of prostate cancer. More randomized controlled trials are needed to determine the subset of patients diagnosed with prostate cancer. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Introduction Prostate cancer ranks the most common cancer and the second most common cause of cancer death in men [ 1 ].