Table Of ContentRadiotherapy and Brachytherapy
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Series B:Physics and Biophysics
Radiotherapy and Brachytherapy
edited by
Yves Lemoigne
European Scientific Institute
Site d’Archamps
France
and
Alessandra Caner
European Scientific Institute
Site d’Archamps
France
Published in cooperation with NATO Public Diplomacy Division
Proceedings of the NATO Advanced Study Institute on
Physics of Modern Radiotherapy & Brachytherapy Archamps
France
15–27 November 2007
Library of Congress Control Number: 2009931108
ISBN 978-90-481-3096-2 (PB)
ISBN 978-90-481-3095-5 (HB)
ISBN 978-90-481-3097 -9 (e-book)
Published by Springer,
P.O. Box 17, 3300 AADordrecht, The Netherlands.
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CONTENTS
Preface................................................................................................................ix
List of Participants..............................................................................................xi
Photographs.......................................................................................................xv
PART I: INTRODUCTION TO RADIOTHERAPY...............................................1
Fundamental Radiobiology and Its Application to Radiation Oncology.............3
Francesca M. Buffa
Accuracy Strategies in Radiotherapy.................................................................11
Günther H. Hartmann
PART II: X-RAYS TELETHERAPY......................................................................29
Dosimetry for Photon and Electron Radiation...................................................31
Günther H. Hartmann
Nomenclature in Radiotherapy..........................................................................57
Günther H. Hartmann
Quality Assurance in Radiotherapy...................................................................71
Alan McKenzie
Radiotherapy Accidents.....................................................................................81
Alan McKenzie
Clinical Applications of 3-D Conformal Radiotherapy.....................................87
Raymond Miralbell
Treatment Planning: IMRT Optimization – Basic and Advanced
Techniques.........................................................................................................95
Simeon Nill
v
vi CONTENTS
Treatment Planning: Stereotactic Treatment Techniques................................107
Simeon Nill
Image Guided Radiotherapy............................................................................113
Uwe Oelfke
Clinical Use of 3-D Image Registration...........................................................127
Peter Remeijer
Geometrical Uncertainties in Radiotherapy.....................................................135
Peter Remeijer
Delivery of Intensity-Modulated Radiation Therapy Including
Compensation for Organ Motion.....................................................................141
Steve Webb
PART III: HADRONTHERAPY............................................................................163
Hadrontherapy: Cancer Treatment with Proton and Carbon Beams................165
Ugo Amaldi and Gerhard Kraft
Proton Therapy................................................................................................173
Uwe Oelfke
PART IV: BRACHYTHERAPY............................................................................183
Photon Sources for Brachytherapy..................................................................185
Alex Rijnders
Calibration of Photon Sources for Brachytherapy...........................................195
Alex Rijnders
Cancer of the Cervix: Examples of BT Treatment Techniques.......................209
Inger-Lena Lamm
Paris System for Interstitial Brachytherapy.....................................................219
Ginette Marinello
CONTENTS vii
Solid State Detectors for Quality Assurance in Brachytherapy.......................227
Ginette Marinello
Monte Carlo Application in Brachytherapy Dosimetry...................................239
Jose Perez-Calatayud, Domingo Granero Cabañero
and Facundo Ballester Pallarés
Appendix I....................................................................................................................251
PREFACE
This book reports the majority of lectures given during the NATO Advanced
Study Institute ASI-982996, which was held at the European Scientific Institute
of Archamps (ESI, Archamps – France) from November 15 to November 27,
2007. The ASI course was structured in two parts: the first was dedicated to
what is often called “teletherapy”, i.e. radiotherapy with external beams, while
the second focused on internal radiotherapy, also called “brachytherapy” or
“curietherapy” in honour of Madame Curie who initiated the technique about a
century ago. This ASI took place after the European School of Medical Physics,
which devoted a 3 week period to medical imaging, a subject complementary to
the topics of this book. Courses devoted to nuclear medicine and digital imaging
techniques are collected in two volumes of the NATO Science Series entitled
“Physics for Medical Imaging Applications” (ISBN 978-1-4020-5650-5) and
“Molecular imaging: computer reconstruction and practice” (ISBN 978-1-4020-
8751-6).
Every year in autumn ESI organises the European School of Medical Physics,
which covers a large spectrum of topics ranging from Medical Imaging to
Radiotherapy, over a period of 5 weeks. Thanks to the Cooperative Science and
Technology sub-programme of the NATO Science Division, weeks four and
five were replaced this year by the ASI course dedicated to “Physics of Modern
Radiotherapy & Brachytherapy”. This allowed the participation of experts and
students from 20 different countries, with diverse cultural background and pro-
fessional experience. A further positive outcome of NATO ASI participation is
the publication of this book, containing the lecture series contributed by speakers
during the ASI. We hope it will be a reference book in radiotherapy, addressing
an audience of young medical physicists everywhere in the world, who are
wishing to review the physics foundations of the relevant technologies, catch up
with the state of the art and look ahead into future developments in their field,
e.g. the emerging technique of “Hadrontherapy”.
This volume starts with an introductory lecture about radiotherapy strategy
and accuracy requirement, two aspects which are of the first importance
(G. Hartmann). Fundamental radiobiology is reviewed by Francesca Buffa, fol-
lowed by G. Hartmann discussing photon and electron dosimetry. G. Hartmann
also illustrates the nomenclature in radiotherapy treatment planning, specified
in the ICRU-50 document. Three lectures by Steve Webb describe Conformal
Radiotherapy (CRT), covering various modern techniques from Multi-Leaf
Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT).
ix
x PREFACE
Simeon Nill from DKFZ develops two topics: inverse planning and opti-
misation techniques first, followed by stereotactic treatment techniques. As well
from DKFZ, Uwe Oelfke reviews image guided techniques in radiotherapy.
Quality assurance in radiotherapy is everybody’s deep concern and is discussed
by A. McKenzie from Bristol.
Despite the quasi totality of patients being presently treated with gamma and
X-rays, some novel powerful tools are emerging implementing proton and light
ions (e.g. carbon ions) beams, which will progressively gain ground in patient
treatment. It was deemed important to introduce this new approach, going under
the comprehensive name of Hadrontherapy (protons and light ions, e.g. Carbon
ions, all belong to a group of particles called hadrons.). Ugo Amaldi presents
an overview of the field, whereas U. Oelfke focuses on proton therapy and its
implementation at the Heidelberg Hadron Therapy centre. The role of medical
imaging in radiotherapy (clinical applications and geometrical uncertainties) is
presented by Peter Remeijer from Amsterdam. Finally, the chief of the radio-
therapy service of the “HCUGE Hospital” concludes this section with two lectures
devoted to clinical application of 3D conformal radiotherapy.
In the Brachytherapy section, a review of the sources and of the conventional
computer calculations used in this field is presented by A. Rijnders (Brussels).
Among different dosimetry systems for interstitial brachytherapy, Ginette
Marinello privileges a description of the so-called “Paris System”. Cervix cancer
treatment is then analysed in details by Inger-Lena Lamm (Lund Sweden). Patient
dose calculation using modern Monte-Carlo techniques is presented by J. Perez-
Calatayud from Valencia (Spain).
We wish to thank all the participants, who allowed the ASI at Archamps to
be a success within an excellent international atmosphere: lecturers, students
(who participated actively) and all the ESI team (Manfred Buhler-Broglin,
Alessandra Caner, Violaine Presset, Filiz Demolis and Julien Lollierou).
Many thanks to the Hôpital Cantonal de Genève, which hosted us twice
(Philippe Nouet) and gave us access to radiotherapy and brachytherapy services
(Dr. Miralbell and Dr. Popowski).
Finally, we wish to thank and express the gratitude to the Cooperative
Science and Technology sub-programme of the NATO Science Division, lead
by Prof. Fausto Pedrazzini, without whom this Advance Study Institute would
have not been possible.
Yves Lemoigne1
Co-Director of ASI-982440
______
1 European School of Medical Physics, European Scientific Institute, Bâtiment Le Salève, Site
d’Archamps F-74166 Archamps (France).
LIST OF PARTICIPANTS
Lecturers’ surnames are in bold
Surname Name Country City E-mail address
Abate Armando Italy Rome [email protected]
Acar Hilal Turkish Istanbul [email protected]
Amaldi Ugo Italy Milano [email protected]
Avitabile Rossella Italy Padova [email protected]
Balabanova Anna Bulgaria Sofia [email protected]
Bartesagi Giacomo Italy Milan [email protected]
Bonnet Jacques France Toulouse [email protected]
Boubir Messaoud Algeria Batna [email protected]
Bourbia Nadjla Algeria Jijel [email protected]
Bucciarelli Bernard France Sevran [email protected]
Buffa Francesca UK Oxford [email protected]
Caner Alessandra Italian Archamps [email protected]
Carrasco Fatima Portugal Porto [email protected]
Ceric Melisa BiH Sarajevo [email protected]
Conti Valentina Italy Milano [email protected]
Djarova Anna Bulgaria Sofia [email protected]
Dogandjiiska Daniela Bulgaria Sofia [email protected]
Demolis Filiz Turkey Izmir [email protected]
Derkaoui Jamal Morocco Oujda [email protected]
Dries Wim NetherlandsEindhoven [email protected]
Drolc Botajan Slovenia Ljubljana [email protected]
Dzharova Anna Bulgaria Sofia [email protected]
Dumitriu Irina Romania Bucharest [email protected]
Falie Dragos Romania Bucharest [email protected]
Ferrand Regis France Orsay [email protected]
Fezov Daniel Bulgaria Sofia [email protected]
Fekete Zsolt Romania Cluj [email protected]
(continued)
xi
