Title Radiotherapy in Cancer Care
Subtitle Facing the Global Challenge
Author Eduardo Rosenblatt, Eduardo Zubizarreta
ISBN 9789201150134
List price USD 73.00
Price outside India Available on Request
Original price
Binding Hardbound
No of pages 578
Book size 153 x 229 mm
Publishing year 2017
Original publisher International Atomic Energy Agency (Eurospan Publishers)
Published in India by .
Exclusive distributors Viva Books Private Limited
Sales territory India, Sri Lanka, Bangladesh, Pakistan, Nepal, .
Status New Arrival
About the book Send Enquiry


This publication presents a comprehensive overview of the major topics and issues to be taken into consideration when planning and implementing radiotherapy services. It provides an introduction to the challenges associated with radiotherapy and its achievements as a cancer treatment modality around the world. Written with health care managers in mind, it contains data on the status of radiotherapy services around the world, established and novel technologies, social and economic factors, current issues and the role of international organizations. Dedicated chapters focus on proton therapy, carbon ion radiotherapy, intraoperative radiotherapy, radiotherapy for children, HIV/AIDS related malignancies, and costing and quality management issues.


Part I: Introduction

Introduction • Background • Radiotherapy in the Context of Cancer Treatment • The Worldwide Shortage of Radiotherapy • Response of the international Community to the Challenge • The Iaea’s Dosimetry Services • Nuclear Medicine and Diagnostic Imaging • Summary

Part II: Radiotherapy in Cancer Care

Chapter 1: Radiotherapy in Cancer Care • Introduction • Radiotherapy in the Context of Cancer Control • A Package Concept for Radiotherapy Services • Making Radiotherapy More Accessible • Cancer Control and National Cancer Control Programmes • The World Health Organization and Cancer Control • Role of the Iaea in Cancer Control • The Iaea Programme of Action for Cancer therapy • The Who–Iaea Joint Programme On Cancer Control • Key Points

Chapter 2: Contribution of Radiation Oncology to Cancer Cure and Palliation • Background • Breast Cancer • Lung Cancer • Stomach Cancer • Prostate Cancer • Rectal Cancer • Oesophageal Cancer • Cervix Uteri • Endometrium — Portec 2 • Key Points

Chapter 3: Assessing Needs and Demand for Radiotherapy • Introduction • Indications for Radiotherapy • Distribution of Types of Cancer and the Need for Radiotherapy • The Effect of Stage at Presentation On the Need for Radiotherapy • Calculating the Demand for Radiotherapy Machines • Optimal Geographical Location of Radiotherapy Services • Summary • Key Points

Chapter 4: Screening for Cancers Responsive to Radiotherapy • Introduction • Screening Versus Early Diagnosis • Cancer of the Breast • Cancer of the Uterine Cervix • Cancer of the Prostate • Cancer of the Oral Cavity • Cancer of the Rectum • Summary • Key Points

Chapter 5: Access and inequities in Radiotherapy • Introduction • Radiotherapy Coverage • Current Radiotherapy Capacity • Demand for Radiotherapy Units • Human Resources Coverage — Existing Capacity and Demand • Gender Equality — the Role of Radiotherapy • Key Points

Part III: The Science and Technology of Radiotherapy

Chapter 6: Why Radiotherapy Works • Background • Mechanism of Cell Kill by Ionizing • Radiation • Types of Ionizing Radiation • Interaction of Ionizing Radiation With Biological Matter • Radiation Chemistry: Direct and indirect Effects • Dna Damage and Repair • Cell Death • Radiosensitivity • Law of Bergonie–Tribondeau • The Oxygen Effect • Cell Cycle • Fractionated Radiotherapy • Repair/Recovery • Redistribution/Reassortment • Reoxygenation • Repopulation • the Role of Radiation Biology in the Future Development of Radiotherapy • Key Points

Chapter 7: Regulatory Prerequisites to Cancer Diagnosis and Treatment • Goals of Regulations for the Use of Ionizing Radiation in Medicine • Regulatory Infrastructure • National Authority • Roles and Responsibilities of the Regulatory Body • Radiation Protection and Safety of Radiation Sources: the international Basic Safety Standards • Responsibilities of the Government • Responsibilities of the Regulatory Body • Responsibilities of the Registrant Or Licensee • General Requirements of the International Basic Safety Standards • Justification • Radiation Protection and Optimization • Dose Constraints and Diagnostic Reference Levels • Safety Requirements for Manufacturers • Safety and Security of Radiation Devices • Prevention and Mitigation of Accidents • Requirements for Planned Exposure Situations • Special Considerations for Developing Countries • Conclusions • Key Points

Chapter 8: Equipment, Quality assurance and Quality Control • Introduction • Equipment • Qa/Qc • Key Points

Chapter 9: Recent Developments in the Technology of Radiation Oncology • Introduction • Recent Technological Advances • Intensity Modulated Radiation therapy • Image Guided Radiation therapy • Helical tomotherapy • Volumetric Modulated Arc therapy • Stereotactic Radiotherapy • Robotic Radiotherapy • The Fourth Dimension: Time and Movement • Pet in Radiotherapy Treatment Planning • Particle therapy: Proton Beam and Heavy Ions • Introduction of Advanced Technologies: the Radiation Oncologist’s Perspective • Introduction of Advanced Technologies: the Medical Physics Perspective Brachytherapy • Introduction of New Technologies in Developing Countries • Summary • Key Points

Chapter 10: Intensity Modulated Radiation therapy and Image Guided Radiation therapy: An Overview • Historical Development • Intensity Modulated Radiation therapy • Image Guided Radiation therapy • Clinical Outcomes • Discussion • Key Points

Chapter 11: Proton therapy: Rationale, Clinical Outcomes and Future Directions • Introduction • History of Proton therapy • Physical Properties of Proton therapy • Dose Distribution • Radiobiological Effects • Dosimetric Studies • Clinical Evidence and Outcomes • Skull Base and Brain Tumours • Ocular Tumours • Prostate Cancer • Lung Cancer • Hepatocellular Carcinoma • Head and Neck Cancers • Paediatric Malignancies • Future Directions • Applications for Developing Countries • Conclusion • Key Points

Chapter 12: Carbon Ion Radiotherapy in Perspective • Introduction • Characteristics of Carbon Ion Beams • Physical aspects • Biological aspects • Benefits of Carbon Ion Radiotherapy • Ion Beam Radiotherapy Facilities in the World • Clinical Results of Carbon Ion Radiotherapy • Skull Base and Paracervical Spine Tumours • Advanced Non-Squamous Cell Carcinoma of the Head and Neck • Non-Small Cell Lung Cancer (T1–2N0m0) • Bone and Soft Tissue Tumours • Hepatocellular Cancer • Pancreatic Cancer • Post-Operative Pelvic Recurrence of Rectal Cancer • Prostate Cancer • Locally Advanced Uterine Cervical Cancer • Uveal Melanoma and Lacrimal Gland Tumour • Summary • Key Points

 Chapter 13: Intraoperative Radiotherapy for Breast and Rectal Cancers • Introduction • Breast Cancer • Ioert Methods • Target Volume and Design of Breast Ioert • Ioert indications • Rectal Cancer • Ioert indications • Clinical Evidence • toxicity • Summary • Key Points

Chapter 14: Connectivity Issues in Radiation Oncology: The Role of integrating the Healthcare Enterprise — Radiation Oncology (Ihe-Ro) • Introduction • Data and Work Flow in Modern Radiation Oncology • Defining the Risks in Radiation Treatment Delivery • Pitfalls in the Process and their Solutions • The Ihe-Ro Process and Examples of How It Can Help • the Ihe-Ro Process • Connectivity Solutions • Multimodality Image Registration • Advanced Radiotherapy Objects • Implementation • Limitations of Ihe-Ro • Future Ihe-Ro Projects • Possible Impact On Low and Middle income Countries • Conclusion • Key Points

Part IV: Education and Training

Chapter 15: Education of Radiation Oncologists • introduction • the Discipline of Radiation Oncology • Training Residents • Radiation Oncology and Clinical Oncology • Teaching Core Competencies • assessment and Evaluation • assessment Methods • the European Model: Development of • A Core Curriculum • the Model Used in the Usa: A Unified Approach Across 50 States • the Iaea Syllabus • Conclusions • Key Points

Chapter 16: Education in Medical Physics • introduction • Roles and Responsibilities of Medical Physicists in Radiation Oncology • Facility Design and Shielding • Radiation Safety and Protection of the Patient, the Staff and the General Public • Patient Dosimetry • Optimization of the Physical and Technical aspects of the therapeutic Procedures • Quality Management of the Physical and Technical aspects of Radiotherapy • Education and Clinical Training Requirements • Accreditation and Certification of Clinical • Medical Physicists • Conclusion • Key Points

Chapter 17: Education and Training of Radiotherapists • Introduction • The Global Challenge • Local, National and international Factors • The Radiotherapy Team • The influence of Education • Educating the Rtt of the Future • Conclusion • Key Points

Part V: Costs and Quality

Chapter 18: Costing in Radiotherapy • Introduction • Activity Based Costing • Development of An Abc Model for Teletherapy in the Iaea Framework • Data Entry • Resource Costs • Activities • Products • Results and Discussion • Productivity • Capital Costs • Operational Costs • Product Costs • Conclusions • Key Points

Chapter 19: Quality Management in Radiotherapy • Introduction • Quality assurance • Details of a Quality System • Quality indicators • Safety Management • Taxonomy for Nonconformities • Failure of the Quality System: Accidents in Radiotherapy • Key Points

Chapter 20: Quality Audits in Radiotherapy • What is a  Quality Audit in Radiotherapy? • Audit Focus and Types • Audit Phases: Planning, Implementation and Post-Audit Activities • Iaea Quality Audits in Radiotherapy • Dosimetry Audit • Audits of Treatment Planning Systems • Comprehensive Clinical Audit • Key Points

Part VI: Focus Topics

Chapter 21: Paediatric Radiation Oncology • Introduction • Incidence and Epidemiology of Childhood Cancers • General Characteristics of Childhood Cancers • Overview of Paediatric Radiotherapy • Radiotherapy Techniques in Children • Role of Radiotherapy in the Management of Specific Malignancies • Leukaemias and Lymphomas • Central Nervous System Tumours • Neuroblastoma • Wilms’ Tumour • Rhabdomyosarcoma • Retinoblastoma • Bone Sarcomas • Late Effects of Radiotherapy • Conclusions • Key Points

Chapter 22: Radiotherapy for Hiv/Aids Related Cancers: A South African Perspective • Introduction • HIV Viruses • Aids Defining Malignancies • invasive Cervical Cancers • Aids Related Lymphomas • Kaposi’s Sarcoma • Non-Aids-Defining Malignancies • Head and Neck Cancers • Anal Cancer • Oesophageal Cancer • Final Considerations • Key Points

Chapter 23: Integration of Radiotherapy in Palliative Care • introduction • Principles of Palliative Radiotherapy • Accurate Anatomical Localization of the Symptomatic Tumour Deposit • Simple Techniques and Field Arrangements • Short Hypofractionated Treatment Regimes • Moderate Doses of Radiation • Tailoring the Treatment • Clinical Overview • Clinical Roles for Palliative Radiotherapy • Painful Bone Metastasis • Mechanical Strength • Bisphosphonates • Bone-Seeking Radioisotopes and Hemibody Radiotherapy • Brain Metastasis • Obstruction/Compression Symptoms • Bleeding, Tumour Ulceration and Fungation • Palliative Management Plan • Underutilization of Radiotherapy • Optimizing Resources in Palliative Radiotherapy • Resource Planning and Priorities • Funding A National Policy • Funding Radiotherapy Units • Key Points

Chapter 24: Research in Radiation Oncology • Perspectives on Research • Evidence Generating Research • Radiation Oncology • Opportunities • Methods of Research • Good Questions • Good Methods • Good Impact • The Enterprise of Research • Summary • Key Points

Part VII: Radiotherapy Around the World

Chapter 25: Status of Radiotherapy Around the World • The Middle East— A Al Mousa, J Imad, M Rasmi • North Africa—L Kochbati • introduction • Demographic and Epidemiological aspects • Radiotherapy Resources in North Africa as of 2012 • Population Served By Machines: Present Situation and Needs • Education in Radiation Oncology and Medical Physics in North Africa • Conclusion • Sub-Saharan Africa—J B Kigula Mugambe, A Kavuma • introduction • Facilities • Staffing • Common Cancers • the Way forward • Southeast asia—S Gondhowiardjo, M J Calaguas, G B Prajogi • introduction • Cancer incidence and Radiotherapy Utilization Rate • Human Resources • Radiotherapy Centres, Equipment and Facilities • Role of Public and Private Sectors • Conclusion • Acknowledgements • Radiotherapy in South asia—R R Prasad • Background • Cancer Burden • Risk Factors • National Cancer Control Programmes and Cancer Registries • Radiotherapy • Summary • Acknowledgements • Radiotherapy in China—Ci Zhu, Wei Bo Yin, Bo Chen, Chun Li Zhang,Hong Zhi Zhang, Ye Xiong Li • Background • History of Chinese Radiotherapy Services • Structure of Radiation Oncology in Mainland China From 1986 to 2011 • Geographical Distribution of Radiotherapy Resources in China • Discussion and Conclusions • Latin America —E Rosenblatt, E Zubizarreta, La Linares • Background • Cancer Epidemiology • Radiotherapy Resources • Quality and Access • Australia, New Zealand and Papua New Guinea—Eng-Siew Koh, T P Hanna, M B Barton • introduction • Workforce • Radiotherapy Utilization Rate • inequalities in Access and Disparities in Cancer Outcomes in Select Groups • Papua New Guinea • States of the former Soviet Union: Eastern Europe and Central asia—E Fidarova, V Sinaika • Background • Cancer Epidemiology • Radiotherapy Resources • Acknowledgements

Part VIII: International Initiatives

Chapter 26: The Role of the international atomic Energy Agency • The Iaea’s Technical Cooperation Programme • Examples of Iaea Support for Radiotherapy Services • Coordinating Research for and in Member States • Scientific and Technical Publications, Training and Communication • Training and Education of Professionals • Directory of Radiotherapy Centres • Auditing Beams • Comprehensive Audits of Radiotherapy Centres • Challenges of the introduction of New Technologies • Programme of Action for Cancer therapy • the Agart initiative to Address A Global Radiotherapy Shortage • Key Points

Chapter 27: International Organizations involved in Cancer Radiotherapy • American Society for Radiation Oncology  (Astro) • European Society for Radiotherapy and Oncology (Estro) • Union for international Cancer Control • Pan American Health Organization

Chapter 28: Success Stories in Radiotherapy Development Projects • Initiating Imrt in Bogota, Colombia—E Rosenblatt, R Ospino Peña • Modern Brachytherapy in El Salvador—E Rosenblatt, A Molina Martinez • Optimizing total Body Irradiation for • Bone Marrow Transplants in Bulgaria—E Rosenblatt, L Gocheva-Petkova • Zambia: the Cancer Diseases Hospital—K Lishimpi • Radiotherapy Service in Mauritania—E Rosenblatt, E Zubizarreta, A Djeutie, • A Meghzifene, M M Mohamedou • Upgrading Radiotherapy Services in the former Yugoslav Republic of Macedonia—I Stojkovski

Chapter 29: Lessons Learned From Radiotherapy Development Projects • introduction • the First Radiotherapy Facility • Sustainability • Expansion • Key Points • Part Ix: the Future

Chapter 30: A Vision of the Future • Estimating increase in Demand • Patient Care • Developments in Technology • External Beam Photon therapy • Brachytherapy • Particle therapy • Developments in Biology • Targeted therapy • Anti-Angiogenesis • Regenerative Medicine • Paracrine Signalling • Stem Cell therapeutics • Nanotechnology • Genomics • the Future • Key Points



Contributors to Drafting And Review

Target Audience:

This book is intended for people interested in radiotherapy technologies, intraoperative radiotherapy, radiotherapy for children, treatment of HIV-AIDS malignancies, and costing and quality management issues.


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