Since the last edition of this textbook, interventional radiation therapy (brachytherapy) has undergone significant developments. The incorporation of advanced image-guiding procedures and the establishment of new applicators allow for the highly accurate implantation of complex implants. 3D-guided real-time adaptive brachytherapy is becoming the newest clinical standard. We now find ourselves in an exciting "new era" of brachytherapy.The current edition of this textbook has been updated to include all these new developments in brachytherapy, including the results of recent clinical trials and…mehr
Since the last edition of this textbook, interventional radiation therapy (brachytherapy) has undergone significant developments. The incorporation of advanced image-guiding procedures and the establishment of new applicators allow for the highly accurate implantation of complex implants. 3D-guided real-time adaptive brachytherapy is becoming the newest clinical standard. We now find ourselves in an exciting "new era" of brachytherapy.The current edition of this textbook has been updated to include all these new developments in brachytherapy, including the results of recent clinical trials and updates to the brachytherapy guidelines by the European Brachytherapy Group within ESTRO (GEC-ESTRO).A number of highly experienced authors and skilled colleagues from all over Europe have contributed to this edition to educate and inspire all members of the radiation oncology team to utilise the full potential of brachytherapy to the benefit of their patients.
1.Introduction212.History of brachytherapy223.Physical aspects - sources, dosimetry and dose specification283.1.Sources283.1.1.Radionuclides in brachytherapy283.1.1.1.Gamma and characteristic X-ray radiation283.1.1.2.Beta-emitters293.1.2.Characterisation of source strength293.2.Dosimetry293.2.1.Control of reference air kerma rate293.2.1.1.Measurement with well-type ionisation chambers293.2.1.2.Measurement in compact chambers in solid body phantoms293.2.2.Checking the source position303.2.3.Calculation of dose distributions303.2.3.1.Dose distributions of single sources303.2.3.2.Applicator reconstruction313.2.4.Optimisation and visualisation of dose distributions334.Quality assurance384.1.Quality assurance for afterloading devices and procedures in case of emergency for a remote afterloader384.2.Quality assurance in brachytherapy treatment planning systems414.3.Special methods415.Dosimetrical aspects - dose specifications, dose-volume definitions, EQD2 concept465.1.Dose specification in general465.2.Dose specification in intraluminal and intracavitary therapy475.2.1.Source positions along one straight line (e.g. vaginal cylinder, oesophageal/bronchial applicators, vessels)475.2.2.Advanced cervical carcinoma485.2.3.Endometrial carcinoma not treated surgically485.3.Dose specification in interstitial brachytherapy485.3.1.Point based systems485.3.2.Dose and volume relations, Dose-volume histograms (DVH) and quality parameters (indices)505.3.2.1.Relevant dose values and volumes505.3.2.2.Quality parameters - QI indices515.4.Dose fractionation, combination with external beam and the EQD2 concept536.Clinical treatment planning and imaging566.1.Clinical treatment planning566.1.1.Indication566.1.1.1.Definitive treatment566.1.1.2.Adjuvant therapy566.1.2.Gross Target Volume (GTV) and Clinical Target Volume (CTV)566.1.3.Selection of technique, preliminary and definitive treatment plan576.1.3.1.Interstitial brachytherapy576.1.3.2.Intracavitary brachytherapy606.1.3.3.Intraluminal brachytherapy606.1.4.Dose, dose fractionation, dose rate606.1.5.Infrastructure and personnel planning616.2.Modern imaging techniques in brachytherapy626.2.1.Basics of image-guided brachytherapy626.2.2.Image-guided preliminary treatment planning646.2.3.Image-guided application646.2.4.Image-guided definitive treatment planning656.2.5.Imaging techniques in brachytherapy666.2.5.1.CT imaging666.2.5.2.MR imaging676.2.5.3.US imaging677.Instruments and equipment697.1.Instruments for interstitial brachytherapy697.1.1.Temporary implants697.1.1.1.Needles, catheters697.1.1.2.Templates717.1.1.3.Auxiliary instruments737.1.2.Permanent implants747.2.Instruments for intracavitary brachytherapy757.2.1.Uterovaginal applicators757.2.2.Vaginal applicators767.2.3.Endometrial applicators777.2.4.Intraluminal applicators for tumours in the oesophagus, bronchus, trachea, common bile duct and nasopharynx and for intravascular brachytherapy777.2.5.Moulds for cancers of the paranasal sinuses or orbit787.3.Surface applicators787.3.1.Skin applicators787.3.2.Eye applicators797.4.Afterloading devices797.4.1.The irradiation device807.4.2.The control unit817.4.3.Important requirements for radiation protection818.Intra- and perioperative brachytherapy828.1.Introduction828.2.Indications and patient selection criteria838.2.1.Intraoperative brachytherapy838.2.2.Perioperative brachytherapy848.3.Practical execution and technique, practical tips858.4.Treatment planning878.4.1.Target volumes, dose specification and dose, QA878.5.Results888.6.Side effects898.6.1.Short-term toxicity898.6.2.Long-term toxicity898.7.Summary909.Interstitial hyperthermia919.1.Techniques of interstitial hyperthermia919.2.Planning, performance and documentation of interstitial hyperthermia919.3.Quality and effectiveness of hyperthermia929.4.Treatment results in interstitial brachytherapy and hyperthermia929.4.1.Glioblastoma929.4.2.Local and
1.Introduction212.History of brachytherapy223.Physical aspects - sources, dosimetry and dose specification283.1.Sources283.1.1.Radionuclides in brachytherapy283.1.1.1.Gamma and characteristic X-ray radiation283.1.1.2.Beta-emitters293.1.2.Characterisation of source strength293.2.Dosimetry293.2.1.Control of reference air kerma rate293.2.1.1.Measurement with well-type ionisation chambers293.2.1.2.Measurement in compact chambers in solid body phantoms293.2.2.Checking the source position303.2.3.Calculation of dose distributions303.2.3.1.Dose distributions of single sources303.2.3.2.Applicator reconstruction313.2.4.Optimisation and visualisation of dose distributions334.Quality assurance384.1.Quality assurance for afterloading devices and procedures in case of emergency for a remote afterloader384.2.Quality assurance in brachytherapy treatment planning systems414.3.Special methods415.Dosimetrical aspects - dose specifications, dose-volume definitions, EQD2 concept465.1.Dose specification in general465.2.Dose specification in intraluminal and intracavitary therapy475.2.1.Source positions along one straight line (e.g. vaginal cylinder, oesophageal/bronchial applicators, vessels)475.2.2.Advanced cervical carcinoma485.2.3.Endometrial carcinoma not treated surgically485.3.Dose specification in interstitial brachytherapy485.3.1.Point based systems485.3.2.Dose and volume relations, Dose-volume histograms (DVH) and quality parameters (indices)505.3.2.1.Relevant dose values and volumes505.3.2.2.Quality parameters - QI indices515.4.Dose fractionation, combination with external beam and the EQD2 concept536.Clinical treatment planning and imaging566.1.Clinical treatment planning566.1.1.Indication566.1.1.1.Definitive treatment566.1.1.2.Adjuvant therapy566.1.2.Gross Target Volume (GTV) and Clinical Target Volume (CTV)566.1.3.Selection of technique, preliminary and definitive treatment plan576.1.3.1.Interstitial brachytherapy576.1.3.2.Intracavitary brachytherapy606.1.3.3.Intraluminal brachytherapy606.1.4.Dose, dose fractionation, dose rate606.1.5.Infrastructure and personnel planning616.2.Modern imaging techniques in brachytherapy626.2.1.Basics of image-guided brachytherapy626.2.2.Image-guided preliminary treatment planning646.2.3.Image-guided application646.2.4.Image-guided definitive treatment planning656.2.5.Imaging techniques in brachytherapy666.2.5.1.CT imaging666.2.5.2.MR imaging676.2.5.3.US imaging677.Instruments and equipment697.1.Instruments for interstitial brachytherapy697.1.1.Temporary implants697.1.1.1.Needles, catheters697.1.1.2.Templates717.1.1.3.Auxiliary instruments737.1.2.Permanent implants747.2.Instruments for intracavitary brachytherapy757.2.1.Uterovaginal applicators757.2.2.Vaginal applicators767.2.3.Endometrial applicators777.2.4.Intraluminal applicators for tumours in the oesophagus, bronchus, trachea, common bile duct and nasopharynx and for intravascular brachytherapy777.2.5.Moulds for cancers of the paranasal sinuses or orbit787.3.Surface applicators787.3.1.Skin applicators787.3.2.Eye applicators797.4.Afterloading devices797.4.1.The irradiation device807.4.2.The control unit817.4.3.Important requirements for radiation protection818.Intra- and perioperative brachytherapy828.1.Introduction828.2.Indications and patient selection criteria838.2.1.Intraoperative brachytherapy838.2.2.Perioperative brachytherapy848.3.Practical execution and technique, practical tips858.4.Treatment planning878.4.1.Target volumes, dose specification and dose, QA878.5.Results888.6.Side effects898.6.1.Short-term toxicity898.6.2.Long-term toxicity898.7.Summary909.Interstitial hyperthermia919.1.Techniques of interstitial hyperthermia919.2.Planning, performance and documentation of interstitial hyperthermia919.3.Quality and effectiveness of hyperthermia929.4.Treatment results in interstitial brachytherapy and hyperthermia929.4.1.Glioblastoma929.4.2.Local and
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