Stereotactic Body Radiation Therapy

Stereotactic Body Radiation Therapy......Page 3
Foreword......Page 6
Foreword......Page 8
Foreword......Page 11
Preface......Page 12
Contents......Page 14
Contributors......Page 17
1…Introduction......Page 22
3…Overview of Radiobiology of SBRT......Page 23
4.1 Patient Immobilization and Respiratory Motion Control......Page 24
4.2 Physics and Dosimetry......Page 25
5…Overview of Clinical Applications......Page 26
References......Page 27
1…Introduction......Page 30
2…Early Radiotherapy Experience......Page 31
3…Origin of Stereotaxis......Page 32
3.1 The Stereotactic Method: Horsley and Clarke......Page 33
4.1 Lars Leksell and the Early Experience with Stereotactic Radiosurgery......Page 34
4.3 The Advent of the Gamma Knife......Page 35
4.4.1 Initial Experience with Linac Radiosurgery......Page 37
4.4.2 The Advent of Micro-Multileaf Collimators......Page 41
4.4.3 2......Page 42
5…The Development of Stereotactic Body Radiation Therapy......Page 43
5.2 The Tucson Experience with Spinal Radiosurgery......Page 44
5.3 Other Frame-Based Approaches to SBRT......Page 45
6.1 Image-Assisted Frame-Based SBRT......Page 46
6.2 Stereophotogrammetric Methods of Stereotactic Localization......Page 48
6.4 Volume-Guided Localization......Page 49
6.5 Future Developments in Image-Guided SRS and SBRT......Page 50
References......Page 51
1…Introduction......Page 57
2.1 Target Tracking/Motion Management......Page 59
2.1.1 6D-Skull Tracking......Page 60
2.1.4 Respiratory Motion Tracking......Page 61
2.1.5 Lung Tumor Tracking......Page 62
3.1 Fiducial and Fiducial Placement......Page 63
3.2 Pre-Treatment Imaging......Page 64
4…Treatment Planning......Page 65
4.1 Dose Calculation......Page 66
4.3 Treatment Planning Optimization Algorithms......Page 67
4.3.3 Sequential Optimization......Page 68
5…Treatment Delivery......Page 69
References......Page 70
1…Introduction......Page 73
3…Multileaf Collimator......Page 75
5…ExacTrac......Page 76
6…On-Board Imager......Page 79
7…Respiratory Gating......Page 81
8…Treatment Planning......Page 82
References......Page 84
1…Introduction......Page 86
2.1 Basics of Treatment Planning and Delivery......Page 87
3.1 Fundamentals of Tomotherapy’s Megavoltage CT......Page 88
3.3 Tomotherapy Registration......Page 89
3.4 Assessment of Image-Guided Patient Setup in SBRT......Page 91
4…Clinical Examples of the Use of Megavoltage CT Images for SBRT Treatments......Page 94
6…Summary......Page 95
References......Page 96
1…Introduction: The History of SBRT at Elekta......Page 97
2.1 Elekta CBCT Technology......Page 98
2.4 4D Image-Guidance......Page 99
3.1.2 Agilitytrade MLC......Page 100
3.1.3 Add-On Dynamic Micro MLCs (DMLCs)......Page 101
5.1 Full-Body Immobilization......Page 102
5.2 Motion Management Solutions: Abdominal Compression, Active Breathing Control, and Laser-Based Positioning Solutions......Page 104
6…The Elekta Linear Accelerator SBRT Platforms......Page 105
7…Summary and Conclusion......Page 106
References......Page 107
Abstract......Page 109
2…Immobilization/Simulation, Imaging, and Segmentation......Page 110
3…Beam Arrangements......Page 119
4.1 General Principles......Page 120
4.4.2 Intensity-Modulated Radiation Therapy......Page 121
4.4.3 Rotational Therapies......Page 122
4.5 IMRT Planning and Respiratory Motion......Page 123
5.2 Calculation Algorithms......Page 124
5.3.1 Lung......Page 125
7…Summary......Page 127
References......Page 128
Abstract......Page 133
2.1 Radiation Oncologist......Page 134
2.3 Dosimetrist......Page 135
3.3 Planning......Page 136
3.4 Image-Guidance and Treatment Delivery......Page 138
4.2 Process Quality Assurance......Page 139
References......Page 140
Abstract......Page 141
2.1 Mammalian Survival Curves......Page 142
2.2.2 Models Applicable to the SBRT Dose Range......Page 143
3.1 Normal Tissue Response......Page 144
3.1.2 Mitigation of Normal Tissue Damage......Page 145
3.2.1 Tumor Hypoxia is a Potential Risk Factor for SBRT Failure......Page 146
3.2.2 1......Page 147
3.2.2 2......Page 148
3.2.3 Targeting DNA Damage Response Unique to Hypoxic Tumors......Page 149
3.2.4 Contextual Synthetic Lethality Approach to Radiosensitize Hypoxic Tumors......Page 150
References......Page 151
Abstract......Page 155
2…Competing Treatment Options for Early Stage NSCLC......Page 156
2.1 Surgical Therapy......Page 157
2.3 Radiofrequency Ablation......Page 158
3.3 Contouring the Target and Sparing Normal Tissues......Page 159
3.4 Issues for Dosimetry and Treatment Planning......Page 160
4…Volumetric Image-Guided and/or Real-Time Tracking SABR Systems......Page 163
5.2 Treatment Planning......Page 164
5.3 Treatment Delivery and Image Guidance......Page 165
6.1 Technical Considerations for Proton Therapy......Page 166
6.2 Clinical Outcomes with Proton Beam Therapy......Page 167
8…Dutch SABR Strategy......Page 168
9.2 Recurrent NSCLC and Metastatic Lesions in Lung......Page 169
9.3 Operable or Borderline Operable Stage I NSCLC......Page 170
10…Toxicities and Challenges......Page 171
12…Case Examples......Page 174
References......Page 175
1.1 Overview of the Current Management of HCC......Page 181
2.1 Screening and Diagnosis of HCC......Page 183
2.2 Staging of HCC......Page 185
3…Clinical Applications Clinical Applications......Page 187
3.1 Patient SelectionPatient Selection......Page 189
4.1 Target Volumes DelineationTarget Volumes Delineation......Page 191
4.3 Organ Dose TolerancesOrgan Dose Tolerances......Page 192
5…Follow-Up......Page 193
7…Future Directions......Page 195
Bib1......Page 197
Abstract......Page 201
2.1.2 Universal Survival Curve and Generalized LQ Models......Page 202
5…Dose Constraints......Page 205
6…Heterogeneous Versus Homogeneous Dose Distribution......Page 206
7…Cancer Distribution in the Prostate......Page 207
9.2.2 Hypofractionation with Three-Dimensional Conformal Radiation Therapy......Page 208
9.2.4 Clinical Studies of Stereotactic Body Radiation Therapy......Page 209
10…Case Examples......Page 211
References......Page 212
Abstract......Page 215
1…Introduction......Page 216
3…Goals and Rationale of SBRT......Page 217
5…Clinical Application and Studies......Page 218
6…Technical Aspects......Page 220
8…Abscopal Effects......Page 221
9…Case Examples......Page 222
10…Future Directions......Page 223
References......Page 226
1…Introduction......Page 228
2.1 Rationale......Page 229
2.3 Treatment Planning......Page 233
2.5 Treatment Delivery and Management of Intra-Fractional Target Motion......Page 234
3.3 Clinical Trials......Page 235
4…Management of Treatment-Related Toxicity from Stereotactic Body Radiotherapy......Page 236
5…Case Example......Page 237
6…Future Directions......Page 238
Conflict of Interest......Page 239
References......Page 240
1…Introduction......Page 243
3.1 Tumor Motion and Gold Fiducial Seeds......Page 244
3.3 Prescription......Page 245
4.1 Studies from Stanford University......Page 246
4.2 Studies from Other Institutions......Page 248
5…Toxicity......Page 249
6…Case Examples......Page 250
References......Page 252
1…Introduction......Page 254
2.2 Target Delineation......Page 255
2.3 Treatment Planning and Delivery......Page 256
3.1.2 Malignant Lesions......Page 257
3.2.1 Intradural Tumors......Page 258
3.2.2 Malignant Extradural Tumors......Page 259
5…Case Examples......Page 260
References......Page 263
1…Introduction......Page 266
2…Radiobiology Considerations......Page 268
3.1 Immobilization and Organ Motion......Page 269
3.2 Target Delineation and Treatment Planning......Page 270
3.3 On-Board Imaging and Treatment Delivery......Page 271
4…Clinical Applications......Page 272
6…Case Examples......Page 274
7…Future Directions......Page 275
References......Page 278
Abstract......Page 281
1.1 Head and Neck Cancer......Page 282
2.1 Immobilization......Page 283
2.2 Target Delineation......Page 285
2.4 On-Board Imaging......Page 286
3.1 Eligibility Criteria......Page 287
3.2.1 Nasopharyngeal Boost After Conventionally Fractionated Radiotherapy......Page 288
3.3 Other Aggressive Malignant Disease at the Skull Base......Page 291
4.4 Cranial Neuropathy......Page 293
5…Case Examples......Page 294
References......Page 296
Abstract......Page 299
1…Introduction......Page 300
2.1.1 Abdominal Compression......Page 301
2.2.1 4D-CT......Page 303
2.2.2 Target Delineation and Margins......Page 304
2.2.4 Prescription Doses......Page 305
2.3.2 Respiratory Gated RT......Page 306
3.1 Oligometastatic Disease......Page 307
3.3 Experiences with Single-Fraction and Fractionated SBRT......Page 308
4.3 Chest Wall......Page 309
5…Case Example......Page 310
References......Page 312
Abstract......Page 318
2.1 xe ‘‘Immobilization techniquesImmobilization......Page 319
2.2 Target Delineation......Page 320
2.4 Treatment Delivery and Intrafractional Motion Control......Page 321
3.2 Studies of SBRT for Liver Metastases......Page 322
4…Toxicities......Page 323
4.2 Bowel Toxicity......Page 324
5…Follow-Up Imaging......Page 325
6…Case Examples......Page 326
7…Future Directions......Page 330
References......Page 331
1…Introduction......Page 334
2.1.1 Open Adrenalectomy (OA)......Page 335
2.2 Conventional Radiation......Page 336
6…Clinical Applications......Page 337
7…Toxicity......Page 339
8…Case Example......Page 340
References......Page 341
1…Introduction......Page 344
2…Studies of Any Histology to Any Primary Site......Page 346
3.1 Non-Small-Cell Lung Cancer......Page 347
4…Colorectal Cancer......Page 348
6…Sarcoma......Page 349
9…Eligibility Criteria......Page 350
11…Case Examples......Page 351
12…Future Directions......Page 352
References......Page 354
1…Introduction......Page 357
2.4 Systemic Radionuclides......Page 358
2.6.1 Dose Fractionation......Page 359
4…Goals of Treatment with SBRT......Page 360
6.2 SBRT for the Treatment of Radioresistant Tumors......Page 361
7…Toxicity......Page 363
8…Case Examples......Page 364
References......Page 365
Abstract......Page 367
2.2 Target Delineation......Page 368
2.3 Treatment Planning......Page 369
2.5 Treatment Delivery and Intra-Fractional Motion Control......Page 371
3.2 Retrospective Studies......Page 372
3.3 Clinical Trials......Page 375
3.5 Spinal Cord Compression......Page 376
4…Patterns of Failure......Page 377
5.2 Nerve Injury......Page 378
6…Case Examples......Page 380
References......Page 381
Abstract......Page 384
2…Complications Associated with Head and Neck SBRT......Page 385
3.1 Decrease in Pulmonary Reserve and Radiation Pneumonitis......Page 386
3.3 Collapse of Airway......Page 387
3.5 Brachial Plexopathy......Page 388
4.1 Radiation-Induced Liver Disease and Other Liver Toxicities......Page 389
4.2 Gastric/Duodenal Injury......Page 390
6.1 Radiation Myelopathy and Radiculopathy......Page 391
6.2 Vertebral Fracture......Page 393
7…Case Examples......Page 394
8…Strategies to Avoid Serious Complications......Page 397
References......Page 399
Abstract......Page 404
2…Lung Tolerance......Page 405
3…Chest Wall Tolerance......Page 407
4…Skin Tolerance......Page 410
6…Bronchial Tolerance......Page 411
7…Liver Tolerance......Page 412
9…Vertebral Bone Tolerance......Page 413
10.1.1 Impact on Spinal Cord Tolerance Secondary to the Inhomogeneity of the Dose Distribution......Page 414
10.1.3 Spinal Cord Contouring Practice......Page 415
10.1.4 Human Spinal Cord Dose Limits......Page 416
10.2.1 Brachial Plexus......Page 417
11…Normal Tissue Constraints Used in RTOG Trials......Page 418
References......Page 419
Erratum to:......Page 422
Erratum to:......Page 423
Index......Page 424