Spatially Fractionated, Microbeam and FLASH Radiation Therapy : A Physics and Multi-Disciplinary Approach / edited by Hualin Zhang and Nina Mayr.

Format:

Book

Contributor:

Zhang, Hualin, editor.

Mayr, Nina, editor.

Series:

IPEM-IOP Series in Physics and Engineering in Medicine and Biology Series

Language:

English

Subjects (All):

Cancer--Radiotherapy.

Cancer.

Medical physics.

Physical Description:

1 online resource (434 pages)

Edition:

First edition.

Place of Publication:

Bristol, England : IOP Publishing, [2023]

Summary:

As an essential text for physicists, radiation oncologists and researchers, this textbook comprehensively addresses the physics of novel heterogeneous radiation approaches, in the context of clinical application and biology. Spatially Fractionated Radiation Therapy technologies and techniques, planning and dosimetric properties and documentation are reviewed. Emerging Minibeam, Microbeam and the novel field of FLASH radiation are addressed.

Contents:

Intro

Preface

Editor biographies

Hualin Zhang

Nina A Mayr

List of contributors

Introductory commentary

References and further reading

Chapter 1 Introduction to the principles of spatially fractionated radiotherapy

1.1 Introduction

1.2 The historical development of spatially fractionated radiotherapy techniques

1.3 Current definitions of spatially fractionated radiotherapy

1.3.1 GRID radiotherapy

1.3.2 Lattice radiotherapy

1.3.3 Minibeam radiotherapy

1.3.4 Microbeam radiotherapy

1.3.5 Implications of dose rate

1.4 Knowledge gaps and future perspectives

1.5 Summary

References

Chapter 2 General principles of SFRT biology

2.1 Introduction

2.1.1 Defining the biologic characteristics of spatially fractionated radiotherapy

2.2 Mechanisms of response to SFRT-current concepts

2.2.1 The bystander response

2.2.2 Microvascular alterations

2.2.3 Immunomodulation

2.2.4 Knowledge gaps and future perspectives

2.3 Summary

Chapter 3 The immunologic effects of nonuniform dose irradiation

3.1 Introduction/overview

3.2 The mechanisms of radiation-induced immunomodulation

3.2.1 DNA damage and innate immune sensing

3.2.2 Immunogenic modulation and adaptive immunity

3.2.3 Local and systemic radiation responses

3.3 The immunologic effects of ionizing radiation

3.3.1 The immunogenic effects of ionizing radiation

3.3.2 The immunosuppressive and tolerogenic effects of ionizing radiation

3.3.3 The immune-depleting effects of ionizing radiation

3.3.4 The irradiation of anatomic/biologic compartments on radiation response

3.4 Understanding the potential immunologic consequences of nonuniform dose irradiation

3.4.1 The integration of nonuniform irradiation and immunomodulation

3.5 Knowledge gaps and future perspectives

3.6 Conclusions.

References

Chapter 4 The biology of FLASH-a critical appraisal for clinical translation

4.1 Introduction

4.2 FLASH-RT

4.2.1 The FLASH effect

4.3 The physical characteristics of FLASH beams

4.3.1 FLASH beams in preclinical studies

4.4 The technological level of existing FLASH systems

4.4.1 The feasibility of performing FLASH-RT using electron linacs

4.4.2 The feasibility of FLASH-RT with medical proton accelerators

4.5 The clinical implementation of FLASH-RT

4.5.1 Ongoing clinical trials

4.5.2 What still needs to be resolved?

4.6 Conclusion

Chapter 5 SFRT experience in multi-disease studies of voluminous and metastatic tumors

5.1 Introduction

5.2 Palliative treatment with GRID radiotherapy

5.3 Transition to the definitive treatment of primary tumors

5.3.1 Head and neck cancer

5.4 Knowledge gaps and future perspectives

Chapter 6 GRID spatially fractionated radiation therapy: definitive radiation therapy in bulky primary tumors

6.1 Introduction/overview

6.1.1 Early experience in palliation at Thomas Jefferson University Hospital

6.1.2 Early University of Kentucky experience: early transition to definitive therapy

6.1.3 University of Maryland

6.1.4 University of Kentucky

6.2 Melanoma

6.2.1 The advantage of hypofractionation for adjuvant melanoma

6.2.2 Modeling hypofractionated GRID for primary melanoma

6.2.3 Melanoma experience gained at the University of Kentucky

6.2.4 Immunological indications of GRID in melanoma

6.3 Experience with bulky primary head and neck cancers

6.3.1 Introduction

6.3.2 Early University of Kentucky experience

6.3.3 University of Kentucky

6.3.4 University of Kentucky updated experience

6.3.5 University of Arkansas experience

6.3.6 University of Texas at San Antonio.

6.3.7 Summary and discussion of studies

6.3.8 Future applications in the developing world

6.4 Lung cancer

6.4.1 Lung experience gained in the United Kingdom

6.4.2 Dosimetric considerations for lung GRID

6.5 Other tumor types

6.6 Breast cancer

6.7 Cervical cancer

6.7.1 Cervical cancer hypofractionated modeling

6.7.2 'Internal' GRID mimicking virtual tandem brachytherapy

6.8 Rectal cancer

6.9 Conclusions

Chapter 7 Lattice Radiotherapy SFRT: definitive radiation therapy in bulky primary tumors

7.1 The history, origins, and development of Lattice therapy

7.2 Clinical LRT experience

7.2.1 LRT in gynecologic cancer

7.2.2 LRT in lung cancer

7.3 Emerging experience with LRT in other tumors and related techniques

7.4 Knowledge gaps and future perspectives

7.5 Conclusions

Chapter 8 Proton beam spatially fractionated radiation therapy: clinical data

8.1 Introduction and rationale for delivering spatially fractionated modalities with proton therapy

8.2 Current limitations of proton therapy

8.3 Clinical experience with proton GRID therapy

8.4 Proton minibeam radiation therapy

8.5 Proton FLASH: rationale, preclinical data, and the first treated patient

8.6 Proton FLASH: methods of delivery

8.7 Proton FLASH: preclinical and clinical data

8.8 Proton FLASH: clinical trial roadmap

8.9 Conclusions

Conflict of interest

Funding

Chapter 9 GRID-collimator-based and static-field SFRT

9.1 Introduction/overview

9.2 The geometry of commercially available GRID collimators

9.2.1 Cerrobend GRID collimator

9.2.2 Brass GRID collimator

9.3 GRID collimation performed by MLC or customer-made GRID formers

9.3.1 MLC-formed GRID fields

9.3.2 GRID collimation performed by customer-made GRID shapers.

9.3.3 GRID fields produced by MLC pairs and the crossfire technique

9.4 Dosimetric properties of GRID fields

9.4.1 Percentage depth-dose and dose profiles of GRID fields produced by commercial GRIDs

9.4.2 Dosimetric properties of customer-made GRID fields

9.4.3 The use of treatment planning systems to perform GRID therapy dose calculations

9.4.4 Dose-volume histograms for GRID therapy

9.5 Dose metrics needed to document GRID therapy

9.6 Dosimetric parameters used when creating a GRID therapy plan

9.7 Knowledge gaps and future perspectives

9.8 Conclusions

References and additional reading

Chapter 10 The technical aspects of 3D lattice radiation therapy (LRT)

10.1 Introduction

10.2 Clinical intent and LRT configuration

10.2.1 Partial tumor boost or debulking

10.2.2 Induction of bystander and abscopal effects

10.2.3 LRT configuration and treatment planning

10.2.4 LRT plan review, approval, and reporting

10.3 Knowledge gaps and future perspectives

10.4 Conclusions

Chapter 11 Rotational arc SFRT

11.1 Introduction/overview

11.2 MLC-based SFRT block and beam characteristics

11.2.1 Virtual grid block

11.2.2 Design of the alloy block and the optimized virtual GRID block

11.2.3 Beam characteristics

11.3 Treatment planning considerations

11.4 Treatment plan evaluation

11.5 Conclusions and future work

Chapter 12 Electron beam SFRT

12.1 Introduction

12.2 GRID collimator designs and their dosimetric characteristics for electron beam SFRT

12.2.1 Electron beam SFRT based on the metal or alloy cutout method

12.2.2 Electron SFRT with tungsten functional paper and tungsten-containing rubber

12.3 Electron beam SFRT dose calibration for clinical safe delivery

12.4 Discussion of electron GRID collimators and strategies for clinical use.

12.5 Knowledge gaps and future perspectives

12.6 Summary

Chapter 13 Proton beam spatially fractionated radiotherapy

13.1 Introduction

13.2 Treatment planning

13.2.1 Placement of spots

13.2.2 Plan optimization

13.2.3 Optimal spot spacing

13.2.4 Dosimetric verification and QA

13.3 Use of parallel opposed beams

13.3.1 Opposed beams with a matched pattern

13.3.2 Opposed beams with an offset pattern

13.3.3 Extremely thick tumors

13.4 Proton GRID versus proton lattice therapy

13.4.1 Proton lattice therapy planning

13.4.2 Dosimetric comparison

13.4.3 Plan robustness

13.5 The advantages and challenges of proton GRID therapy

13.6 Summary

Chapter 14 Radiobiological modeling and equivalent uniform dose for spatially fractionated radiation therapy

14.1 Introduction

14.2 Dosimetric and biophysical concepts

14.2.1 Physical dose

14.2.2 LQ cell survival model

14.2.3 Iso-effective dose

14.3 Nonuniform dose distributions

14.4 The uses of EUD and EQD2 in SFRT

14.5 Preclinical and clinical studies

14.5.1 Examples from the literature

14.5.2 Treatment planning

14.6 Discussion

14.7 Knowledge gaps and future perspectives

14.8 Conclusion and recommendations

14.8.1 Glossary of selected concepts and notation

Chapter 15 Spatially fractionated radiation therapy field calibration and commissioning

15.1 Introduction/overview

15.2 GRID block calibration and commissioning

15.2.1 Mechanical integrity checks

15.2.2 Dosimetric characterization of physical GRID blocks

15.2.3 Implementation of the physical block within the treatment planning system

15.3 Commissioning and quality assurance for lattice SFRT

15.3.1 General considerations for patient-specific SFRT QA

15.3.2 Radiochromic film dosimetry for lattice SFRT QA.

15.4 Suggested treatment workflows and safety checks.

Notes:

Description based on publisher supplied metadata and other sources.

Description based on print version record.

Includes bibliographical references.

ISBN:

0-7503-4619-1

OCLC:

1429725511