Search results for: stereotactic-body-radiotherapy

Stereotactic Body Radiotherapy

Author : Andrew Gaya
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This is a single, comprehensive handbook for clinical oncology trainees and consultants, covering the basic aspects of stereotactic radiotherapy systems and treatment.

Handbook of Evidence Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy

Author : Rajni A Sethi
File Size : 64.59 MB
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This handbook concisely summarizes state-of-the-art information about stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), including the history and development of these modalities, the biologic rationale for these technologies, typical practices, and reported results. Developed as a companion to Handbook of Evidence-Based Radiotherapy, Second Edition, edited by Eric Hansen and Mack Roach, III, it is organized by disease site and presents treatment techniques and recommended imaging; safety and quality assurance; toxicities and management; recommended follow-up; and supporting evidence. Inclusion of evidence-based guidelines is intended to help inform decisions regarding the appropriateness of SRS and SBRT and guide treatment and evaluation. Handbook of Evidence-Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy can be easily referenced in the clinic and is a valuable guide for oncology practitioners.​

Handbook of Evidence Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy

Author : Rajni A. Sethi
File Size : 21.22 MB
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This handbook concisely summarizes state-of-the-art information about stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), including the history and development of these modalities, the biologic rationale for these technologies, typical practices, and reported results. Developed as a companion to Handbook of Evidence-Based Radiotherapy, Second Edition, edited by Eric Hansen and Mack Roach, III, it is organized by disease site and presents treatment techniques and recommended imaging; safety and quality assurance; toxicities and management; recommended follow-up; and supporting evidence. Inclusion of evidence-based guidelines is intended to help inform decisions regarding the appropriateness of SRS and SBRT and guide treatment and evaluation. Handbook of Evidence-Based Stereotactic Radiosurgery and Stereotactic Body Radiotherapy can be easily referenced in the clinic and is a valuable guide for oncology practitioners.​

Hypofractionated and Stereotactic Radiation Therapy

Author : Orit Kaidar-Person
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This handbook summarizes the data and techniques for hypofractionation and stereotactic radiation in a clinically-accessible way. Hypofractionated radiation therapy, which consists of larger-dose radiation treatments that are given over a shorter time period compared to conventional radiation fraction sizes, is used to treat a variety of cancers, including prostate, breast, lung, and colorectal. Conventional radiation therapy and hypofractionated radiation therapy have different effectiveness rates for cancer treatment and have different impacts on normal tissues in terms of causing toxicity. There is a significant and growing body of literature on the use of different dosing regimens to treat a variety of cancers and radiation oncologists need to keep up with the various dosing schedules, the effect of each regimen on cancer control in different cancers, and how the different schedules affect each organ in terms of toxicity. The book thus provides concise information ranging from commonly-used dose-fractionation schemes for hypofractionated and stereotactic body radiotherapy to simulation and treatment specifications to published safety and efficacy data. Chapters additionally examine the biological rationales for the efficacy of hypofractionated radiation; present clinical studies that demonstrate the efficacy and safety of hypofractionated radiation treatment in a variety of cancers; and describe the advances in technology that have allowed hypofractionated radiation to be safely given. This is an ideal guide for radiation oncology clinicians and trainees.

Stereotactic Body Radiation Therapy

Author : Simon S. Lo
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Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

Author : Daniel M. Trifiletti
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This book is a comprehensive review of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): its physics, clinical evidence, indications, and future directions. The utilization of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) is increasing internationally because of several factors. First, it offers patients a local treatment option that has demonstrated effectiveness similar to traditional surgery without the morbidity of general anesthesia and open surgical resection. Second, recent advancements in the quality of scientific evidence supporting a SRS or SBRT-containing approach in patients continues to evolve and demonstrate favorable disease-specific outcomes with little, if any, toxicity in various anatomic disease sites and for various conditions including cancer, benign tumors, and other psychiatric and neurologic conditions. Third, and most provocatively, is the notion that definitive local therapy (i.e. SRS or SBRT) in patients with cancer can boost the immune system to fight cancer in other sites throughout the body. While traditional medical knowledge would suggest that all patients with metastatic cancer are incurable, there is a mounting body of evidence that there is a subset of these patients that can be cured with definitive SRS or SBRT. This volume thus delves into each of these benefits and aspects of treatment, guiding physicians to the best treatment plan for their patients. Expert, international authors provide guidelines for SRS and SBRT use by clinicians. Chapters are divided into six main sections: Radiobiology of Radiosurgery and Stereotactic Body Radiation Therapy, Intracranial Radiosurgery Technique, Intracranial Radiosurgery by Indication, Stereotactic Body Radiation Therapy Technique, Stereotactic Body Radiation Therapy by Indication, The Future of Radiosurgery and SBRT. Overall physics are explained, as well as specific considerations for particular surgical tools (including the Leksell Gamma Knife and Accuray CyberKnife), techniques (including fractionated and charged particle radiosurgery), and anatomic sites (including brain metastases, pituitary tumors, and the prostate). Detailed images and charts enhance the chapters. This book provides physicians with a single, practical resource incorporating both of these broad categories of treatment, SRS and SBRT, and better defines the current role and the direction of radiosurgery.

Clinical Application of Stereotactic Body Radiotherapy SBRT Cranium to Prostate

Author : Dwight E. Heron
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Stereotactic radiosurgery is a relatively recent radiation technique initially developed using a frame-based system in 1949 by a Swedish neurosurgeon, Lars Leksell, for lesions not amendable to surgical resection. Radiosurgery is founded on principles of extreme radiation dose escalation, afforded by precise dose delivery with millimeter accuracy. Building upon the success of frame-based radiosurgery techniques, which were limited to cranial tumors and invasive head-frame placement, advances in radiation delivery and image-guidance have lead to the development of stereotactic body radiotherapy (SBRT). SBRT allows for frameless delivery of dose distributions akin to frame-based cranial stereotactic radiosurgery to both cranial and extra-cranial sites and has emerged as a important treatment strategy for a variety of cancers from the cranium to prostate. Herein we highlight ongoing investigations for the clinical application of SBRT for a variety of primary and recurrence cancers aimed at examining the growing clinical evidence supporting emerging roles for SBRT in the ever growing oncologic armamentarium.

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy SBRT

Author : Dwight E. Heron, MD, MBA, FACRO, FACR
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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy (SBRT) is a comprehensive guide for the practicing physician and medical physicist in the management of complex intracranial and extracranial disease. It is a state-of-the-science book presenting the scientific principles, clinical background and procedures, treatment planning, and treatment delivery of SRS and SBRT for the treatment of tumors throughout the body. This unique textbook is enhanced with supplemental video tutorials inclusive to the resource. Beginning with an overview of SRS and SBRT, Part I contains insightful coverage on topics such as the evolving radiobiological principles that govern treatment, imaging, the treatment planning process, technologies and equipment used, as well as focused chapters on quality assurance, quality management, and patient safety. Part II contains the clinical application of SRS and SBRT for tumors throughout the body including those in the brain, head and neck, lung, pancreas, adrenal glands, liver, prostate, cervix, spine, and in oligometastatic disease. Each clinical chapter includes an introduction to the disease site, followed by a thorough review of all indications and exclusion criteria, in addition to the important considerations for patient selection, treatment planning and delivery, and outcome evaluation. These chapters conclude with a detailed and site-specific dose constraints table for critical structures and their suggested dose limits. International experts on the science and clinical applications of these treatments have joined together to assemble this must-have book for clinicians, physicists, and other radiation therapy practitioners. It provides a team-based approach to SRS and SBRT coupled with case-based video tutorials in disease management, making this a unique companion for the busy radiosurgical team. Key Features: Highlights the principles of radiobiology and radiation physics underlying SRS and SBRT Presents and discusses the expected patient outcomes for each indicated disease site and condition including a detailed analysis of Quality of Life (QOL) and Survival Includes information about technologies used for the treatment of SRS and SBRT Richly illustrated with over 110 color images of the equipment, process flow diagrams and procedures, treatment planning techniques and dose distributions 7 high-quality videos reviewing anatomy, staging, treatment simulation and planning, contouring, and management pearls Dose constraint tables at the end of each clinical chapter listing critical structures and their appropriate dose limits Includes access to the fully-searchable downloadable eBook

Stereotactic Body Radiation Therapy

Author : Yasushi Nagata
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This book serves as a practical guide for the use of stereotactic body radiation therapy in clinics. On the basis of more than 10 years of clinical experience with lung cancer, liver cancer and other cancers, a remarkable volume of knowledge has been accumulated. At the same time, great progress in techniques has been achieved. Various new fixing apparatuses, new respiratory regulation techniques, new dose fractionation schedules and new image-guided radiation therapy machines have been developed. This book reviews the history of those developments and reports on various types of toxicities. Review of recent clinical studies is also included. The authors were key members of the JCOG 0403 clinical trials on stereotactic body radiation therapy (SBRT) for both inoperable and operableT1N0M0 primary lung cancer. Readers will learn of the superior outcomes obtained with SBRT for lung cancer and other cancers in terms of local control and toxicities. With its practical focus, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists and senior nurses as well as medical oncologists and surgical oncologists who are interested in radiotherapy.

Stereotactic Body Radiotherapy

Author : Andrew Gaya
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This is a single, comprehensive handbook for clinical oncology trainees and consultants, covering the basic aspects of stereotactic radiotherapy systems and treatment.

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

Author : Stanley H. Benedict
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Written by internationally known experts in the field, Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy examines one of the fastest-developing subspecialties within radiation oncology. These procedures deliver large doses of radiation in one to five sessions to a precisely determined target. Often these techniques have proven to be as or more effective than traditional radiation therapy techniques, while at the same time being cost-efficient and convenient for the patient. These techniques, however, require careful planning, specialized equipment, and well-trained staff. This volume provides a cutting-edge look at the biological and technical underpinnings of SRS and SBRT techniques. It includes a history of the development of SRS and SBRT; clinical applications of the techniques; dedicated devices for delivering precisely shaped, high doses of radiation; use of in-room imaging for treatment planning and treatment guidance; immobilization techniques for accurate targeting; and future developments that will continue to evolve and refine existing techniques. A valuable introduction to those just learning about these specialized techniques, and an ideal reference for those who are already implementing them, this book covers a wide variety of topics, with clear discussions of each aspect of the technology employed.

Stereotactic Body Radiation Therapy

Author : Brian D. Kavanagh
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"Kavanaugh (radiation oncology, University of Colorado Comprehensive Cancer Center) and Timmerman (image guided stereotactic radiation therapeutics, University of Texas Southwestern Medical Center) demonstrate the power of stereotactic body radiation therapy (SBRT) as a weapon in the cancer-fighting arsenal, and give advice on building a clinical SBRT program. Intended as a primer for radiation oncologists, physicists, radiobiologists, dosimetrists, and other members of the cancer team, and the book covers the radiobiology, physics, and dosimetry of SBRT, and gives practical details on procedures for specific conditions. B&w photos and medical images are included. Annotation: 2004 Book News, Inc., Portland, OR (booknews.com)"--[source inconnue].

In field Stereotactic Body Radiotherapy SBRT Reirradiation for Pulmonary Malignancies as a Multicentre Analysis of the German Society of Radiation Oncology DEGRO

Author : Caroline John
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Abstract: Data of thoracic in-field reirradiation with two courses of stereotactic body radiotherapy (SBRT) is scarce. Aim of this study is to investigate feasibility and safety of this approach. Patients with a second course of thoracic SBRT and planning target volume (PTV) overlap were analyzed in this retrospective, multicenter study. All plans and clinical data were centrally collected. 27 patients from 8 centers have been amenable for evaluation: 12 with non-small-cell lung cancer, 16 with metastases, treated from 2009 (oldest first course) to 2020 (latest second course). A median dose of 38.5 Gy to the 65%-isodose over a median of 5 fractions was prescribed in the first course and 40 Gy in 5 fractions for the second SBRT-course. Median PTV of the second SBRT was 29.5 cm3, median PTV overlap 22 cm3. With a median interval of 20.2 months between the two SBRT-courses, 1-year OS, and -LCR were 78.3% and 70.3% respectively. 3 patients developed grade 1 and one grade 2 pneumonitis. No grade > 2 toxicity was observed. Peripheral location and dose were the only factors correlating with tumor control. A second SBRT-course with PTV overlap appears safe and achieves reasonable local control

IMRT IGRT SBRT

Author : John Meyer
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New high-precision technologies for the planning and delivery of radiotherapy are major advances in cancer treatment. This volume is a comprehensive guidebook to these new technologies and the many clinical treatment programs that bring them into practical use. Advances in intensity modulated radiation therapy (IMRT), 4D and adaptive treatment planning are clearly explained, and the new target localization and image-guided radiotherapy (IGRT) systems are comprehensively reviewed. Clinical tutorials fully illustrate the target definitions for the major cancer sites, and techniques for organ motion management are shown. In addition, chapters explore the technical basis for stereotactic body radiotherapy (SBRT) and the latest clinical experience with it for most organ sites.

Four Dimensional Monte Carlo Stereotactic Body Radiotherapy for Lung Cancers Using Image Guided Robotic Target Tracking

Author : Ka-Heng Chan
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This dissertation, "Four-dimensional Monte Carlo Stereotactic Body Radiotherapy for Lung Cancers Using Image-guided Robotic Target Tracking" by Ka-heng, Chan, 陳加慶, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Stereotactic body radiotherapy (SBRT) is a promising treatment strategy for early-stage lung cancers. Conventional three-dimensional (3D) SBRT based on a static patient geometry is an insufficient model of reality, posing constraints on accurate Monte Carlo (MC) dose calculation and intensity-modulated radiotherapy (IMRT) optimization. Four-dimensional (4D) radiotherapy explicitly considers temporal anatomical changes by characterizing the organ motion and building a 4D patient model, generating a treatment plan that optimizes the doses to moving tissues, i.e., 4D dose (as opposed to the static 3D dose to tissue), and delivering this plan by synchronizing the radiation with the moving tumor. This thesis focuses on 4D robotic tracking lung SBRT. By recalculating the conventional 3D plan on the 4D patient model using MC simulation, it was found that 4D moving dose distributions could detect increase of normal tissue doses and complication probabilities (NTCP), and decrease of tumor dose and control probability. For one patient, the risk of myelopathy was estimated at 8% and 18% from the 3D equivalent path-length corrected (EPL) and the 4D MC doses, respectively. Such increased NTCP suggests that better estimations of different dosimetric quantities using 4D MC dose calculation are crucial to improve the existing dose-response models. Dosimetric error in 4D robotic tracking SBRT was found to be caused predominately by tissue heterogeneities, as assessed by the comparisons of the 4D moving tissue doses calculated using the conventional EPL and MC algorithms. At 3% tolerance level, our results indicated clinically significant dose prediction errors only in tumor but not in other major normal tissues. Furthermore, 4D tracking radiotherapy was found to have greater ability to limit the normal tissue volume receiving high to medium doses than the other advanced SBRT strategy combining volumetric-arc radiotherapy with 4D cone-beam CT verification. Invariant target motion was found to be an unrealistic assumption of 4D radiotherapy from the analysis of probability motion function (pmf) of motion data. Systematic and random variations of motion amplitude, frequency, and baseline were found to reduce the reproducibility of pmfs, on average, to just 30% for the principal motion of 3400 seconds. Experimental evaluations showed that systematic motion change reduced the gamma passing rate of radiochromic film measurements at 3mm distance-to-agreement and 3% dose difference criteria from 91% for 4D dose calculated with MCand EPL algorithms to 47% and 53% in the static object, respectively, . For moving target object, gamma passing rates of the 4D MC doses hardly changed with reproducible and non-reproducible motion (95% vs. 93%), and barely differed between conventional 3D and 4D MC doses (95% vs. 95% with reproducible, and 96% vs. 93% with non-reproducible motions). Distortions due to image artifacts and registration errors were consistently observed in the 4D dose distributions but not the 3D dose distributions. In conclusion, 4D Monte Carlo planning shall be considered for robotic target tracking only if robustness against uncertainties of patient geometry, and accuracy of 4DCT imaging and deformation registration are significantly improved. DOI: 10.5353/th_b5317051 Subjects: Lungs - Cancer - Radiotherap

Stereotactic Body Radiation Therapy

Author : U. S. Department of Health and Human Services
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The development of stereotactic body radiation therapy (SBRT) began in the early 1990s at the Karolinska Institute (Stockholm, Sweden) with researchers Ingmar Lax and Henric Blomgren and was derived from the techniques and procedures of stereotactic radiosurgery (SRS). Researchers in Japan and North America helped develop this treatment during this same time in the 1990s. The American College of Radiology (ACR) and the American Society for Radiation Oncology (ASTRO) define SBRT as “an external beam radiation therapy method used to very precisely deliver a high dose of radiation to an extracranial target within the body, using either a single dose or a small number of fractions.” SBRT combines multiple finely collimated radiation beams and stereotaxy (3D target localization). The multiple radiation beams intersect to deliver an accurate, high dose of radiation to a carefully defined location. There are several terms that have been used interchangeably for SBRT. These terms include “stereotactic radiotherapy,” “fractionated stereotactic radiosurgery,” “hypofractionated stereotactic radiosurgery,” and “staged radiosurgery.” Consensus does not exist for the definition of SBRT with respect to a maximum number of radiation fractions, the minimum radiation dose per fraction, or the maximum number and diameter of lesions to be treated. SBRT is characterized by patient immobilization, limiting normal tissue exposure to highdose radiation, preventing or accounting for organ motion (e.g., respiratory motion), the use of stereotaxy, and the subcentimeter accuracy of the delivered dose. The key components of a SBRT procedure are target delineation, treatment planning, and treatment delivery. The treatment team includes a radiation oncologist, medical physicist, radiation therapist, and depending on the body site and indication, a diagnostic radiologist, nurse, anesthetist, and dosimetrist as needed.6 Medical professionals, such as surgeons, may also play a role in the treatment team. Stereotactic radiosurgery is a distinct discipline that utilizes externally generated ionizing radiation in certain cases to inactivate or eradicate (a) defined target (s) in the head or spine without the need to make an incision. The target is defined by high-resolution stereotactic imaging. To assure quality of patient care the procedure involves a multidisciplinary team consisting of a neurosurgeon, radiation oncologist, and medical physicist. Stereotactic radiosurgery (SRS) is typically performed in a single session, using a rigidly attached stereotactic guiding device, other immobilization technology and/or a stereotactic image-guidance system, but can be performed in a limited number of sessions, up to a maximum of five. Technologies that are used to perform SRS include linear accelerators, particle beam accelerators and multisource Cobalt 60 units. In order to enhance precision, various devices may incorporate robotics and real time imaging. The goal of this Technical Brief is to provide a broad overview of the current state of SBRT for solid malignant tumors. This Technical Brief reports on the current technologies available to deliver SBRT; the types and locations of tumors that have been treated with SBRT; the possible advantages and disadvantages of the technology; the extent of diffusion of the technology; and provide information about advances in the technology that are currently in development.

Role of SRS SBRT in Oligometastatic Disease

Author : Michael T. Milano
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Oligometastatic disease represents an intermediate state between the early localized disease and widespread metastatic malignancy. Some patients with oligometastatic disease, treated by ablative therapies to all sites of metastatic disease, can achieve long disease-free survival and sometimes cure. Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) are accepted treatment options for these patients, achieving high rates of local control. While most of the studies report outcomes of SBRT for solitary oligometastasis, patients with oligometastatic disease might present with multiple concurrent lesions either in the same organ or in neighboring organs. There are few studies addressing the role of SBRT in patients with multiple concurrent oligometastases. Furthermore, these patients likely recur either in the same organ or at distance. Therefore, the need for retreatment with SBRT might be required. There remains a dearth of data regarding the re-irradiation after prior SBRT, toxicity, and dose volume constraints. Particularly as it related to significant improvements in systemic therapies (including immunotherapies), it is likely that patients with widespread metastases can become oligometastatic after systemic treatments. While targeted, immune therapies and SBRT are increasingly used in patients with oligometastatic disease, their sequencing, interaction, and toxicities have not been studied and are poorly understood. In this e-book, we discuss the state of the science of oligometastatic disease & SBRT in a variety of locations and outline potential future direction of research efforts.

Stereotactic Body Radiotherapy for Spinal Metastases

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IMRT IGRT SBRT

Author : John Meyer
File Size : 71.87 MB
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Over the last 4 years, IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy has become a standard reference in the field. During this time, however, significant progress in high-precision technologies for the planning and delivery of radiotherapy in cancer treatment has called for a second edition to include these new developments. Thoroughly updated and extended, this new edition offers a comprehensive guide and overview of these new technologies and the many clinical treatment programs that bring them into practical use. Advances in intensity-modulated radiotherapy (IMRT), and 4D and adaptive treatment planning are clearly presented. Target localization and image-guided radiotherapy (IGRT) systems are comprehensively reviewed as well. Clinical tutorials illustrate target definitions for the major cancer sites, and useful techniques for organ motion management are described and compared. There are also several chapters that explore the technical basis and latest clinical experience with stereotactic body radiotherapy (SBRT) and summarize practical treatment recommendations. Furthermore, the significant and increasing contributions of proton therapy to cancer care are also highlighted, alongside the practical allocation of all these new technologies from an economic perspective. As a highlight of this volume, a number of images can be viewed online in time-elapse videos for greater clarity and more dynamic visualizationWritten by leading authorities in the field, this comprehensive volume brings clinical and technical practitioners of radiotherapy fully up to date with the key developments in equipment, technologies and treatment guidelines.

Stereotactic Body Radiotherapy in Non small Cell Lung Cancer

Author : Pia Baumann
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