1st Edition
Pediatric Radiotherapy Planning and Treatment
By becoming knowledgeable about optimal treatment methods designed specifically for childhood cancers, members of a radiotherapy team can help improve both pediatric cancer survival statistics and patients’ quality of life. Pediatric Radiotherapy Planning and Treatment is the first single, focused resource available for health care providers to accurately plan and deliver radiation therapy to children.
The first section of the book discusses the statistics of pediatric cancer incidence and survival. It also reviews the literature on radiation-induced secondary malignancies, addressing the use of intensity-modulated radiation therapy (IMRT) in children.
The second section presents disease-specific chapters. Each chapter in this section gives a clinical overview of the disease, describes treatment planning and delivery concepts and guidance, and surveys late effects and organ tolerance doses. Many of the techniques presented can be readily translated to any radiotherapy department. The book also explores the historical background underpinning current treatment paradigms, which reveals the tremendous creativity of radiation oncologists and physicists in addressing difficult treatment dilemmas.
Medical physicists, dosimetrists, radiation oncologists, and others in a pediatric radiotherapy team must understand pediatric cancers and know how to accurately and safely implement optimal treatments to minimize late effects and maximize the chance for cure or palliation. The methods and clinical background in this book help these health care providers—even those with no formal training in pediatric radiotherapy—recognize the differences between pediatric cancers and adult cancers and then design and administer an appropriate treatment plan.
Section 1: Pediatric Cancers and Challenges for Radiotherapy
Overview of Childhood Cancer: Incidence, Survival, and Late Effects
Challenges of Treating Children with Radiation Therapy
Overview
Treatment Planning Considerations
Secondary Malignancies
Appendix
Section 2: Guide to Treatment Planning and Dose Delivery
Leukemia
Clinical Overview
Total Body Irradiation (TBI) as Preparation for Bone Marrow Transplant
Early Animal and In Vitro Radiobiological Data
Clinical Basis for TBI Prescription
TBI Delivery Method Evolution
Conventional TBI Treatment Methods
Conventional TBI Commissioning and Dosimetry Requirements
Treatment Planning
Organ-at-Risk Doses and Late Effects
Tumors of the Central Nervous System
Clinical Overview
Target Volume Definition
Treatment Strategies
Organ-at-Risk Doses and Late Effects
Appendix
Hodgkin Lymphoma
Clinical Overview
General Treatment Planning Guidelines
Three-Dimensional Conformal Radiation Therapy (3DCRT) and Intensity-Modulated Radiation Therapy (IMRT) for Hodgkin Lymphoma (HL)
Organ-at-Risk Doses and Late Effects
Neuroblastoma
Clinical Overview
Target Volume Definition
Treatment Planning Techniques and Dosimetry
Organ-at-Risk Doses and Late Effects
Wilms’ Tumor
Clinical Overview
Field Design
Intensity-Modulated Radiation Therapy (IMRT) Treatment Planning
Proton Therapy
Organ-at-Risk Doses and Late Effects
Soft Tissue Tumors (Rhabdomyosarcoma and Other Soft Tissue Sarcomas)
Clinical Overview
External Beam Treatment Planning
Brachytherapy and Intraoperative Electron Beam (IORT)
Proton Therapy
Organ-at-Risk Doses and Late Effects
Bone Sarcomas (Osteosarcoma and Ewing’s Sarcoma)
Clinical Overview
Treatment Planning
Late Effects
Retinoblastoma
Clinical Overview
Treatment Planning
Treatment Techniques
Organ-at-Risk Doses and Late Effects
Index
References appear at the end of each chapter.
Biography
Arthur J. Olch is a professor of clinical pediatrics and radiation oncology in the Keck School of Medicine at the University of Southern California. He is also chief of physics for the Children’s Hospital of Los Angeles Radiation Oncology Program, one of only a few radiotherapy centers in the United States that treats children exclusively. Dr. Olch earned a PhD in medical physics from the University of Los Angeles. A Fellow of the American Association of Physicists in Medicine (AAPM), Dr. Olch has authored or coauthored more than 40 journal articles and book chapters.
"This is a very well-written and -organized book covering the planning and delivery aspects unique to pediatric radiotherapy. The author is a respected and well-known medical physicist with extensive pediatric radiotherapy experience. … a very useful book for any clinical physicist treating pediatric cases and seeking contextual and historical perspective. … a great reference for medical physicists who may not see many pediatric cases and can look to this text as a one-stop shop for not only a comprehensive overview, but detailed explanation for specific pediatric disease sites. Overall, it is a great addition to the reference library of any radiation therapy physicist."
—Medical Physics, April 2014