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.