radiotherapy and brachytherapy3a978-90... · devoted to clinical application of 3d conformal...
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Radiotherapy and Brachytherapy
This Series presents the results of scientific meetings supported under the NATO
Advanced Research Workshops (ARW) are expert meetings where an intense butinformal exchange of views at the frontiers of a subject aims at identifying directions forfuture action
re-organised. Recent volumes on topics not related to security, which result from meetingssupported under the programme earlier, may be found in the NATO Science Series.
Sub-Series
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E. Human and Societal Dynamics
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The Series is published by IOS Press, Amsterdam, and Springer, Dordrecht, in conjunction with the NATO Public Diplomacy Division.
A. Chemistry and Biology
C. Environmental SecurityB. Physics and Biophysics
and Mediterranean Dialogue Country Priorities. The types of meeting supported are generally "Advanced Study Institutes" and "Advanced Research Workshops". The NATOSPS Series collects together the results of these meetings. The meetings are co-organized by scientists from NATO countries and scientists from NATO's "Partner" or"Mediterranean Dialogue" countries. The observations and recommendations made at the meetings, as well as the contents of the volumes in the Series, reflect those of parti-cipants and contributors only; they should not necessarily be regarded as reflecting NATOviews or policy.
latest developments in a subject to an advanced-level audienceAdvanced Study Institutes (ASI) are high-level tutorial courses intended to convey the
Following a transformation of the programme in 2006 the Series has been re-named and
NATO Science for Peace and Security Series
Programme: Science for Peace and Security (SPS).
Defence Against Terrorism; (2) Countering other Threats to Security and (3) NATO, Partner The NATO SPS Programme supports meetings in the following Key Priority areas: (1)
Series B: Physics and Biophysics
Published in cooperation with NATO Public Diplomacy Division
and
edited by
Radiotherapy and Brachytherapy
Yves Lemoigne
Alessandra Caner
European Scientific InstituteSite d’ArchampsFrance
European Scientific InstituteSite d’ArchampsFrance
Published by Springer,
Printed on acid-free paper
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Proceedings of the NATO Advanced Study Institute on
ISBN 978-90-481-3095-5 (HB)
ISBN 978-90-481-3097 -9 (e-book)
ISBN 978-90-481-3096-2 (PB)
Physics of Modern Radiotherapy & Brachytherapy Archamps France15–27 November 2007
Library of Congress Control Number: 2009931108
v
CONTENTS
Preface ................................................................................................................ ix
List of Participants .............................................................................................. xi
Photographs ....................................................................................................... xv
PART I: INTRODUCTION TO RADIOTHERAPY ............................................... 1
Fundamental Radiobiology and Its Application to Radiation Oncology............. 3 Francesca M. Buffa
Accuracy Strategies in Radiotherapy................................................................. 11 Günther H. Hartmann
PART II: X-RAYS TELETHERAPY ......................................................................29
Dosimetry for Photon and Electron Radiation................................................... 31 Günther H. Hartmann
Nomenclature in Radiotherapy .......................................................................... 57 Günther H. Hartmann
Quality Assurance in Radiotherapy ................................................................... 71 Alan McKenzie
Radiotherapy Accidents..................................................................................... 81 Alan McKenzie
Clinical Applications of 3-D Conformal Radiotherapy ..................................... 87 Raymond Miralbell
Treatment Planning: IMRT Optimization – Basic and Advanced Techniques......................................................................................................... 95 Simeon Nill
vi CONTENTS
Treatment Planning: Stereotactic Treatment Techniques ................................ 107 Simeon Nill
Image Guided Radiotherapy ............................................................................ 113 Uwe Oelfke
Clinical Use of 3-D Image Registration........................................................... 127 Peter Remeijer
Geometrical Uncertainties in Radiotherapy..................................................... 135 Peter Remeijer
Delivery of Intensity-Modulated Radiation Therapy Including Compensation for Organ Motion..................................................................... 141 Steve Webb
PART III: HADRONTHERAPY............................................................................163
Hadrontherapy: Cancer Treatment with Proton and Carbon Beams................ 165 Ugo Amaldi and Gerhard Kraft
Proton Therapy ................................................................................................ 173 Uwe Oelfke
PART IV: BRACHYTHERAPY ............................................................................183
Photon Sources for Brachytherapy .................................................................. 185 Alex Rijnders
Calibration of Photon Sources for Brachytherapy ........................................... 195 Alex Rijnders
Cancer of the Cervix: Examples of BT Treatment Techniques ....................... 209 Inger-Lena Lamm
Paris System for Interstitial Brachytherapy ..................................................... 219 Ginette Marinello
CONTENTS vii
Solid State Detectors for Quality Assurance in Brachytherapy....................... 227 Ginette Marinello
Monte Carlo Application in Brachytherapy Dosimetry................................... 239 Jose Perez-Calatayud, Domingo Granero Cabañero and Facundo Ballester Pallarés
Appendix I ....................................................................................................................251
ix
PREFACE
This book reports the majority of lectures given during the NATO AdvancedStudy Institute ASI-982996, which was held at the European Scientific Institute of Archamps (ESI, Archamps – France) from November 15 to November 27, 2007. The ASI course was structured in two parts: the first was dedicated to
the second focused on internal radiotherapy, also called “brachytherapy” or “curietherapy” in honour of Madame Curie who initiated the technique about a century ago. This ASI took place after the European School of Medical Physics, which devoted a 3 week period to medical imaging, a subject complementary to the topics of this book. Courses devoted to nuclear medicine and digital imaging techniques are collected in two volumes of the NATO Science Series entitled “Physics for Medical Imaging Applications” (ISBN 978-1-4020-5650-5) and “Molecular imaging: computer reconstruction and practice” (ISBN 978-1-4020-8751-6).
Every year in autumn ESI organises the European School of Medical Physics, which covers a large spectrum of topics ranging from Medical Imaging to Radiotherapy, over a period of 5 weeks. Thanks to the Cooperative Science and Technology sub-programme of the NATO Science Division, weeks four and five were replaced this year by the ASI course dedicated to “Physics of Modern Radiotherapy & Brachytherapy”. This allowed the participation of experts and students from 20 different countries, with diverse cultural background and pro-fessional experience. A further positive outcome of NATO ASI participation is the publication of this book, containing the lecture series contributed by speakers during the ASI. We hope it will be a reference book in radiotherapy, addressing an audience of young medical physicists everywhere in the world, who are wishing to review the physics foundations of the relevant technologies, catch up with the state of the art and look ahead into future developments in their field, e.g. the emerging technique of “Hadrontherapy”.
This volume starts with an introductory lecture about radiotherapy strategy and accuracy requirement, two aspects which are of the first importance (G. Hartmann). Fundamental radiobiology is reviewed by Francesca Buffa, fol-lowed by G. Hartmann discussing photon and electron dosimetry. G. Hartmann also illustrates the nomenclature in radiotherapy treatment planning, specified in the ICRU-50 document. Three lectures by Steve Webb describe Conformal Radiotherapy (CRT), covering various modern techniques from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT).
what is often called “teletherapy”, i.e. radiotherapy with external beams, while
x PREFACE
Simeon Nill from DKFZ develops two topics: inverse planning and opti-misation techniques first, followed by stereotactic treatment techniques. As well from DKFZ, Uwe Oelfke reviews image guided techniques in radiotherapy. Quality assurance in radiotherapy is everybody’s deep concern and is discussed by A. McKenzie from Bristol.
Despite the quasi totality of patients being presently treated with gamma and X-rays, some novel powerful tools are emerging implementing proton and light ions (e.g. carbon ions) beams, which will progressively gain ground in patient treatment. It was deemed important to introduce this new approach, going under the comprehensive name of Hadrontherapy (protons and light ions, e.g. Carbon ions, all belong to a group of particles called hadrons.). Ugo Amaldi presents an overview of the field, whereas U. Oelfke focuses on proton therapy and its implementation at the Heidelberg Hadron Therapy centre. The role of medical imaging in radiotherapy (clinical applications and geometrical uncertainties) is presented by Peter Remeijer from Amsterdam. Finally, the chief of the radio-therapy service of the “HCUGE Hospital” concludes this section with two lectures devoted to clinical application of 3D conformal radiotherapy.
In the Brachytherapy section, a review of the sources and of the conventional computer calculations used in this field is presented by A. Rijnders (Brussels). Among different dosimetry systems for interstitial brachytherapy, Ginette Marinello privileges a description of the so-called “Paris System”. Cervix cancer treatment is then analysed in details by Inger-Lena Lamm (Lund Sweden). Patient dose calculation using modern Monte-Carlo techniques is presented by J. Perez-Calatayud from Valencia (Spain).
We wish to thank all the participants, who allowed the ASI at Archamps to be a success within an excellent international atmosphere: lecturers, students (who participated actively) and all the ESI team (Manfred Buhler-Broglin, Alessandra Caner, Violaine Presset, Filiz Demolis and Julien Lollierou).
Many thanks to the Hôpital Cantonal de Genève, which hosted us twice (Philippe Nouet) and gave us access to radiotherapy and brachytherapy services (Dr. Miralbell and Dr. Popowski).
Finally, we wish to thank and express the gratitude to the Cooperative Science and Technology sub-programme of the NATO Science Division, lead by Prof. Fausto Pedrazzini, without whom this Advance Study Institute would have not been possible.
Yves Lemoigne1 Co-Director of ASI-982440
1 European School of Medical Physics, European Scientific Institute, Bâtiment Le Salève, Site
d’Archamps F-74166 Archamps (France).
______
xi
LIST OF PARTICIPANTS
Lecturers’ surnames are in bold Surname Name Country City E-mail address
Abate Armando Italy Rome [email protected]
Acar Hilal Turkish Istanbul [email protected]
Amaldi Ugo Italy Milano [email protected]
Avitabile Rossella Italy Padova [email protected]
Balabanova Anna Bulgaria Sofia [email protected]
Bartesagi Giacomo Italy Milan [email protected]
Bonnet Jacques France Toulouse [email protected]
Boubir Messaoud Algeria Batna [email protected]
Bourbia Nadjla Algeria Jijel [email protected]
Bucciarelli Bernard France Sevran [email protected]
Buffa Francesca UK Oxford [email protected]
Carrasco Fatima Portugal Porto [email protected]
Ceric Melisa BiH Sarajevo [email protected]
Conti Valentina Italy Milano [email protected]
Djarova Anna Bulgaria Sofia [email protected]
Dogandjiiska Daniela Bulgaria Sofia [email protected]
Caner Alessandra Italian Archamps [email protected]
Demolis Filiz Turkey Izmir [email protected]
Derkaoui Jamal Morocco Oujda [email protected]
Dries Wim Netherlands Eindhoven [email protected]
Drolc Botajan Slovenia Ljubljana [email protected]
Dzharova Anna Bulgaria Sofia [email protected]
Dumitriu Irina Romania Bucharest [email protected]
Falie Dragos Romania Bucharest [email protected]
Ferrand Regis France Orsay [email protected]
Fezov Daniel Bulgaria Sofia [email protected]
Fekete Zsolt Romania Cluj [email protected] (continued)
xii LIST OF PARTICIPANTS
LIST OF PARTICIPANTS (continued)
Georgiev Ivaylo Bulgaria Sofia [email protected] Ghitulescu Zoe Romania Bucharest [email protected] Goksel
Evren Ozan
Turkey
Istanbul
Hamdy Abdelmaboud
Ahmed
Egypt
Cairo
Hartmann Gunther Germany Heidelberg [email protected]
Hristova Julia Bulgaria Sofia [email protected]
Ivanova Severina Bulgaria Sofia [email protected] Jarry
Patrick
France
Gif-sur-Yvette
Jobs J. T. Germany Freiburg [email protected]
Kaufhold Alexander Germany Freiburg [email protected]
Kaulich Theodor Germany Tübingen [email protected] Kostova-Lefterova
Desislava
Bulgaria
Sofia
Lafrenière Geneviève UK Yarnton [email protected]
Lamm Inger-Lena Sweden Lund [email protected]
Lanche Stephanie France Archamps [email protected]
Lemoigne Yves France Archamps [email protected]
Li Pan Germany Heidelberg [email protected] Loja Nunes Pires
Paola
Germany
Berlin
Lollierou Julien France Presilly [email protected]
Marinello Ginette France Creteil [email protected] Mazeron
J-Jacques
France
Paris
McKenzie Alan UK Bristol [email protected]
Marinov Filip Bulgaria Sofia [email protected]
Masiuk Mariusz Poland Gdañsk [email protected]
Miralbell Raymond Spain Barcelona [email protected]
Mukov Mihail Bulgaria Sofia [email protected]
Multan Marta Poland Krakow [email protected]
Nikollari Ermal Albania Tirana [email protected] (continued)
LIST OF PARTICIPANTS xiii
Nikolov Ivaylo Bulgaria Sofia [email protected] Nill Simeon Germany Heidelberg [email protected]
Nouet Philippe Switzerland Genève [email protected]
Oelfke Uwe Germany Heidelberg [email protected]
Pasciuti Katia Italy Rome [email protected] Perez-Calatayud
José
Spain
Valencia
Popowski Youri Belgium Brussels [email protected]
Remeijer Peter Netherlands Amsterdam [email protected]
Rijnders Alex Belgium Brussels [email protected]
Ruiz-Bueno Antonio Spain Valladolid [email protected]
Samet Nina Moldova Chisinau [email protected]
Saoud Houda Morocco Rabat [email protected] Shekel
Efrat
Israel
Petach Tikva
Smail Hassen Algeria Batna [email protected]
Toschi Nicola Italy Rome [email protected]
Zajacova Zuzana Slovakia Bratislava [email protected] Webb Steve UK London [email protected]
PHOTOGRAPHS
Class room Computer room
G. Hartmann (De) lecturing PC exercises with G. Hartmann
Working group Equipement demonstration
xv
Equipment explanation Steve Webb (UK) Lecturing
Work at Geneva hospital J. Bonnet (Fr) lecturing
Wim Dries (Nl) lecturing T. Kaulich (De) lecturing
PHOTOGRAPHS xvi
PHOTOGRAPHS
G. Marinello (Fr) lecturing Tutorial on Brachytherapy
I. Lamm (Se) at Geneva Hospital
After lunch Coffee
Farewell dances Farewell Dinner
xvii
PHOTOGRAPHS xviii