Physics for clinical oncology Radiotherapy in Practice PDF
Preview Physics for clinical oncology Radiotherapy in Practice
Radiotherapy in Practice This page intentionally left blank Radiotherapy in Practice Physics for Clinical Oncology Edited by Amen Sibtain Department of Radiotherapy & Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK Andrew Morgan Head of Radiotherapy Physics, The Beacon Centre, Musgrove Park Hospital, Taunton, Somerset, UK Niall MacDougall Head of Clinical Dosimetry, Radiotherapy Physics, St Bartholomew's Hospital, West Smithfield, London, UK 1 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press 2012 The moral rights of the authors have been asserted Database right Oxford University Press (maker) First published 2012 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloging in Publication Data Data available Typeset in Minion by Cenveo, Bangalore, India Printed and bound by CPI Group (UK) Ltd, Croydon, CR0 4YY ISBN 978–0–19–957335–6 10 9 8 7 6 5 4 3 2 1 Whilst every effort has been made to ensure that the contents of this book are as complete, accurate and up-to-date as possible at the date of writing, Oxford University Press is not able to give any guarantee or assurance that such is the case. Readers are urged to take appropriately qualified medical advice in all cases. The information in this book is intended to be useful to the general reader, but should not be used as a means of self-diagnosis or for the prescription of medication. Dedication AS: For Isabella and Theo NMD: For Emily AMM: For Jean Morgan, Hilda Beswick, Marg Davies and more recently Kàren Morgan—who between them have managed to ensure that I've survived long enough to do something vaguely useful . . . Foreword Radiotherapy remains the most effective non-surgical treatment in the management of malignant disease. Over 50% of patients treated will have curative treatment and for the remainder effective palliation of pain, haemorrhage, obstructive symptoms and neurological complications can be achieved. In the years ahead, cancer will remain a major burden throughout the world with the incidence estimated to continue upward trends. In this setting, access to modern radiotherapy is an essential component of any healthcare system. A sound knowledge of physics is an essential pre-requisite for those wishing to prac- tice radiation oncology, yet it is often considered the most arduous component of training, particularly for clinicians. However, understanding the basic principles of radioactivity and the interaction of ionising radiation with matter lies at the heart of the therapeutic use of ionising radiation. The basis of modern radiation dosimetry is rooted in the fundamental principles of radiation physics and modern training pro- grammes rightly retain this element in their requirements for aspiring radiation oncologists and radiographers as well as medical physicists. Recent years have seen dramatic changes in the use of radiotherapy. The advent of intensity modulated radiotherapy, image guided radiotherapy, image guided brachy- therapy and stereotactic radiotherapy each present new challenges and opportunities to those charged with their implementation. A firm grounding in the underlying phys- ics concepts enables practitioners to embrace these developments and apply them to the clinical care of patients, who will benefit from ever increasing sophistication in the radiotherapy techniques available. I am delighted to include this new title on radiation physics in the series Radiotherapy in Practice. It provides a comprehensive coverage of the subject addressing both the basic principles and their modern application in the clinical setting. It is unique in providing this information under a single cover and will, I am sure, be highly valued by trainees and practitioners in radiation oncology across the world. Peter Hoskin Mount Vernon Cancer Centre Acknowledgements We are grateful to Professor David Thwaites for providing the benefit of his experi- ence, his advice and guidance on this project. We are also particularly grateful to Nicola Wilson and Jenny Wright at OUP for their support, patience, advice and understanding. This page intentionally left blank Contents Contributors x 1 Introduction 1 A Sibtain, A Morgan and N MacDougall 2 Basic physics essentials for the radiation oncologist 3 A Sibtain, A Morgan and N MacDougall 3 The life of a photon 19 A Sibtain, A Morgan and N MacDougall 4 Electrons, protons and neutrons 32 A Morgan 5 Putting the IT in RT 44 N MacDougall and A Morgan 6 Principles of imaging for radiotherapy 54 V Khoo and N Van As 7 Radiation dosimetry 66 T Greener and J Byrne 8 X-ray beam physics 86 R Mackay and A Hounsell 9 Electron beam physics 102 G Pitchford and A Nisbet 10 Radiotherapy treatment planning 114 N MacDougall, C Nalder and A Morgan 11 Beam therapy equipment 146 S J Colligan and J Mills 12 Brachytherapy 174 P Bownes, C Richardson and C Lee 13 Radioactive sources 191 C Richardson, G Workman and P Bownes 14 Unsealed sources for therapy 202 S J Chittenden, G Flux and B Pratt 15 Radiation protection 210 C Taylor, M Waller and P Bownes 16 Quality assurance in radiotherapy 238 T Jordan and E Aird Further reading 253 Index 255
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