HOMEOPATHIC MEDICINE
CONTENTS PART I ION BEAM THERAPY IN PERSPECTIVE FROM X-RAYS TO ION BEAMS: A SHORT HISTORY OF RADIATION THERAPY INTRODUCTION THE DISCOVERY ERA THE ORTHOVOLTAGE ERA MEGAVOLTAGE ERA THE ERA OF ION BEAMS PERSPECTIVE REFERENCES THE PLACE OF ION BEAMS IN CLINICAL APPLICATIONS THE ROLE OF PROTON THERAPY ABLATIVE INTENT WITH SINGLE AND HYPOFRACTIONATED THERAPY ORGAN PRESERVATION DOSE ESCALATION AROUND CRITICAL STRUCTURES WITH HIGHLY FRACTIONATED TREATMENT REDUCTION IN MORBIDITY AND SECONDARY MALIGNANCIES INVESTIGATIONAL CARBON ION RADIOTHERAPY CONCLUSION SOCIO-ECONOMIC ASPECTS OF ION BEAM THERAPY FACILITY DEVELOPMENT COST COST-EFFECTIVENESS OF IBT CLINICAL TRIALS PRIOR TO ADOPTING IBT PART II PHYSICAL AND BIOLOGICAL ASPECTS PHYSICAL AND BIOLOGICAL RATIONALE FOR USING IONS IN THERAPY PHYSICAL PROPERTIES INTERACTION OF PHOTONS AND IONS WITH MATTER MAGNETIC DE?ECTION FOR ACTIVE BEAM SHAPING BIOPHYSICAL PROPERTIES STOPPING POWER AND LET BIOLOGICAL PROPERTIES RELATIVE BIOLOGICAL EFFECTIVENESS OXYGEN ENHANCEMENT RATIO VARIATION IN RADIOSENSITIVITY WITH THE CELL CYCLE SUBLETHAL CELL DAMAGE COMPARISON OF PROTONS AND HEAVIER IONS EARLY AND LATE RESPONSES TO ION IRRADIATION BASIC CONCEPTS DE?NITION OF EARLY AND LATE TISSUE RESPONSES CELLULAR AND MOLECULAR ORIGIN OF RADIATION RESPONSE DOSE–VOLUME EFFECTS BIOLOGICAL DOSE WEIGHTING EARLY AND LATE TISSUE RESPONSES TO PROTON AND ION IRRADIATION EARLY NORMAL TISSUE RESPONSES LATE NORMAL TISSUE RESPONSES THE IMPACT OF RADIATION QUALITY ON CURE RATE PHYSICAL SELECTIVITY AND RADIATION QUALITY FROM ABSORBED DOSE TO RADIOBIOLOGICAL EFFECTS RBE FOR THE DIFFERENT RADIATION QUALITIES USED IN THERAPY CRITERIA FOR PATIENT SELECTION FOR HIGH-LET RADIATION THERAPY QUALITY ASSURANCE CONCLUSIONS PART III MODELS AND PRECLINICAL STUDIES MONTE CARLO METHODS FOR DOSE CALCULATIONS MC CODES FOR IBT THE ROADMAP FOR MC DOSE CALCULATIONS IN IBT MODELING OF THE BEAM DELIVERY SYSTEM DOSE CALCULATIONS IN PHANTOMS DOSE CALCULATIONS IN THE PATIENT CT BIOLOGICAL DOSE CALCULATIONS MODELING HEAVY ION RADIATION EFFECTS AMORPHOUS TRACK MODELS EARLY APPROACHES BY KATZ AND COWORKERS MICRODOSIMETRIC KINETIC MODEL LOCAL EFFECT MODEL ORIGINAL LOCAL EFFECT MODEL LEM II LEM III GENERALIZATION OF LEM (LEM IV) COMPARISON TO EXPERIMENTAL IN VITRO CELL SURVIVAL DATA APPLYING THE MODELS TO COMPLEX RADIATION FIELDS COMPARISON OF LEM, MKM, AND KATZ APPROACH APPLICATION IN TREATMENT PLANNING FOR HEAVY IONS CONCLUSIONS AND FUTURE DIRECTIONS PRECLINICAL RADIOBIOLOGY AND PREDICTIVE ASSAYS MEASUREMENTS OF THE RELATIVE BIOLOGICAL EFFECTIVENESS SPATIAL MAPPING OF RBE RBE–LET RELATION FOR NORMAL AND MALIGNANT TISSUES ADDITIONAL VARIABLES IN MEASURING RBE DIFFERENT DOSES AND DOSE FRACTIONATION REGIMES DIFFERENCES IN BIOLOGICAL GEOMETRY RELATIVE TO THE BEAM EXPOSURE DIFFERENCES IN CELL CYCLE STATUS DIFFERENCES IN INDIVIDUAL RADIOSENSITIVITY DIFFERENCES BETWEEN SPECIES DIFFERENCES IN THE GENDER OF THE ORGANISM PART IV CLINICAL RESULTS AND INDICATIONS OCULAR PROTON THERAPY CENTERS PRINCIPAL CONSTITUENTS OF A PT FACILITY PROTON ACCELERATORS PROTON BEAM CHARACTERISTICS BEAM-MODIFYING DEVICES PATIENT TREATMENT CHAIR AND MASK PATIENT POSITIONING, X-RAY VERI?CATION SYSTEMS AND MARKERS RADIATION PROTECTION TREATMENT DOSES, FRACTIONATION, AND RBE OCULAR PT-PLANNING SYSTEMS QUALITY-ASSURANCE METHODOLOGY IN-BEAM DOSE MONITORING DAILY BEAM AND DOSIMETRY CHECKS FOR TREATMENT PRETREATMENT CHECKS REFERENCE AND ABSOLUTE DOSIMETRY PROCEDURES CHARACTERIZATION OF THE TREATMENT BEAM IN VIVO DOSIMETRY DISCUSSION CLINICAL INDICATIONS FOR CARBON ION RADIOTHERAPY AND RADIATION THERAPY WITH OTHER HEAVIER IONS SKULL BASE TUMORS BRAIN TUMORS HEPATOCELLULAR CARCINOMA PROSTATE CANCER RECURRENT RECTAL CANCER LUNG CANCER HEAD AND NECK TUMORS SOFT-TISSUE AND BONE SARCOMAS GYNECOLOGICAL MALIGNANCIES CHORDOMAS AND CHONDROSARCOMAS CHORDOMAS CHONDROSARCOMA MALIGNANT SALIVARY GLAND TUMORS MENINGIOMA NEURINOMA AND PITUITARY ADENOMA NEURINOMA PITUITARY ADENOMA PROTON THERAPY FOR THORACOABDOMINAL TUMORS LUNG STAGE I NSCLC STAGE II–III NSCLC ESOPHAGUS SURVIVAL, LOCAL CONTROL, AND SEQUELAE FOR ESOPHAGEAL CANCER TREATMENT PROCEDURES FOR ESOPHAGEAL CANCER PRACTICED AT THE PMRC LIVER GENERAL MANAGEMENT OF HCC PT PROCEDURE FOR HCC CLINICAL OUTCOME OF PT FOR HCC CARBON ION RADIOTHERAPY FOR PERIPHERAL STAGE I NON-SMALL CELL LUNG CANCER CIRT FOR LUNG CANCER AT NIRS TREATMENT METHODOLOGY STAGING MARKER INSERTION IMMOBILIZATION RESPIRATORY GATING TREATMENT PLANNING IRRADIATION CLINICAL RESULTS PHASE II CLINICAL TRIAL WITH 9 OR 4 FRACTIONS PHASE I/II CLINICAL TRIAL: SINGLE FRACTIONATION COMPARISONS OF CIRT AND OTHER MODALITIES ION BEAM THERAPY FOR GYNECOLOGICAL TUMORS PROTON THERAPY FOR GYNECOLOGICAL TUMORS THE TSUKUBA UNIVERSITY EXPERIENCE CARBON ION RADIOTHERAPY FOR GYNECOLOGICAL TUMORS THE NIRS EXPERIENCE LOCALLY ADVANCED CERVICAL CARCINOMA LOCALLY ADVANCED CERVICAL SQUAMOUS CELL CARCINOMA LOCALLY ADVANCED UTERINE ADENOCARCINOMA INTER- AND INTRAFRACTIONAL TUMOR AND ORGAN MOTION OUTLOOK IS PROSTATE CANCER A GOOD CANDIDATE FOR ION BEAM THERAPY? PROTON THERAPY RESULTS CIRT RESULTS RATIONALE FOR PROTON THERAPY IN PEDIATRIC MALIGNANCIES PEDIATRIC SOLID TUMORS LATE TOXICITIES OF RT METHODS TO POTENTIALLY REDUCE LATE EFFECTS OF RT RATIONALE FOR PT IN THE TREATMENT OF PEDIATRIC MALIGNANCIES CHALLENGES OF PT TOLERANCE OF NORMAL TISSUES TO ION BEAM THERAPY OCULAR TUMORS PROTONS LIGHT IONS TUMORS OF THE HEAD AND NECK BRAIN CRANIAL NERVES AND COCHLEA PITUITARY–HYPOTHALAMIC AXIS TUMORS OF THE TRUNK GENITOURINARY AND LOWER DIGESTIVE TRACT UPPER DIGESTIVE TRACT LUNGS SKIN PEDIATRIC TUMORS SECOND CANCERS DESIGN AND IMPLEMENTATION OF CLINICAL TRIALS OF ION BEAM THERAPY DIFFERENT TYPES OF CLINICAL TRIALS LEVELS OF EVIDENCE CLINICAL PT TRIALS CLINICAL TRIALS WITH PROTONS AND CARBON IONS DESIGN STRATEGIES FOR CLINICAL TRIALS EQUIPOISE AND THE ETHICS OF CLINICAL INVESTIGATIONS OF ION BEAMS MECHANISMS FOR CLINICAL INVESTIGATIONS OF IBT SUMMARY PART V MEDICAL ACCELERATORS AND BEAM LINE DESIGN DESIGN CRITERIA FOR MEDICAL ACCELERATORS CLINICAL SPECI?CATIONS TECHNICAL DESIGN CRITERIA FOR MEDICAL ACCELERATORS ACCELERATOR AND BEAM DELIVERY SYSTEM BEAM ENERGY BEAM ENERGY VARIATION LATERAL BEAM QUALITY BEAM INTENSITY AND TIME STRUCTURE BEAM CONTROL AND SAFETY ASPECTS CONTROL SYSTEM COST CONSIDERATIONS AND AVAILABILITY DESIGN CRITERIA AND LAYOUT OF SYNCHROTRON-BASED SYSTEMS BASIC SYNCHROTRON PARAMETERS THE SYNCHROTRON INJECTOR SYSTEM BEAM EXTRACTION FROM THE SYNCHROTRON THE HIGH-ENERGY BEAM TRANSPORT LINE WITH GANTRIES NEW ACCELERATOR CONCEPTS FFAG LINAC BOOSTERS INDUCTION LINACS LASERS ANTIPROTONS SHIELDING AND RADIATION PROTECTION IN ION BEAM THERAPY FACILITIES DOSE LIMITS RADIATION SHIELDING BASICS SHIELDING MATERIALS MAZE AND DOOR CONSTRUCTION ACTIVATION DOSE CONSIDERATIONS FOR ELECTRONICS OUT-OF-FIELD DOSE EQUIVALENTS COMMERCIAL ION BEAM THERAPY SYSTEMS THE HISTORY OF COMMERCIAL ION BEAM THERAPY SYSTEMS SYSTEMS AND COMPONENTS OF IBT FACILITIES COMMERCIAL PT SYSTEMS IBA SUMITOMO HITACHI MITSUBISHI VARIAN STILL RIVER SYSTEMS OPTIVUS COMMERCIAL SYSTEMS FOR IONS HEAVIER THAN PROTONS SIEMENS ADVANTAGES AND CHALLENGES OF SUPERCONDUCTING ACCELERATORS MATERIAL PROPERTIES OF SUPERCONDUCTORS IN COMPARISON TO NORMAL-CONDUCTING MATERIALS DE?NITION OF A “SUPERCONDUCTING” ACCELERATOR FOR IBT SPECI?CATIONS OF A POSSIBLE SC ACCELERATOR FOR IBT THE ACCEL/VARIAN ISOCHRONOUS CYCLOTRON FOR PT OVERVIEW CYCLOTRON DESIGN PARAMETERS AND PERFORMANCE DATA OPERATIONAL ROUTINES AND MAINTENANCE ASPECTS ASSESSING THE POTENTIAL ADVANTAGES OF AN SC CYCLOTRON LOW POWER CONSUMPTION FAST MORNING START-UP TIME COMPACTNESS AMPLE ROOM FOR PARTICLE ACCELERATION OTHER SC MEDICAL ACCELERATORS FOR PROTONS SC MEDICAL ACCELERATORS FOR IONS HEAVIER THAN PROTONS EULIMA SCENT300 C400 IBA SC BEAM LINE MAGNETS AND SC GANTRY MAGNETS PART VI BEAM PREPARATION AND CONTROL ALL-IN-ONE: AN ATTEMPT TO INTEGRATE THE FULL POTENTIAL OF PROTON PENCIL BEAM SCANNING IN A NEW GANTRY SYSTEM THE FIRST SCANNING GANTRY AT PSI THE RATIONALE OF USING A PROTON GANTRY THE MOTIVATION FOR A GANTRY WITH PENCIL BEAM SCANNING THE OPEN PROBLEM OF SCANNING: SENSITIVITY TO ORGAN MOTION MECHANICAL LAYOUT OF THE NEW GANTRY 2 GANTRY BEAM OPTICS NOZZLE DESIGN DEVELOPMENT OF NOVEL SCANNING TECHNIQUES BEAM SPREADING DEVICES ION BEAMS INTERACTING WITH MATTER SCATTERING ENERGY LOSS RELATIVE EFFECTS LONGITUDINAL BEAM CONFORMANCE LONGITUDINAL BEAM SPREADING TRANSVERSE BEAM SPREADING SINGLE SCATTERING DOUBLE SCATTERING THREE DIMENSIONAL DOSE CONFORMATION ADDITIONAL HARDWARE AND RELATED BEAM PROPERTIES SCANNING DOSIMETRY TECHNIQUES FOR ION BEAMS PROPERTIES AND REQUIREMENTS OF ION BEAMS ABSOLUTE DOSIMETRY DETECTOR REQUIREMENTS FOR RELATIVE DOSIMETRY CURRENT DETECTOR TYPES FOR IBT CONTROL AND SAFETY SYSTEMS FOR ION BEAM THERAPY CONTROL SYSTEM DESIGN CHARACTERISTICS OF AN IBT SYSTEM USER AND MODE DE?NITIONS REQUIREMENT DE?NITION STRUCTURE OF THE CONTROL SYSTEM DESIGN OF THE SAFETY SYSTEM SAFETY PHILOSOPHY ROLE OF THE SAFETY SYSTEM FUNCTION OF THE SAFETY SYSTEM CON?GURATION OF THE SAFETY SYSTEM RISK MANAGEMENT AND SAFETY MEASURES TYPICAL HAZARDOUS SITUATIONS AND SAFETY MEASURES OTHER SAFETY CONSIDERATIONS INTERFACE TO OTHER SYSTEMS PRODUCT LIFE CYCLE CONSIDERATIONS FOR AN EFFECTIVE QUALITY ASSURANCE PROGRAM FOR PROTON THERAPY QUALITY ASSURANCE ON CT SIMULATORS FOR PROTONS QUALITY ASSURANCE ON PT PLANNING SYSTEMS QUALITY ASSURANCE ON THE ELECTRONIC MEDICAL RECORD FOR PROTONS QUALITY ASSURANCE ON THE PT DELIVERY SYSTEM DAILY MACHINE QA TESTS WEEKLY MACHINE QA TESTS MONTHLY MACHINE QA TESTS ANNUAL MACHINE QA TESTS PATIENT-SPECI?C QA PART VII PATIENT POSITIONING AND TREATMENT PLANNING IMAGING AND TUMOR LOCALIZATION FOR ION BEAM THERAPY SEGMENTATION DOSE CALCULATION POSITION VERI?CATION MONITORING OF INTERFRACTIONAL MOTION MONITORING OF INTRAFRACTIONAL MOTION TREATMENT VERI?CATION FUTURE DEVELOPMENTS MORPHOLOGY: INCREASING IMAGING RESOLUTION MOVEMENT: INTEGRATION OF IMAGING AND TREATMENT MOLECULAR PRO?LING TREATMENT PLANNING FOR ION BEAM THERAPY ASPECTS OF PATIENT POSITIONING AND IMMOBILIZATION ASPECTS OF IMAGING AND SEGMENTATION DE?NITION OF TREATMENT PARAMETERS SELECTION OF BEAM DIRECTIONS DE?NITION OF THE PLANNING TARGET VOLUME SELECTING A PARTICLE TYPE DOSE-CALCULATION ALGORITHMS ABSORBED-DOSE CALCULATION NUCLEAR FRAGMENTATION BIOLOGICAL MODELING OPTIMIZATION ALGORITHMS SINGLE-FIELD UNIFORM DOSE INTENSITY-MODULATED IBT PLAN REVIEW AND ASSESSMENT OF DOSE DISTRIBUTIONS PLANNING OF COMBINED TREATMENTS QUALITY ASSURANCE AND DOSIMETRIC PLAN VERI?CATION ONLINE IRRADIATION CONTROL BY MEANS OF PET PHYSICAL BACKGROUND TECHNOLOGY AND IMPLEMENTATION CURRENT PET INSTALLATIONS GSI HELMHOLTZZENTRUM F¨UR SCHWERIONENFORSCHUNG, DARMSTADT, GERMANY HIMAC, CHIBA, JAPAN NATIONAL CANCER CENTER HOSPITAL EAST, KASHIWA, JAPAN HYOGO ION BEAM MEDICAL CENTER, TATSUNO, JAPAN CATANA, CATANIA, ITALIA UNIVERSITY OF FLORIDA PROTON THERAPY INSTITUTE, JACKSONVILLE, USA MASSACHUSETTS GENERAL HOSPITAL, BOSTON, USA CLINICAL EXAMPLES COMPENSATION OF TARGET MOTION IMPACT OF ORGAN MOTION MOTION MONITORING TIME-RESOLVED VOLUMETRIC IMAGING TREATMENT TECHNIQUES FOR INTRAFRACTIONALLY MOVING ORGANS RESCANNING GATING BEAM TRACKING COMPARISON OF MOTION MITIGATION TECHNIQUES INDUSTRIAL ROBOTS FOR PATIENT SUPPORT PATIENT TABLES FOR CONVENTIONAL RT PATIENT TABLES FOR IBT POSITIONER FOR A GANTRY POSITIONER FOR A FIXED BEAM PRECISION IMAGING CAPABILITY TABLETOP FACILITY WORK?OW AND QA SAFETY ASPECTS IN MEDICAL EQUIPMENT COLLISION CONTROL SPEED CONTROL STANDARDS POWER FAILURE DESIGN PRINCIPLES OF ROBOTIC PATIENT POSITIONERS CUSTOM MANUFACTURED SOLUTIONS STANDARDIZED SOLUTIONS DESIGN STEPS AND CHALLENGES SERVICE AND MAINTENANCE THE USER INTERFACE HISTORY AND TODAY’S SOLUTIONS THE PIONEERS OF ROBOTIC POSITIONERS CURRENT SOLUTIONS PART VIII INDIVIDUAL FACILITIES AND MANAGEMENT ISSUES TWENTY YEARS OF PROTON RADIATION THERAPY AT LOMA LINDA UNIVERSITY MEDICAL CENTER THE ORIGIN OF PROTON THERAPY AT LLUMC DEVELOPING CLINICAL STRATEGIES FOR PT CLINICAL APPLICATIONS STEREOTACTIC RADIOSURGERY OF THE CENTRAL NERVOUS SYSTEM AND BASE OF SKULL FRACTIONATED PROTON TREATMENT FOR TUMORS OF THE CENTRAL NERVOUS SYSTEM DISEASES OF THE EYE BREAST CANCER CLINICAL PERSPECTIVE THE RESEARCH FOUNDATION LOOKING AHEAD THE FRANCIS H BURR PROTON THERAPY CENTER THE FACILITY CYCLOTRON ACCELERATOR THE BTS INCLUDING DEGRADER AND ENERGY ANALYZER GANTRIES BEAM DELIVERY SYSTEMS PPS FIXED-BEAM TREATMENT ROOMS COMPUTER CONTROL SYSTEM SAFETY SYSTEM BUILDING MISSION AND CAPACITY SYSTEM STATISTICS HIMAC: A NEW START FOR HEAVY IONS CIRT AT NIRS TREATMENT RESULTS BY TUMOR TYPE HEAD AND NECK CANCER LIVER CANCER BONE AND SOFT-TISSUE SARCOMAS RECTAL CANCER FUTURE PROSPECTS FOR CIRT A NATIONAL ACTION PLAN IN JAPAN: FROM EXPERIMENTAL STUDIES TO HIGHLY ADVANCED MEDICAL TECHNOLOGY PROGRESS OF HIMAC TECHNOLOGY DEVELOPMENT AND MEDICAL PHYSICS AT HIMAC BEAM DELIVERY SYSTEM MEDICAL PHYSICS PROGRAM DOWNSIZED VERSION OF HIMAC DESIGN AND R&D WORK CONSTRUCTION OF A PILOT FACILITY NEW TREATMENT RESEARCH FACILITY PROJECT AT NIRS FACILITY PLANNING 3D PENCIL BEAM RESCANNING ROTATING GANTRY JAPAN’S NATIONAL ACTION PLAN OPERATIONAL AND TRAINING ISSUES RELATED TO FACILITY START-UP GOVERNING PRINCIPLES OPERATIONAL AND TRAINING ISSUES PROGRAM DESIGN OPERATIONAL ISSUES TASKS REFERENCE PART IX FUTURE DEVELOPMENTS THE SINGLE-ROOM ION BEAM FACILITY PROTON THERAPY SYSTEM COST AN EXAMPLE OF A PT SYSTEM THAT REDUCES SIZE AND COMPLEXITY SYSTEM DESCRIPTION DOSIMETRIC PROPERTIES FACILITY CHALLENGES STRAY MAGNETIC FIELD HEAD LEAKAGE COMPATIBILITY WITH IMPT SMALLER – LIGHTER – CHEAPER: NEW TECHNOLOGICAL CONCEPTS IN PROTON THERAPY PT TECHNOLOGY CIRCA 2010 FUTURE SYSTEMS DE?NE WHAT YOU WANT TO TREAT MAINTAIN THE BALLISTIC ADVANTAGES OF PROTON BEAMS SMALLER AND LIGHTER ACCELERATORS, GANTRIES, AND BEAM LINES SPREAD OF PT TREATMENT TIMES AND SYSTEM AVAILABILITY GENERAL CONSIDERATIONS OF COST REDUCTION COMMISSIONING AND STAFF TRAINING NEW FACILITIES: PLANS AND PROPOSALS SITUATION IN EUROPE PROTON THERAPY FACILITIES CARBON ION BEAM FACILITIES DUAL ION BEAM FACILITIES COOPERATIONS WITHIN THE ION BEAM COMMUNITY SITUATION IN THE USA SITUATION IN ASIA PT FACILITIES FUTURE DIRECTIONS IN ION BEAM THERAPY FUTURE CONTRIBUTIONS OF RADIOBIOLOGY TO IBT FUTURE CHALLENGES OF CLINICAL TRIALS IN IBT COMBINED TREATMENT OF INTENSITY- MODULATED X-RAY RT (IMRT) AND IBT COMPARISON OF IBT WITH NONRADIOTHERAPEUTIC MODALITIES TESTING OF DIFFERENT FRACTIONATION SCHEDULES WITH CURATIVE INTENT USING IBT IN BOTH ARMS DOSE-SEARCHING TRIALS COMPARING IBT AT DIFFERENT DOSE LEVELS COMBINATION OF CONCURRENT SYSTEMIC THERAPIES WITH IBT AS COMPARED TO CONCURRENT CHEMOTHERAPY WITH X-RAY RT COMPARISON OF HEAVY ION THERAPY WITH PT FUTURE ADVANCES IN MEDICAL PHYSICS OF IBT MOVING ORGANS ROLE OF POSITRON EMISSION TOMOGRAPHY