Clinical Radiobiology
Applied Radiobiology:
Brachytherapy and Continuous Irradiation by Wigg D R.
Following the first book I was invited to write another but, this time concentrating on brachytherapy and continuous irradiation, a subject of particular interest in recent years. This task has taken 4 years to complete and the final manuscript which has been forwarded to the publisher. It is now undergoing a peer review process and it is proposed to be published in mid 2008.
In order to make many of the most useful interactive equations available to users who only have a PC and Microsoft Windows a software install CD has been made by Bold Enterprise Pty. Ltd. as a companion to the book. The draft CD cover is shown. A brief review of the contents of this book is listed below
CHAPTER 1:Basic Radiobiology of Continuous Irradiation
CHAPTER 2:Therapeutic Gain Models for Continuous Irradiation
CHAPTER 3:Permanent Seed Implants
CHAPTER 4:Properties of Small Volume Tumors and
Sub-Clinical Disease
CHAPTER 5:Dose and Dose Volume Inhomogeneities
CHAPTER 6:Tissue Architecture and its Effect on Normal Tissue and Tumor Response to Irradiation
CHAPTER 7:3D Volume Effects
CHAPTER 8:Guidelines to the Use of the Models on the CD
GLOSSARY
REFERENCES
INDEX
MATHEMATICAL APPENDIX A
TABLES OF PARAMETER VALUES APPENDIX B ......................................................................................................Click for larger image
RADIATION FACTS: FALLACIES AND PHOBIAS
Anticipating an increasing debate on radiation issues I wrote a paper Radiation Facts:Fallacies and Phobias (Australasian Radiology 2007 51;21-25). This paper, by invitation, has been included in the World Nuclear Association Website.
There is frequent debate in the media and the scientific published reports about the use of radiation for diagnosis and treatment, the benefits and risks of the nuclear industry, uranium mining and the storage of radioactive wastes. Driving this debate is increasing concern about the reliance on fossil fuels for power generation for which alternatives are required. Unfortunately, there is generally a poor understanding of the relevant basic sciences compounded by widespread irrational fear of irradiation (radiation phobia). Radioactivity, with special reference to uranium and plutonium is simply described. How radiation affects tissues and the potential hazards to individuals and populations are explained. The origins of radiation phobia and its harmful consequences are examined. Whether we like it or not, Australia is heavily involved in the uranium industry by virtue of having one-third of the world’s known reserves, exports of which are worth approximately $470m annually. As this paper has been written as simply as possible, it may also be of interest to readers who may have had little scientific training. It is concluded that ignorance and fear are major impediments to rational debate on radiation issues.
This paper is now easily obtained, for example by using Google and entering the title. It has relevance to hospital staff and general members of the community who frequently have limited understanding or exaggerated fear of radiation.
HAPATOCELLULAR CARCINOMA
Hepatocellular carcinoma (HCC) is a significant worldwide health problem with a mortality of about 600,000 deaths annually, mostly in Asia.
Traditionally external beam radiotherapy has not been extensively used for many reasons including the general poor understanding of the available basic radiobiology of HCC and of the developments in modern radiotherapy techniques. Examination of the literature confirms the haphazard treatments that have been used in the past and the poverty of appropriate models specific for the tumour. Consequently the literature has been reviewed with the aim of collecting the available data on HCC and normal liver parameter values including radiosensitivity and tissue kinetics. Models have been written that may be applied specifically to hepatocellular carcinoma treatments.
These models have been derived from my book Applied Radiobiology and Bioeffect Planning and also from my new book Applied Radiobiology:Continuous Irradiation and Brachytherapy.
So far some of this preliminary work has been presented in poster form:Multimodality Ablation with RFA and Radiotherapy for Early Stage HCC in Child-Pugh A cirrhosis. An abstract has been published in the Journal of Gastroenterology and Hepatology 2006. The issues have been presented to the Australia and New Zealand Liver Transplant Society November 2007. A review paper has been completed for submission to an appropriate journal.
Overseas interest in this subject is increasing and it was pleasing to have a visit by Professor Kayashi Kishi from Japan specifically to discuss the use of my equations for this disease.
FUTURE DIRECTIONS
The demands of the Brachytherapy work have necessitated putting on hold a number of partly completed papers, for example the Treatment of Skin Cancer. A paper on Hormone Replacement Therapy has been written in which it is demonstrated that the kinetics of breast cancer are central to the interpretation of the published results. In the more distant future – given the resources, mainly technical assistance – a Brachytherapy Bioeffect Planning System including some of the models described in the Brachytherapy book could be developed here. As far as I am aware there are no such systems developed for brachytherapy.
Comment:
The Clinical Radiobiology Unit is unique in Australia. Overseas it is becoming recognised that there is a need to develop academic integrated radiotherapy and radiobiology and in the UK steps are being taken to proceed with this. A review of this may be seen in the Editorial of Clinical Oncology (2005) 17;299-304.