World Health Organization : Technical Report Series, No. 644: Optimization of Radiotherapy

By G. E. Adams

Book Id: WPLBN0000168285
Format Type: PDF eBook:
File Size: 3.52 MB
Reproduction Date: 2005

Title:	World Health Organization : Technical Report Series, No. 644: Optimization of Radiotherapy
Author:	G. E. Adams
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago E. Adam, B. G. (n.d.). World Health Organization : Technical Report Series, No. 644. Retrieved from http://gutenberg.us/

Description
Medical Reference Publication

Excerpt
1. INTRODUCTION A WHO Meeting of Investigators on the Optimization of Radiotherapy, particularly for Developing Countries, met in St John's College, Cambridge, England, from 11 to 15 September 1978. Dr W. Seelentag, Chief Medical Officer, Radiation Medicine, World Health Organization, opened the meeting on behalf of Dr H. Mahler, Director-General of WHO. It was stressed that optimization in the sense used by the Meeting means making the best use of existing manpower and resources, bearing in mind the aim of providing cancer control services for as many patients as possible, irrespective of whether they live in cities or rural areas and with the best treatment results achievable under these conditions. This report therefore provides general guidance for planning and implementing radiotherapy services, particularly in developing countries. It was agreed, however, that these guidelines could well be followed in developed countries also, in the interest of the cancer patient. The report may be considered as an updating of the 1966 IAEA/ WHO report Planning of radiofherapy facilities ( I ) , and it may with advantage be read in conjunction with another called The medical uses of ionizing radiation and radioisotopes (2).

Table of Contents
CONTENTS Page I . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2 . General considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2.1 Frequency of cancer treatment modalities . . . . . . . . . . . . . . . . 8 2.2 Special problems of cancer in developing countries . . . . . . . . . . . 9 2.3 Treatment capacity and organization of radiotherapy services . . . . . 12 3 . Equipment and dosimetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.1 External beam therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.2 Brachytherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 3.3 Clinical dosimetry requirements . . . . . . . . . . . . . . . . . . . . . 29 3.4 Treatment planning and dose computation . . . . . . . . . . . . . . . 38 3.5 Optimum utilization of a radiotherapy facility . . . . . . . . . . . . . . 41 3.6 Requirements specific to developing countries . . . . . . . . . . . . . . 42 3.7 Cost evaluation of radiotherapy and chemotherapy . . . . . . . . . . . 46 4 . Optimization of biological response to radiotherapy . . . . . . . . . . . . . 49 4.1 Modification of radiosensitivity . . . . . . . . . . . . . . . . . . . . . . 50 4.2 Combination of radiotherapy and chemotherapy . . . . . . . . . . . . 52 4.3 Normalization models for dose-time factors . . . . . . . . . . . . . . . 53 4.4 Application of normalization models . . . . . . . . . . . . . . . . . . . 57 4.5 Clinical experience with various fractionation schemes . . . . . . . . . 58 5 . International studies on the optimization of treatment regimes . . . . . . . . 61 5.1 Programmes for standardization of prescriptions . . . . . . . . . . . . 61 5.2 Feasibility of clinical time-dose studies . . . . . . . . . . . . . . . . . . 61 5.3 Working plan for data collection . . . . . . . . . . . . . . . . . . . . . 62 5.4 Thedatabank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 6 . Summary and conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 The need for radiotherapy . . . . . . . . . . . . . . . . . . : . . . . . . 66 Education in oncology . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Collaboration in cancer control . . . . . . . . . . . . . . . . . . . . . . 67 Radiotherapy equipment requirements . . . . . . . . . . . . . . . . . . 67 Applications of radiobiologq- to radiotherapy . . . . . ; . . . . . . . . 69 Establishment of a new radiotherapy centre . . . . . . . . . . . . . . . 71 Cancer registries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Radiotherapy data bank . . . . . . . . . . . . . . . . . . . . . . . . . . 72 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Annex . Forms and codes for reporting to the WHO Radiotherapy Data Bank 76