CHAPTER 1
General Radiation Therapy
1.1. Monte Carlo techniques should replace analytical methods for
estimating dose distributionsin radiotherapy treatment planning
Radhe Mohan and John Antolak
Reproduced from Medical Physics, Vol. 28, No. 2, pp. 123–126, February 2001
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, TABLE OF CONTENTS
List of Contributors xi
Preface xvi
CHAPTER 1: General Radiation Therapy 1
1.1. Monte Carlo techniques should replace analytical methods for estimating dose
distributions in radiotherapy treatment planning: Radhe Mohan and John Antolak 1
1.2. Dm rather than Dw should be used in Monte Carlo treatment planning: H. Helen
Liu and Paul Keall 6
1.3. Over the next decade the success of radiation treatment planning will be judged by
the immediate biological response of tumor cells rather than by surrogate measures such
as dose maximization and uniformity: C. Clifton Ling and X. Allen Li 10
1.4. Image-guided radiotherapy is being overvalued as a clinical tool in radiation
oncology: Howard I. Amols and David A. Jaffray 15
1.5. The value of PET/CT is being over-sold as a clinical tool in radiation oncology: Lei
Xing and Barry Wessels 21
1.6. Respiratory gating for radiation therapy is not ready for prime time: X. Allen Li and
Paul J. Keall 26
1.7. Heterogeneity corrections should be used in treatment planning for lung cancer:
Nikos Papanikolaou and Eric E. Klein 32
1.8. The rate of evolution of radiation therapy planning and delivery systems is exceeding
the evolution rate of quality assurance processes: Sheri D. Henderson and Peter J. Biggs 36
1.9. Long-term changes in irradiated tissues are due principally to vascular damage in the
tissues: John Hopewell and H. Rodney Withers 40
1.10. The best radiotherapy for the treatment of prostate cancer involves
hypofractionation: John F. Fowler and Alan E. Nahum 45
1.11. The routine use of personal patient dosimeters is of little value in detecting
therapeutic misadministrations: Arnold Feldman and Fredric Marc Edwards 51
1.12. Thermoradiotherapy is underutilized for the treatment of cancer: Eduardo G. Moros
and Peter M. Corry 56
2.1. It is necessary to validate each individual IMRT treatment plan before delivery:
Chester Ramsey and Scott Dube 62
2.2. Every patient receiving 3D or IMRT must have image-based target localization prior
to turning on the beam: Michael G. Herman and Douglas P. Rosenzweig 67
2.3. Linear accelerators used for IMRT should be designed as small field, high intensity,
intermediate energy units: Tiru S. Subramanian and John P. Gibbons, Jr. 72
iii
, 2.4. Segmental MLC is superior to dynamic MLC for IMRT delivery: Ping Xia and
Joseph Y. Ting 76
2.5. IMRT should not be administered at photon energies greater than 10 MV: David S.
Followill and Fridtjof Nüsslin 81
2.6. New radiation therapy rooms should be designed to accommodate treatments of the
future such as IMRT and tomotherapy: William G. Van de Riet and Richard G. Lane 86
2.7. IMRT may be used to excess because of its higher reimbursement from medicare:
Bhudatt R. Paliwal and Ivan A. Brezovich 90
2.8 Future developments in external beam radiotherapy will be unlikely to significantly
improve treatment outcomes over those currently achieved with 3D-conformal and IMRT
treatments: Robert J. Schulz and Dirk L. J. Verellen 95
2.9. Compared with inverse-planning, forward planning is preferred for IMRT
stereotactic radiosurgery: Fred Hacker and Daniel Low 100
2.10. Very high energy electromagnetically-scanned electron beams are an attractive
alternative to photon IMRT: Lech Papiez and Thomas Bortfeld 105
2.11. Intensity-modulated conformal radiation therapy and 3-dimensional treatment
planning will significantly reduce the need for therapeutic approaches with particles such
as protons: T. Rockwell Mackie and Alfred R. Smith 110
2.12. Proton therapy is the best radiation treatment modality for prostate cancer: Michael
F. Moyers and Jean Pouliot 114
2.13. Proton therapy is too expensive for the minimal potential improvements in outcome
claimed: Robert J. Schulz and Alfred R. Smith 119
2.14. Within the next decade conventional cyclotrons for proton radiotherapy will become
obsolete and replaced by far less expensive machines using compact laser systems for the
acceleration of the protons: Chang-Ming Charlie Ma and Richard L. Maughan 124
2.15. High energy electron beams shaped with applied magnetic fields could provide a
competitive and cost-effective alternative to proton and heavy-ion radiotherapy:
Frederick D. Becchetti and Janet M. Sisterson 129
2.16. Modern linac stereotactic radiosurgery systems have rendered the Gamma Knife
obsolete: Frank J. Bova and Steven J. Goetsch 133
2.17. In stereotactic radiosurgery, implanted fiducials are superior to an external
coordinate system: Eric G. Hendee and Wolfgang A. Tomé 137
2.18. Three-dimensional rotational angiography (3DRA) adds substantial information to
radiosurgery treatment planning of AVM'S compared to angio-CT and angio-MR: Carlo
Cavedon and Frank Bova 141
2.19. New methods for precision radiation therapy exceed biological and clinical
knowledge and institutional resources needed for implementation: Sarah S. Donaldson
and Arthur L. Boyer 146
2.20. Kilovoltage imaging is more suitable than megavoltage imaging for guiding
radiation therapy: Lei Xing and Jenghwa Chang 151
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