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Brachytherapy: Techniques and Evidences

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Brachytherapy has a long history since the discovery of radium-226 by Marie Curie in 1898 and its introduction to the cancer treatment in France in 1901. Already in 1913, the clinical results of brachytherapy in cervical cancer surpassed the results obtained through Wertheim’s operation. The era of “Strahl statt Stahl” (rays instead of iron knife) came. Brachytherapy was at that time a sole modality which can be curative in the deep-lying tumors. Additionally the wisdom of fractionated radiation therapy derived from the experience obtained through low-dose-rate brachytherapy using radium-226. However, with the advent of telecobalt and megavoltage radiation therapy, the indications of brachytherapy were quite narrowed and once seemed to be obsolete. In addition, radiation exposure to the medical personnel remained quite annoying. The introduction of the afterloading method by Henschke and a small radionuclide with a high specific radioactivity such as iridium-192 changed the scene of brachytherapy. Now the high-dose-rate irradiation in interstitial as well as intracavitary applications became possible. Provided that radionuclide placement is performed according to the planning, inverse square law guarantees very sharp dose distribution confined to the tumor. Additionally, implanted applicators move according to the physiological movement of the tumor and planning target volume can be reduced to a minimum. Even in comparison to the most modern external beam radiation like intensity-modulated proton therapy, brachytherapy can attain favorable physical dose distribution. Fame of brachytherapy as the utmost precision therapy remains impeccable.

In this book, radiation oncologists majoring in brachytherapy describe the present status of brachytherapy in oncology with their eagerness. This book is dedicated to young radiation oncologists and we wish many of them will be inspired to join the fascinating and stimulating world of brachytherapy.

This book provides a comprehensive and up-to-date overview of major technical advances and research findings in the field of brachytherapy. Especially research conducted on brachytherapy in Japan has made tremendous strides, offering readers valuable insights into new treatment outcomes, evidence and techniques. In the respective chapters, each author elucidates cutting-edge findings, addressing both the basic and clinical aspects including the application to various cancers, and especially focusing on highly valuable data gleaned in Japan. As such, the book will benefit not only radiation oncologists but also basic researchers, radiation technologists, medical physicists and members of medical staff who are involved in the development and utilization of this advanced therapy.

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