Journal of Medical Physics
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Year : 2016  |  Volume : 41  |  Issue : 1  |  Page : 77-79

Basic radiotherapy physics and biology

Department of Medical Physics, School of Medicine, University of Medical Sciences, Tehran, Iran

Date of Web Publication23-Feb-2016

Correspondence Address:
Hamid Abdollahi
Junction of Shahid Hemmat and Shahid Chamran Expressways, Tehran
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Abdollahi H. Basic radiotherapy physics and biology. J Med Phys 2016;41:77-9

How to cite this URL:
Abdollahi H. Basic radiotherapy physics and biology. J Med Phys [serial online] 2016 [cited 2020 Aug 4];41:77-9. Available from:

by David S. Chang, Foster D. Lasley, Indra J. Das, Marc S. Mendonca, Joseph R. Dynlachts

(Published by Springer International Publishing, 2014, Copyright Holder, Springer Science Business Media New York, eBook ISBN 978-3-319-06841-1, DOI 10.1007/978-3-319-06841-1, Soft-cover ISBN 978-3-319-06840-4, Price $109.00 for USA).

Basicradiotherapy physics and biologyis a digestible book, which has been prepared for the American Board of Radiology radiation therapy physics and biology examinations. This unique book has been written in a special manner and attempts to provide a simple collection of radiotherapy physics and addresses the mathematical concepts in a summarized style. Authors of this book have intended to provide a guide to the involved people to rapidly review physics and biology, whether for daily use or for examination preparation. This book is a collection of basic rules and principles and dose not use any special references. The topics contained in this book are organized into two equal parts: physics and biology. Chapters 1–16 cover physics and the biology topics are covered in Chapters 17–32. In all chapters, there are series of concepts explained with bullet points of text, together with figures, equations, and mnemonics where appropriate. Furthermore, heavy mathematical rules have been expressed as rules of thumb.

The first major strength is the comprehensive coverage of radiation physics and biology. Specifically, all relevant physical and biological issues from basic rules to advanced techniques are addressed. It is also unique in its coverage of the advanced treatment planning, linac quality assurance and quality management program. In addition, the authors removed detailed algebraic manipulations of physics and dosimetric theories. In the biology chapters, the authors provide coverage of molecular biology, genetics, and signaling of cancers. They also describe basics of radiobiology and explain new paradigms in clinical radiobiology including tumor microenvironments, combined modality therapy, hyperthermia, and all normal tissue radiation responses.

In Chapter 1, 'Atomic and nuclear structure', basic structures of atom and nucleus, and also Bohr atomic models, electron orbits and transitions are described. The main aim of Chapter 2, 'Radioactive decay', appears to provide a comprehensive overview of radioactive decays, equilibriums, and radioisotopes. Chapter 3, 'Production and properties of radiation', is intended to provide a review on different types of radiation and also their production mechanisms and machines. This chapter may be important due to good overviews on linear and cyclic accelerators and their components (particularly linac). Main interactions of electromagnetic radiation with matter including Compton, photoelectric, pair and triplet production, and also photonuclear interaction, are addressed in Chapter 4 named 'Interactions of electromagnetic radiation with matter'. Simple and explicit photos of these interactions make readers enthusiastic to learn more and more. Chapter 5, 'Interactions of particulate radiation with matter', like Chapter 4, tries to provide a simple and clear overview on interactions of particulate radiation with matter. Subjects regarding neutrons, pions, and electron interactions and also ionization in biological systems are illustrated in this chapter. In Chapter 6, 'Quantification and measurement of dose', authors have expressed some aspects and equations of basic radiotherapy dosimetry including KERMA, exposure, and dose equivalent. Dosimetry protocols, such as AAPM TG-51 and TG-21 are also dealt with. The interesting part of this chapter is a full overview on different dosimeters and their advantages and limitations. Chapter 7, 'Characteristics of photon beams' deals with brief views on characteristics of photon beams, wedge, filters, and beam quality characteristics. Chapter 8, 'Dosimetry of photon beams in water', provides illustrative information on all radiotherapy dosimetric issues. Authors start this chapter with “how does a dose calculation work?” and finished it with “rules of thumb” which solves some basic problems in dosimetry calculation, which may occur daily. Main points on dosimetric parameters such as percentage depth dose, tissue air ratio, tissue maximum ratio, scatter-air ratio and relevant factors are addressed. The main aim of Chapter 9, 'Dosimetry of photon beams in a patient', is to make readers eager to find how patient dosimetry works. There is plenty of simple data regarding patient dosimetry, early planning, dose specification, dose delivery, and mixed beam therapy in this chapter. Chapter 10, 'Dosimetry of electron beams', covers all required matter relevant to electron dosimetry including total body electron irradiation. Examples are electron range, electron field shaping, inhomogeneities, bolus, and spoilers. Brachytherapy physics and dosimetry issues such as radionuclide sources, and TG-43 dosimetry protocol and factors such as anisotropy and geometry, classical dose systems including interstitial and intracavitary are discussed in Chapter 11, 'Physics and dosimetry of brachytherapy'. Chapter 12, 'Advanced treatment planning for external beam radiation therapy', focuses on advanced treatment planning techniques: imaging, immobilization, and treatment planning and evaluation techniques. In this section, intensity modulated radiation therapy (IMRT) physics and optimization software and approaches were also presented. The main idea of Chapter 13, 'Linac quality assurance', is to define, review, and give a brief overview on quality assurance in linac systems. Basic radiation protection and shielding rules are presented in Chapter 14, 'Radiation protection and safety'. In Chapter 15, 'Quality management program', a brief overview on quality management programs such as radionuclide regulations, plans, actions, and written directive based on nuclear regulatory commission are taken into account. Hyperthermia is a re-established cancer treatment approach, which plays an adjuvant role in new cancer therapy era. Chapter 16, 'Special topics: Hyperthermia and computers', deals with hyperthermia physics and techniques briefly. In the remaining sections, authors provide scientific roles of computers in modern radiation oncology. Image registration, treatment planning software, and simulated annealing (inverse planning in IMRT), as main sources of computer applications, have been clarified in this chapter. The simple and basic concepts of molecular biology and signaling such as DNA, gene functions, mutations, molecular signaling, receptors and ligands, and also radiation-induced molecular signals, death, and effects are presented in Chapter 17: 'Molecular biology and signaling'. Authors have tried to provide main issues regarding cancer genetics, epigenetics, and genomics in Chapter 18: 'Cancer genetic and molecular characteristics'. They have presented EGFR-MAPK and PI3K-Akt-mTOR signaling pathways and a basic overview of radiation targeting and therapy. Radiation induced DNA damages is the main idea of Chapter 19, 'Molecular mechanisms of DNA damage and repair'. All issues related to this phenomenon such as types, measurement, and models are also provided. In Chapter 20, 'Cell death and survival assays', readers can find basic concepts of cell death and survival assays.In vivo and in vitro assays of radiation-induced tumors and normal tissues alterations are also clarified briefly. Chapter 21, 'Fractionated radiation survival models', provides the basics of radiobiology of radiotherapy particularly fractionation, “4 R's” of radiobiology, different radiation survival models, and limitation of linear quadratic models in very large fractions are mentioned accordingly. Chapter 22: 'Oxygen effect, relative biological effectiveness, and linear energy transfer', focuses on oxygen effect, relative biological effectiveness, and linear energy transfer and their relations using curves and simple photos. Chapter 23, 'Tumor microenvironment', uses such examples to clarify the importance of tumor microenvironments particularly tumor vasculature. Furthermore, the importance of hypoxia with a good manner and mechanisms are presented in this chapter. Chapter 24: 'Cell and tissue kinetics', gives useful information about cell and tissue kinetics, such as cell cycle, repopulation, radiosensitivity and molecular biology of the cell cycle, and cell cycle imaging. Equations in regard to cell cycle also are included. Chapter 25, 'Acute effects of total body irradiation (TBI)', is very informative regarding radiation accidents. Readers can find different aspects of TBI such as acute radiation syndromes, their health consequences and main supportive cares and stem cell therapies. Authors inform about radiotherapy-induced normal tissue complications in Chapter 26, 'Normal tissue radiation responses'. Different normal tissue responses to radiotherapy, damage scoring systems, and volume effects are addressed here. Tumor control probability, normal tissue complication probability, therapeutic window and therapeutic ratio with their curves are presented in the Chapter 27, Therapeutic Ratio. Sensitizers, protectors, and combined modality also have been explained. The main aim of Chapter 28, 'Combined modality therapy', is to provide a brief overview on radiosensitizers, radioprotectors, systemic therapy agents, targeted photodynamic, and gene therapies. Due to the introduction of new conformal therapies such as particle therapy, authors intend to provide the biological basis of interactions of proton, neutron capture, neutron, and heavy ion therapies briefly in Chapter 29, 'Biology of brachytherapy, particle therapy, and alternative radiation modalities'. In addition, radioimmunotherapy is also presented. In the Chapter 30, Hyperthermia, rationale for hyperthermia, its physics and techniques, thermometry, hyperthermia and radiotherapy and hyperthermia difficulties are discussed. Radiation-induced carcinogenesis and heritable effects, are also discussed. Absolute and relative risk and mechanisms of carcinogenesis, genetic risk of radiation, and radiation protection bodies are main concepts of Chapter 31, 'Carcinogenesis and heritable effects'. Chapter 32, 'Radiation effects in the embryo and fetus', addresses effects of radiation in the embryo and fetus in animals and humans. The effect of therapeutic radiation in pregnancy and prenatal cancer are discussed also in this section.

As conclusion remarks, the major strength of this book is the fact that it is a quick reference, helpful for examination preparation and daily clinical practice. In my mind, the most useful aspect of this book is the simplification of hard problems of radiotherapy physics and their reformation. Overall, this book serves as a quick reference for those who wish to find essential knowledge regarding clinical physics of radiotherapy.


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