{"title":"11. Sources and Absorbed-Dose Calculation","authors":"","doi":"10.1093/jicru/ndw014","DOIUrl":"10.1093/jicru/ndw014","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
After multidisciplinary evaluation, it was decided to offer curatively intended radiochemotherapy using 3D conformal external beam radiation therapy to the pelvis (45 Gy in 1.8 Gy fractions) with 6 courses of concomitantly weekly cisplatin and a boost of high dose rate brachytherapy to the residual tumour, aiming at a total dose of 80 Gy EQD210 at point A. Overall treatment time 7 weeks with brachytherapy delivered in 5 fractions starting in the fourth week of treatment (Figure A.4.2).
{"title":"Case 4: Cervical Cancer Stage IB1 Treated with 3D Conformal External Beam Irradiation, Concomitant Chemotherapy, and Radiograph-Based Intracavitary Tandem/Ovoid High Dose Rate Brachytherapy","authors":"","doi":"10.1093/jicru/ndw021","DOIUrl":"10.1093/jicru/ndw021","url":null,"abstract":"After multidisciplinary evaluation, it was decided to offer curatively intended radiochemotherapy using 3D conformal external beam radiation therapy to the pelvis (45 Gy in 1.8 Gy fractions) with 6 courses of concomitantly weekly cisplatin and a boost of high dose rate brachytherapy to the residual tumour, aiming at a total dose of 80 Gy EQD210 at point A. Overall treatment time 7 weeks with brachytherapy delivered in 5 fractions starting in the fourth week of treatment (Figure A.4.2).","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"185-191"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Various imaging modalities have been used to stage patients with gynecologic cancers and are invaluable in assessing local, regional, and metastatic spread of disease. As cervical cancer is directly accessible on pelvic examination, clinical findings based on visual and digital examination, and documented on clinical diagrams, also remain essential. Plain radiographs, including chest x rays, barium enemas (BE), intravenous urography (IVU), skeletal surveys, and lymphangiography (LAG), as well as cystoscopy and rectal endoscopy, have long been mainstays of staging of cervical cancer and remain so in many parts of the world. Radiographs to guide both external-beam therapy and brachytherapy have been used nearly universally, but are limited by their inability to demonstrate the tumor and its extensions to many of the critical, adjacent abdomino-pelvic organs. Reliance on bony anatomy is not sufficient for treatment planning for cervical cancer (Finlay et al., 2006; McAlpine et al., 2004). More recently, three-dimensional (3D)-imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) have become the techniques of choice for external-beam and brachytherapy treatment planning, for monitoring response during treatment, and for post-treatment surveillance. Functional imaging, in particular positron-emission tomography (PET) combined with CT, and, recently functional MRI, play increasingly important roles. Ultrasound (US) has been replaced by MRI in the last two decades in the initial staging of patients, but it might have an essential role for image-guided intracavitary and interstitial gynecologic brachytherapy. The focus in the following will be on the role of clinical diagrams and imaging in treatment planning and response monitoring leading to adaptive therapy.
各种成像方式已被用于妇科癌症患者的分期，在评估局部、区域和转移性疾病传播方面是无价的。由于宫颈癌可通过盆腔检查直接诊断，因此基于视觉和数字检查以及临床图表记录的临床结果也至关重要。x线平片，包括胸部x线、钡灌肠、静脉尿路造影、骨骼检查和淋巴管造影，以及膀胱镜检查和直肠内镜检查，长期以来一直是宫颈癌分期的主要手段，在世界许多地方仍然如此。x线片指导外束治疗和近距离治疗几乎已被普遍使用，但由于无法显示肿瘤及其向许多关键的邻近腹部-骨盆器官的扩展，x线片受到限制。仅依靠骨骼解剖不足以制定宫颈癌的治疗计划(Finlay等人，2006;McAlpine et al.， 2004)。最近，三维(3D)成像方法，如计算机断层扫描(CT)和磁共振成像(MRI)已成为外束和近距离治疗计划、治疗期间监测反应和治疗后监测的首选技术。功能成像，特别是正电子发射断层扫描(PET)与CT结合，以及最近的功能MRI，发挥着越来越重要的作用。在过去的二十年中，超声(US)在患者的初始阶段已被MRI所取代，但它可能在图像引导的腔内和间质妇科近距离治疗中发挥重要作用。下面的重点将是临床图表和成像在治疗计划和反应监测中的作用，从而导致适应性治疗。
{"title":"4. Brachytherapy Imaging for Treatment Planning","authors":"","doi":"10.1093/jicru_ndw007","DOIUrl":"https://doi.org/10.1093/jicru_ndw007","url":null,"abstract":"Various imaging modalities have been used to stage patients with gynecologic cancers and are invaluable in assessing local, regional, and metastatic spread of disease. As cervical cancer is directly accessible on pelvic examination, clinical findings based on visual and digital examination, and documented on clinical diagrams, also remain essential. Plain radiographs, including chest x rays, barium enemas (BE), intravenous urography (IVU), skeletal surveys, and lymphangiography (LAG), as well as cystoscopy and rectal endoscopy, have long been mainstays of staging of cervical cancer and remain so in many parts of the world. Radiographs to guide both external-beam therapy and brachytherapy have been used nearly universally, but are limited by their inability to demonstrate the tumor and its extensions to many of the critical, adjacent abdomino-pelvic organs. Reliance on bony anatomy is not sufficient for treatment planning for cervical cancer (Finlay et al., 2006; McAlpine et al., 2004). More recently, three-dimensional (3D)-imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) have become the techniques of choice for external-beam and brachytherapy treatment planning, for monitoring response during treatment, and for post-treatment surveillance. Functional imaging, in particular positron-emission tomography (PET) combined with CT, and, recently functional MRI, play increasingly important roles. Ultrasound (US) has been replaced by MRI in the last two decades in the initial staging of patients, but it might have an essential role for image-guided intracavitary and interstitial gynecologic brachytherapy. The focus in the following will be on the role of clinical diagrams and imaging in treatment planning and response monitoring leading to adaptive therapy.","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"39 1","pages":"37 - 47"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81585333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstract","authors":"","doi":"10.1093/jicru/ndw001","DOIUrl":"https://doi.org/10.1093/jicru/ndw001","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"3-3"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67909981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This section summarizes the practical aspects of clinical treatment planning for intracavitary cervical brachytherapy. Treatment planning is based on the overall planning aim for the combined dose distributions of external-beam radiotherapy (EBRT) and brachytherapy. Based on information available at diagnosis, a schedule for EBRT and brachytherapy, their relative contribution to the overall EQD2 for defined target volumes, fractionation, and timing is defined. Due to regression of the primary tumor, the target volume for brachytherapy can diminish significantly during treatment. Therefore, adaptive treatment planning is based on a reassessment of tumor and target volumes before and possibly at the time of brachytherapy. Adaptations of the brachytherapy implant itself to the anatomical situation after weeks of EBRT are also an integral part of the optimized adaptive-treatment-planning procedure. Adaptation is possible at different levels of complexity, ranging from the minimum requirement of a detailed clinical examination to image-guided approaches simulating the implantation technique and geometry (preplanning). During implantation, further optimization of the implant can be obtained by intraoperative image guidance. The final implantation geometry in relation to target volumes and organs at risks (OARs) is determined with volumetric imaging or radiographic approximation with the applicator in place. A set of dose–volume constraints for the individual brachytherapy fractions must be available prior to the optimization of dwell positions and dwell times, taking into account the pre-defined overall planning aims as well as spatial distributions of absorbed dose from previous brachytherapy and/or external-beam fractions. The method to achieve reproducible and controlled absorbed dose distributions is to start the optimization process with standardized loading patterns for the active dwell positions. In an iterative process, the dwell positions and dwell times are adjusted until an acceptable compromise between target coverage and OAR constraints is achieved. Inverse optimization and graphically assisted dosedistribution shaping should be performed with care as the spatial distribution of over-dosed and underdosed spots within the treated volume is often changed substantially compared with the manual iterative procedure. Clinical experience and quantitative radiobiology has shown that dose–effect curves for toxicity in the pelvis can be steep depending on the OAR and the chosen endpoint (Bentzen, 1993; Georg et al., 2012; Perez et al., 1998; Petereit et al., 1999; Pourquier et al., 1982; 1987). Figure 8.1 illustrates an example of dose–volume correlations for late rectal morbidity in cervical cancer patients treated with MRI-based brachytherapy, where a steep dose–effect is evident, especially when D2cm3 is used as a descriptor of the cumulative dose of EBRT and brachytherapy EQD2 delivered to the rectum (Georg et al., 2009). Considering the sharp a
本节总结了腔内宫颈近距离放射治疗的临床治疗计划的实际方面。治疗计划是基于对外束放疗(EBRT)和近距离放疗联合剂量分布的总体规划目标。根据诊断时可获得的信息，确定了EBRT和近距离治疗的时间表，以及它们对既定靶体积、分诊和时间的总体EQD2的相对贡献。由于原发肿瘤的消退，近距离放疗的靶体积在治疗过程中会明显减小。因此，适应性治疗计划是基于在近距离治疗之前和可能在近距离治疗时对肿瘤和靶体积的重新评估。经过数周的EBRT后，近距离治疗植入物本身对解剖情况的适应也是优化适应性治疗计划程序的一个组成部分。适应不同的复杂程度是可能的，从详细临床检查的最低要求到模拟植入技术和几何(预先计划)的图像引导方法。在植入过程中，可以通过术中图像引导对植入体进行进一步优化。与靶体积和危险器官(OARs)相关的最终植入几何形状是通过体积成像或放射线近似确定的。在优化停留位置和停留时间之前，必须有一组针对单个近距离治疗部分的剂量-体积限制，同时考虑到预先定义的总体规划目标以及先前近距离治疗和/或外束部分吸收剂量的空间分布。实现可复制和可控制的吸收剂量分布的方法是对活性驻留位置进行标准化加载模式的优化过程。在迭代过程中，将调整驻留位置和驻留时间，直到在目标覆盖范围和桨面约束之间达到可接受的折衷。反向优化和图形辅助剂量分布整形应小心进行，因为与手动迭代过程相比，处理体积内过量和不足剂量点的空间分布经常发生实质性变化。临床经验和定量放射生物学表明，骨盆毒性的剂量效应曲线可能很陡，这取决于OAR和所选择的终点(Bentzen, 1993;george et al.， 2012;Perez et al.， 1998;peter et al.， 1999;Pourquier et al.， 1982;1987)。图8.1显示了接受基于mri的近距离放射治疗的宫颈癌患者晚期直肠发病率的剂量-体积相关性，其中明显的剂量效应，特别是当D2cm3被用作EBRT和近距离放射治疗EQD2的累积剂量描述时(Georg等，2009)。考虑到近距离放射治疗固有的吸收剂量急剧下降，在试图向肿瘤提供治疗性吸收剂量的同时，对邻近结构的毒性最小时，存在一个密切的平衡(Dimopoulos等，2009;2009 d)。治疗计划的目标是通过仔细规划近距离放射治疗的吸收剂量递送，为个体患者获得简单治疗的最佳机会(Holthusen, 1936) (Kirisits等人，2005;2006年;Pötter et al.， 2006)。然而，从最广泛的意义上讲，近距离治疗计划还应包括将近距离治疗纳入整个治疗链，包括EBRT和伴随化疗，重点关注EBRT和近距离治疗之间的吸收剂量平衡、总体治疗时间和近距离治疗植入策略等项目(Lindegaard et al.， 2011)。基于放射学的妇科近距离放射治疗为治疗计划提供了基础，并产生了非常令人印象深刻的临床结果(Eifel等，1994;Gerbaulet et al.， 1995;Horiot et al.， 1988;ICRU, 1985;Perez et al.， 1998;Pernot et al.， 1995)。基于体积成像的近距离放射治疗的引入增加了靶标体积和OAR的新信息，以及这些体积如何随时间变化，提供了更好的理解(barilllot等人，1994;Haie-Meder等，2010;Kirisits et al.， 2005;2006年;Lindegaard et al.， 2008;2013;Pelloski et al.， 2005;Pötter等人，2007;2011;Viswanathan等人，2006年b)。ICRU Journal of the ICRU Vol 13 No 1-2 (2013) Report 89 doi:10.1093/jicru/ndw016牛津大学出版社
{"title":"12. Treatment Planning","authors":"","doi":"10.1093/jicru_ndw016","DOIUrl":"https://doi.org/10.1093/jicru_ndw016","url":null,"abstract":"This section summarizes the practical aspects of clinical treatment planning for intracavitary cervical brachytherapy. Treatment planning is based on the overall planning aim for the combined dose distributions of external-beam radiotherapy (EBRT) and brachytherapy. Based on information available at diagnosis, a schedule for EBRT and brachytherapy, their relative contribution to the overall EQD2 for defined target volumes, fractionation, and timing is defined. Due to regression of the primary tumor, the target volume for brachytherapy can diminish significantly during treatment. Therefore, adaptive treatment planning is based on a reassessment of tumor and target volumes before and possibly at the time of brachytherapy. Adaptations of the brachytherapy implant itself to the anatomical situation after weeks of EBRT are also an integral part of the optimized adaptive-treatment-planning procedure. Adaptation is possible at different levels of complexity, ranging from the minimum requirement of a detailed clinical examination to image-guided approaches simulating the implantation technique and geometry (preplanning). During implantation, further optimization of the implant can be obtained by intraoperative image guidance. The final implantation geometry in relation to target volumes and organs at risks (OARs) is determined with volumetric imaging or radiographic approximation with the applicator in place. A set of dose–volume constraints for the individual brachytherapy fractions must be available prior to the optimization of dwell positions and dwell times, taking into account the pre-defined overall planning aims as well as spatial distributions of absorbed dose from previous brachytherapy and/or external-beam fractions. The method to achieve reproducible and controlled absorbed dose distributions is to start the optimization process with standardized loading patterns for the active dwell positions. In an iterative process, the dwell positions and dwell times are adjusted until an acceptable compromise between target coverage and OAR constraints is achieved. Inverse optimization and graphically assisted dosedistribution shaping should be performed with care as the spatial distribution of over-dosed and underdosed spots within the treated volume is often changed substantially compared with the manual iterative procedure. Clinical experience and quantitative radiobiology has shown that dose–effect curves for toxicity in the pelvis can be steep depending on the OAR and the chosen endpoint (Bentzen, 1993; Georg et al., 2012; Perez et al., 1998; Petereit et al., 1999; Pourquier et al., 1982; 1987). Figure 8.1 illustrates an example of dose–volume correlations for late rectal morbidity in cervical cancer patients treated with MRI-based brachytherapy, where a steep dose–effect is evident, especially when D2cm3 is used as a descriptor of the cumulative dose of EBRT and brachytherapy EQD2 delivered to the rectum (Georg et al., 2009). Considering the sharp a","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"142 2","pages":"151 - 160"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru_ndw016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72490273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Historically, variation in dose is kept to a minimum inside each CTV and planning target volume (PTV) in external-beam treatments, with the aim of achieving a homogeneous dose distribution with the dose varying between 95 % and 107 % of the prescribed dose (ICRU, 1993b; 2000). However, with new techniques [such as intensity-modulated radiation therapy (IMRT)], some dose inhomogeneity (dose painting) may be specifically planned (ICRU, 2010). For intracavitary brachytherapy (ICBT), the dose may be prescribed to a point but more typically to a CTV with a volume of 10 cm to 200 cm (Pötter et al., 2006). Dose to a CTV may be prescribed as a D98 or other dose–volume value or to other clinical volumes as discussed in Sections 5 and 6. Even in the smaller CTVs, the dose distribution is heterogeneous with relatively low doses near the margin of the CTV and two to three times greater dose rates and doses delivered immediately adjacent to the radioactive sources. The average dose and dose rate within the CTV is consequently much higher than the dose and dose rate at the periphery. In external beam therapy, because of dose–volume–effect relationships, these high doses would not be tolerated by normal tissues, given the larger volumes commonly exposed. A study by De Brabandere et al. (2008) shows that the GTV receives on average 146 % (108 % to 273 %) of the dose to the periphery of the CTV. Outside of the CTV, there is a steep decrease in dose rate and dose.
从历史上看，在外束治疗中，剂量变化在每个CTV和计划靶体积(PTV)内保持最小，目的是实现均匀剂量分布，剂量变化在规定剂量的95%至107%之间(ICRU, 1993b;2000)。然而，随着新技术[如调强放射治疗(IMRT)]的出现，一些剂量不均匀性(剂量涂漆)可能会被特别规划(ICRU, 2010)。对于腔内近距离放射治疗(ICBT)，剂量可以指定为一个点，但更典型的剂量是一个体积为10厘米至200厘米的CTV (Pötter et al.， 2006)。CTV的剂量可以按照D98或其他剂量-体积值或第5和6节中讨论的其他临床剂量来规定。即使在较小的CTV中，剂量分布也是不均匀的，在CTV边缘附近的剂量相对较低，而紧挨着放射源的剂量率和剂量则高出2至3倍。因此，CTV内的平均剂量和剂量率远高于周围的剂量和剂量率。在外部束流治疗中，由于剂量-体积-效应关系，正常组织不能耐受这些高剂量，因为通常暴露的体积更大。De Brabandere等人(2008)的一项研究表明，GTV接受的剂量平均为CTV周围的146%(108%至273%)。在CTV外，剂量率和剂量急剧下降。
{"title":"7. Radiobiological Considerations","authors":"","doi":"10.1093/jicru_ndw011","DOIUrl":"https://doi.org/10.1093/jicru_ndw011","url":null,"abstract":"Historically, variation in dose is kept to a minimum inside each CTV and planning target volume (PTV) in external-beam treatments, with the aim of achieving a homogeneous dose distribution with the dose varying between 95 % and 107 % of the prescribed dose (ICRU, 1993b; 2000). However, with new techniques [such as intensity-modulated radiation therapy (IMRT)], some dose inhomogeneity (dose painting) may be specifically planned (ICRU, 2010). For intracavitary brachytherapy (ICBT), the dose may be prescribed to a point but more typically to a CTV with a volume of 10 cm to 200 cm (Pötter et al., 2006). Dose to a CTV may be prescribed as a D98 or other dose–volume value or to other clinical volumes as discussed in Sections 5 and 6. Even in the smaller CTVs, the dose distribution is heterogeneous with relatively low doses near the margin of the CTV and two to three times greater dose rates and doses delivered immediately adjacent to the radioactive sources. The average dose and dose rate within the CTV is consequently much higher than the dose and dose rate at the periphery. In external beam therapy, because of dose–volume–effect relationships, these high doses would not be tolerated by normal tissues, given the larger volumes commonly exposed. A study by De Brabandere et al. (2008) shows that the GTV receives on average 146 % (108 % to 273 %) of the dose to the periphery of the CTV. Outside of the CTV, there is a steep decrease in dose rate and dose.","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"55 1","pages":"104 - 89"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79113770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The first non-racial elections in South Africa, held on 27/04/1994, ushered in a government whose political framework is grounded on principles of democracy, nonracism and non-sexism. The ‘rainbow people of the South’ is a phrase popularized by Archbishop Desmond Tutu to describe the new post-apartheid South African society. The ‘rainbow’ metaphor captures both the different backgrounds of South Africans and the common non-racial values to which the nation should strive. Underlying both this rainbow metaphor, and the new South African political framework, is an implied intention to de-emphasize the boundaries or partitions which kept different races or population groups of one nation apart.
{"title":"1. Introduction","authors":"","doi":"10.1093/jicru/ndw003","DOIUrl":"10.1093/jicru/ndw003","url":null,"abstract":"The first non-racial elections in South Africa, held on 27/04/1994, ushered in a government whose political framework is grounded on principles of democracy, nonracism and non-sexism. The ‘rainbow people of the South’ is a phrase popularized by Archbishop Desmond Tutu to describe the new post-apartheid South African society. The ‘rainbow’ metaphor captures both the different backgrounds of South Africans and the common non-racial values to which the nation should strive. Underlying both this rainbow metaphor, and the new South African political framework, is an implied intention to de-emphasize the boundaries or partitions which kept different races or population groups of one nation apart.","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"6. Organs at Risk and Morbidity-Related Concepts and Volumes","authors":"","doi":"10.1093/jicru/ndw010","DOIUrl":"10.1093/jicru/ndw010","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"79-88"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"12. Treatment Planning","authors":"","doi":"10.1093/jicru/ndw016","DOIUrl":"10.1093/jicru/ndw016","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"13 1-2","pages":"151-160"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndw016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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