Linda Ding

By Thomas J. FitzGerald, Maryann Bishop-Jodoin, Killian Dickson, Yuan-Chyuan Lo, Carla Bradford, Linda Ding, Jessica Hiatt, Harry Bushe, Jonathan Saleeby, I-lin Kuo, Elizabeth Bannon, Kenneth Ulin, David DeSantis, Sherri L. Shul, Bashera Nochomowitz, Julie Trifone, Thomas Quinn, Catherine Whelan, Joshua Taylor, Maureen Britton, Shannon Higgins, Karen Morano, Jean Quigley and Kathleen Briggs

The discovery of radiation has enabled great healthcare advances as well as catastrophic injury. This paper reviews major historical incidents of public radiation exposure and the evolution of standards affecting today’s public and health care workers. Current patient care and response assessment to radiation exposure are reviewed. The strengths of modern radiation therapy and the need for continuous process improvements to ensure optimal patient care and secure safe environments are identified. The discovery of radiation has brought significant scientific achievements as well as catastrophic injury.

Part of the book: Essentials of Accident and Emergency Medicine

By James Shen, Linda Ding, Kevin O’Connor, Ameer Elaimy, Carla Bradford, Fenhong Liu, Abdulnasser Khalifeh, Suhong Yu, Harry Bushe, Jonathan Saleeby, Kenneth Ulin, I-Lin Kuo, Yankhua Fan, Maryann Bishop-Jodoin, Paul Rava and Thomas J. FitzGerald

The discovery of radiation has led to many advances. Guidelines have been created to minimize radiation exposure and treatment management following both unintentional and intentional exposure. The effects of radiation exposure on specific tissues varies. Tragic consequences can result, ranging from severe, acute injury to long- lasting effects that present years after the initial exposure. In this chapter we provide observations that demonstrate the importance of understanding guidelines to minimize radioactive exposure and the expectations and treatment management following exposure. For the safety and well-being of patients, health care professionals need to remain well-informed to minimize the risks of this tool.

Part of the book: Trauma and Emergency Surgery

By Ameer L. Elaimy, Linda Ding, Carla Bradford, Yansong Geng, Harry Bushe, I-Lin Kuo, Yankhua Fan, Fenhong Liu, Abdulnasser Khalifeh, Suhong Yu, Jonathan Saleeby, James Shen, Kevin O’Connor and Kenneth Ulin

The use of proton therapy in oncology is not a new idea. The unique physical properties of protons and potential advantages in radiation therapy were initially recognized in the 1940s. Since the first patients were treated in the 1950s, technology and clinical applications have evolved as evidenced by the increasing number of proton therapy centers and patients being treated throughout the world. This chapter will review the history of proton therapy providing a detailed overview of the cyclotron and synchrotron techniques used and how they have advanced with time.

Part of the book: Proton Therapy

By Ameer L. Elaimy, Linda Ding, Jonathan Glanzman, Lakshmi Shanmugham, Beth Herrick, Jody Morr, Dan Han, Jeffrey C. Buchsbaum and Thomas J. FitzGerald

Due to space requirements and a substantial financial burden, the feasibility of health systems adopting proton therapy has been called into question. However, advances in facility design and treatment delivery have allowed institutions offering proton therapy to reduce footprint while incorporating technological improvements at reduced costs. As the number of centers and patients treated continue to increase, this chapter will review the layout and interface of proton therapy facilities providing a detailed overview of the design, costs and faculty and staff considerations.

Part of the book: Proton Therapy

By Linda Ding, Carla D. Bradford, Kenneth Ulin, Koren Smith, I-Lin Kuo, Yankhua Fan, Abdulnasser Khalifeh, Fenghong Liu, Suhong Lu, Harry Bushe, Salvatore Larosa, Camelia Bunaciu, Jonathan Saleeby, Shannon Higgins, Julie Trifone, Maureen Britton, Joshua Taylor, Marious Croos, Katie Figura, Thomas Quinn, Linda O’Connor, Kathleen Briggs, Sherri Suhl, Jean Quigley, Heather Reifler, Shawn Kirby, Fred Prior, Joel Saltz, Maryann Bishop-Jodoin and Thomas J. FitzGerald

Technology and computational analytics are moving forward at an extraordinary rate with changes in patient care and department workflows. This rapid pace of change often requires initiating and maintaining the educational support at multiple levels to introduce technology to radiation oncology staff members. Modern physics quality assurance and dosimetry treatment planning now require expertise beyond traditional skill based in computational algorithms and image management including quality assurance of the process of image acquisition and fusion of image datasets. Expertise in volumetric anatomy and normal tissue contouring are skills now performed by physics/dosimetry in collaboration with physicians and these skills are required in modern physics dosimetry training programs. In this chapter, challenges of modern radiation planning are reviewed for each disease site. Skills including future applications of image integration into planning objects and the future utility of artificial intelligence in modern radiation therapy treatment planning are reviewed as these issues will need to be added to modern training programs.

Part of the book: Dosimetry

By Koren Smith, Linda Ding, Maryann Bishop-Jodoin, Matt Iandoli, Fran Laurie, Stephen Kry, Michael Knopp, Mark Rosen, Ying Xiao, Fred Prior, Joel Saltz and Thomas J. FitzGerald

Clinical trials in radiation oncology are the best vehicle to optimize our strengths in therapeutic technology, define progress in our field, and improve patient outcome. Trials advance our knowledge in each disease site and provide us information to improve the radiation dose-volume for both tumor control and therapeutic sequelae to normal tissue. An increasing number of systemic and targeted therapies have been developed and are currently in early phase clinical trial design. Ultimately, these new therapies will need to be tested with standard-of-care therapy including radiation oncology. Therefore, during a study, it is essential that radiation therapy is delivered in a uniform and consistent manner for the credibility of the study. If the radiation therapy component of the study does not have a structure or management for maintaining therapeutic compliance, including a real-time data management strategy, it becomes difficult to trust the study outcome and apply the outcome to daily clinical practice. In this chapter, we review the strategy and process involved in the management of dosimetry in radiation oncology clinical trials and how this can impact clinical trial management, primary study endpoints, and the overall success of the study.

Part of the book: Advances in Dosimetry and New Trends in Radiopharmaceuticals

By David Harris, Jessica Yancey, Gavin Jones, Koren Smith, Sandy Kessel, Fran Laurie, Matthew Iandoli, Maryann Bishop-Jodoin, Yansong Geng, Linda Ding, Julie Trifone, Julia Hayden, Eric Ko and Paul Rava

Radiation therapy remains a cornerstone in the clinical care of patients with medulloblastoma. Nevertheless, while treatment with radiation improves disease control, it is also associated with potential late effects impacting neurologic and neurocognitive function, pituitary function as well as hearing. The development of secondary, treatment-related malignancies is an uncommon but possible late outcome. In this chapter, we review the role of radiation therapy in medulloblastoma, as well as changes in management that have resulted both from technological therapeutic advancements and enterprising cooperative group clinical trials for this disease. Moreover, with increasing utilization of molecular diagnostics both for prognosis and stratification of treatment, we also endeavor to explore opportunities to further improve the delivery of radiation therapy to patients with varied risk of disease recurrence.

Part of the book: Medulloblastoma - Therapeutic Outcomes and Future Clinical Trials [Working title]