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Hypofractionated and Stereotactic Radiation Therapy : A Practical Guide

https://libcat.nshealth.ca/en/permalink/provcat42650
Orit Kaidar-Person, Ronald Chen, editors. --Cham: Springer , c2018.
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This handbook summarizes the data and techniques for hypofractionation and stereotactic radiation in a clinically-accessible way. Hypofractionated radiation therapy, which consists of larger-dose radiation treatments that are given over a shorter time period compared to conventional radiation fraction sizes, is used to treat a variety of cancers, including prostate, breast, lung, and colorectal. Conventional radiation therapy and hypofractionated radiation therapy have different effectiveness r…
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Other Authors
Kaidar-Person, Orit
Chen, Ronald
Responsibility
Orit Kaidar-Person, Ronald Chen, editors
Place of Publication
Cham
Publisher
Springer
Date of Publication
c2018
Physical Description
1 online resource (xxvii, 406 p.) : 51 illus., 40 illus. in color
ISBN
9783319928029
9783319928005 (print ed.)
9783319928012 (print ed.)
Subjects (MeSH)
Radiation Dose Hypofractionation
Radiosurgery - methods
Stereotaxic Techniques
Specialty
Radiotherapy
Abstract
This handbook summarizes the data and techniques for hypofractionation and stereotactic radiation in a clinically-accessible way. Hypofractionated radiation therapy, which consists of larger-dose radiation treatments that are given over a shorter time period compared to conventional radiation fraction sizes, is used to treat a variety of cancers, including prostate, breast, lung, and colorectal. Conventional radiation therapy and hypofractionated radiation therapy have different effectiveness rates for cancer treatment and have different impacts on normal tissues in terms of causing toxicity. There is a significant and growing body of literature on the use of different dosing regimens to treat a variety of cancers and radiation oncologists need to keep up with the various dosing schedules, the effect of each regimen on cancer control in different cancers, and how the different schedules affect each organ in terms of toxicity. The book thus provides concise information ranging from commonly-used dose-fractionation schemes for hypofractionated and stereotactic body radiotherapy to simulation and treatment specifications to published safety and efficacy data. Chapters additionally examine the biological rationales for the efficacy of hypofractionated radiation; present clinical studies that demonstrate the efficacy and safety of hypofractionated radiation treatment in a variety of cancers; and describe the advances in technology that have allowed hypofractionated radiation to be safely given. This is an ideal guide for radiation oncology clinicians and trainees.
Contents
1. The History and Radiobiology of Hypofractionation -- 2. The Physics of Hypofractionation and SRS/SBRT -- Part I. Benign Central Nervous System Tumors -- 3. Arteriovenous Malformation -- 4. Trigeminal Neuralgia -- 5. Meningioma -- 6. Vestibular Schwannoma -- 7. Pituitary Adenoma -- Part II. Malignant Central Nervous System Tumors -- 8. Glioblastoma -- 9. Secondary Malignant (Metastases) -- Part III. Head and Neck Tumors -- 10. Nasopharynx -- 11. Larynx -- 12. Other Head and Neck Sites -- 13. Intraoral Cone (IOC) -- 14. Brachytherapy -- 15. Intraoperative Radiotherapy (IORT) -- 16. Re-irradiation -- Part IV. Skin -- 17. Skin (Melanoma and Nonmelanoma Skin Cancers) -- Part V. Lung Tumors -- 18. Hypofractionation for Lung Tumors (Primary Malignant, Secondary Malignant) -- Part VI. Breast Cancer -- 19. Breast Cancer -- Part VII. Gastrointestinal Cancer -- 20. Hepatobiliary Malignancies -- 21. Pancreas Cancer -- 22. Rectal Cancer -- Part VIII. Genitourinary Cancer -- 23. Prostate Cancer Hypofractionation -- 24. Kidney Cancer -- Part IX. Spine Tumors and Non-Spine Bone Metastases -- 25. Spine Tumors and Non-Spine Bone Metastases -- Part X. Gynecologic Malignancies -- 26. Uterine Cervix Cancer -- 27. Endometrial Cancer.
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e-Book
Location
Online
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Stereotactic ablative body radiotherapy (SABR) information for prostate cancer patients

https://libcat.nshealth.ca/en/permalink/chpams38152
Nova Scotia Health Authority. Prostate SABR Site Group. Halifax, NS: Nova Scotia Health Authority , 2022.
Pamphlet Number
4039
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You have agreed to have stereotactic ablative body radiotherapy (SABR) for your prostate cancer. It is also called stereotactic radiation therapy. This is a focused type of radiation that gives a high dose of radiation in 5 treatments. The information in this pamphlet supports the teaching you will get from your radiation therapy team. The pamphlet explains how prostate SABR works, how to get ready for treatment, what will happen during your treatment sessions, and what to expect after your tre…
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Corporate Author
Nova Scotia Health Authority. Prostate SABR Site Group
Place of Publication
Halifax, NS
Publisher
Nova Scotia Health Authority
Date of Publication
2022
Format
Pamphlet
Language
English
Physical Description
1 electronic document (6 p.) : digital, PDF file
Subjects (MeSH)
Radiosurgery
Prostatic Neoplasms - radiotherapy
Stereotaxic Techniques
Subjects (LCSH)
Prostate--Cancer--Radiotherapy
Radiosurgery
Stereotaxic techniques
Specialty
Cancer Care
Abstract
You have agreed to have stereotactic ablative body radiotherapy (SABR) for your prostate cancer. It is also called stereotactic radiation therapy. This is a focused type of radiation that gives a high dose of radiation in 5 treatments. The information in this pamphlet supports the teaching you will get from your radiation therapy team. The pamphlet explains how prostate SABR works, how to get ready for treatment, what will happen during your treatment sessions, and what to expect after your treatments are finished. Contact information is included in case you have treatment or health-related questions, or want to speak to a social worker. The pamphlet also includes a list of supplies to pick up from a pharmacy and a calendar to record important dates during your treatment.
Responsibility
Prepared by: Prostate SABR Site Group; Approved by: Nova Scotia Cancer Patient Education Committee
Pamphlet Number
4039
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Stereotactic and Functional Neurosurgery

https://libcat.nshealth.ca/en/permalink/provcat40816
edited by Guido Nikkhah, Marcus Pinsker. --Vienna: Springer , c2013.
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Since its introduction about sixty years ago, stereotactic and functional neurosurgery has evolved into a fascinating and interdisciplinary endeavor that combines modern neurosurgery, neurobiology, and neuroimaging with innovative diagnostic and treatment strategies. In this collection, acknowledged experts from Europe and North and South America present their scientific and clinical experience in stereotactic and functional neurosurgery for movement disorders and brain tumors. The contribution…
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Other Authors
Nikkhah, Guido
Pinsker, Marcus
Responsibility
edited by Guido Nikkhah, Marcus Pinsker
Place of Publication
Vienna
Publisher
Springer
Date of Publication
c2013
Physical Description
1 online resource (x, 112 p. : ill.)
Series Vol.
117
Series Title
Acta neurochirurgica. Supplement
ISBN
9783709114827
9783709114810 (print ed.)
ISSN
0065-1419
Subjects (MeSH)
Nervous System Diseases - surgery
Stereotaxic techniques
Abstract
Since its introduction about sixty years ago, stereotactic and functional neurosurgery has evolved into a fascinating and interdisciplinary endeavor that combines modern neurosurgery, neurobiology, and neuroimaging with innovative diagnostic and treatment strategies. In this collection, acknowledged experts from Europe and North and South America present their scientific and clinical experience in stereotactic and functional neurosurgery for movement disorders and brain tumors. The contributions present a wide range from the beginnings of human stereotactic neurosurgery to the most modern molecular and restorative strategies to treat diseases of the human nervous system. They clearly demonstrate that the discipline is still young and dynamic with alternative and sometimes competing strategies whose evaluation is underway. They also document that operative lesioning techniques such as thalamotomies, though still chosen under certain circumstances, have been succeeded by novel neuromodulation techniques such as deep brain stimulation in the great majority of clinical cases.
Contents
The birth of human stereotactic surgery -- Functional neurosurgery in Parkinson's disease: a long journey from destruction over modulation towards restauration -- Improving MRT image quality in patients with movement disorders -- STN Stimulation in general anaesthesia: evidence beyond "evidence-based medicine" -- The impact of multichannel microelectrode recording (MER) in deep brain stimulation of the basal ganglia -- A comparison between stereotactic targeting methods of the subthalamic nucleus in cases with Parkinson's disease -- Behind the screen: pseudobulbar symptoms after deep brain stimulation -- Psychiatric side effects of bilateral deep brain stimulation for movement disorders -- Active stimulation site of nucleus accumbens deep brain stimulation in obsessive-compulsive disorder is localized in the ventral internal capsule -- Functional neurosurgery for secondary dystonia: indications and long-term results -- Deep brain stimulation of the ventrolateral thalamic base and posterior subthalamic area in dystonic head tremor -- Intra-operative transdural electric stimulation in awake patient: Target refining for motor cortex stimulation -- Restorative strategies for the dopaminergic nigrostriatal projection pathway -- Some recent trends and further promising directions in functional neurosurgery -- Impact of automated hotspot detection for 18FET PET-guided stereotactic biopsy -- Interstitial radiosurgery with Iodine-125 seeds in the treatment of brain metastases, glial tumours, and benign intracranial lesions.
Format
e-Book
Location
Online
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Stereotactic and Functional Neurosurgery : Principles and Applications

https://libcat.nshealth.ca/en/permalink/provcat45194
Nader Pouratian, Sameer A. Sheth, editors. --Cham: Springer , c2020.
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This text presents a comprehensive and state-of the-art approach to stereotactic and functional neurosurgery. Overarching sections include achieving stereotactic precision, defining trajectories and targets, the biophysics of stereotactic therapies, diseases and targets, and the future of functional neurosurgery. Each section is designed to be inclusive of all relevant topics, serving as an unbiased resource to new clinicians in this field or established clinicians that are aiming to better und…
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Other Authors
Pouratian, Nader
Sheth, Sameer A.
Responsibility
Nader Pouratian, Sameer A. Sheth, editors
Place of Publication
Cham
Publisher
Springer
Date of Publication
c2020
Physical Description
1 online resource (xviii, 563 p.) : 114 illus., 78 illus. in color
ISBN
9783030349066
9783030349059 (Print ed.)
9783030349073 (Print ed.)
9783030349080 (Print ed.)
Subjects (MeSH)
Brain - surgery
Nervous System Diseases - therapy
Neurosurgical Procedures
Stereotaxic Techniques
Specialty
Neurosurgery
Abstract
This text presents a comprehensive and state-of the-art approach to stereotactic and functional neurosurgery. Overarching sections include achieving stereotactic precision, defining trajectories and targets, the biophysics of stereotactic therapies, diseases and targets, and the future of functional neurosurgery. Each section is designed to be inclusive of all relevant topics, serving as an unbiased resource to new clinicians in this field or established clinicians that are aiming to better understand complementary methods. Importantly, each section and the associated chapters can be used by basic and translational scientists as well as engineers and industry to better understand and deliver innovation to the field. Chapters within each section methodically analyze traditional and recently emerging concepts and techniques; address underlying principles with examples drawn from specific diseases and applications; and cover patient selection, target selection, available stereotactic methods, nuanced surgical methods, and clinical evidence across treatment options. Written by experts in each area, Stereotactic and Functional Neurosurgery is a definitive guide to the latest developments in stereotactic targeting, electrode implantation, surgical treatment of neurological and psychiatric disorders, the renaissance of stereotactic lesions, and the frontier of restorative neurosurgery for a variety of disorders that have no other therapeutic options.
Contents
Part I. Achieving Stereotactic Precision -- Traditional and Mini-Frames -- Stereotactic Robots -- Intraoperative Magnetic Resonance Imaging and Computed Tomoraphy -- Frameless Image Guidance in Stereotactic Radiosurgery -- Part II. Defining Trajectories and Targets -- Principles of Safe Sterotactic Trajectories -- Structural Imaging and Target Visualization -- Network-Based Imaging and Connections -- Microelectrode Recording in Neurosurgical Patients -- Local Field Potentials and ECoG -- Awake Testing to Confirm Target Engagement -- Cloud-Based Stereotactic and Functional Neurosurgery and Registries -- Part III. The Biophysics of Stereotactic Therapy -- Responsive Neurostimulation -- Spinal Stimulation -- Peripheral Nerve Stimulation -- Non-Invasive Central Neuromodulation with Transcranial Magnetic Stimulation -- Ablation: Radiofrequency, Laser, and HIFU -- Radiosurgery -- Part IV. Diseases and Targets -- Parkinson's Disease: Deep Brain Stimulation -- Parkinson's Disease: Lesions -- Deep Brain Stimulation and Essential Tremor -- Essential Tremor: Lesions -- Dystonia -- Invasive Monitoring in Epilepsy Surgery -- Epilepsy: Mesial Temporal -- Neocortical Epilespy -- Stereotactic Neurosurgery for the Management and Treatment of Pediatric Epilepsy -- Epilepsy: Neuromodulation -- Deep Brain Stimulation for Treatment-Resistant Depression -- Deep Brain Stimulation for Obsessive Compulsive Disorder -- Stereotactic Lesion Procedures for Obsessive-Compulsive Disorder -- Deep Brain Stimulation for Gilles de la Tourette Syndrome -- Neuromodulation for Chronic Pain -- Chronic Pain: Lesion -- Deep Brain Stimulation for Cluster Headache -- Part V. The Future of Functional Neurosurgery -- Developing New Indications: Strategies and Hurdles to Discovery -- Imaging: Patient Selection, Targeting, and Outcome Biomarkers -- The Design of Clinical Studies for Neuromodulation -- Registries and Big Data.
Format
e-Book
Location
Online
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Stereotactic biopsy

https://libcat.nshealth.ca/en/permalink/chpams34172
Nova Scotia Health Authority. QEII. Division of Neurosurgery. Halifax, NS: Nova Scotia Health Authority , 2017.
Pamphlet Number
0059
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Sterotactic surgery is used to diagnose or treat several types of brain-related conditions, such as movement disorders, pain syndromes, and brain tumours/tumors. A biopsy is when a small sample of tissue is taken. A pathologist (a doctor who diagnoses changes in body tissues or fluids) will look at the tissue sample and make a diagnosis. What to expect before, during, and after surgery are stated.
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Corporate Author
Nova Scotia Health Authority. QEII. Division of Neurosurgery
Place of Publication
Halifax, NS
Publisher
Nova Scotia Health Authority
Date of Publication
2017
Format
Pamphlet
Language
English
Physical Description
1 electronic document ([4] p.) : digital, PDF file
Subjects (MeSH)
Stereotaxic Techniques
Neurosurgery - methods
Brain Neoplasms - diagnosis
Subjects (LCSH)
Stereotaxic techniques
Brain--Surgery
Brain--Tumors--Diagnosis
Abstract
Sterotactic surgery is used to diagnose or treat several types of brain-related conditions, such as movement disorders, pain syndromes, and brain tumours/tumors. A biopsy is when a small sample of tissue is taken. A pathologist (a doctor who diagnoses changes in body tissues or fluids) will look at the tissue sample and make a diagnosis. What to expect before, during, and after surgery are stated.
Responsibility
Prepared by: Division of Neurosurgery
Pamphlet Number
0059
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Stereotactic Body Radiation Therapy : Principles and Practices

https://libcat.nshealth.ca/en/permalink/provcat39483
Yasushi Nagata, editor. --Tokyo: Springer Japan , c2015.
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This book serves as a practical guide for the use of stereotactic body radiation therapy in clinics. On the basis of more than 10 years of clinical experience with lung cancer, liver cancer and other cancers, a remarkable volume of knowledge has been accumulated. At the same time, great progress in techniques has been achieved. Various new fixing apparatuses, new respiratory regulation techniques, new dose fractionation schedules and new image-guided radiation therapy machines have been develop…
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Other Authors
Nagata, Yasushi
Responsibility
Yasushi Nagata, editor
Place of Publication
Tokyo
Publisher
Springer Japan
Date of Publication
c2015
Physical Description
1 online resource (xii, 254 p. : 76 illus., 55 illus. in color)
ISBN
9784431548836
9784431548829 (print ed.)
Subjects (MeSH)
Radiotherapy, Image-Guided - methods
Stereotaxic techniques
Abstract
This book serves as a practical guide for the use of stereotactic body radiation therapy in clinics. On the basis of more than 10 years of clinical experience with lung cancer, liver cancer and other cancers, a remarkable volume of knowledge has been accumulated. At the same time, great progress in techniques has been achieved. Various new fixing apparatuses, new respiratory regulation techniques, new dose fractionation schedules and new image-guided radiation therapy machines have been developed. This book reviews the history of those developments and reports on various types of toxicities. Review of recent clinical studies is also included. The authors were key members of the JCOG 0403 clinical trials on stereotactic body radiation therapy (SBRT) for both inoperable and operableT1N0M0 primary lung cancer. Readers will learn of the superior outcomes obtained with SBRT for lung cancer and other cancers in terms of local control and toxicities. With its practical focus, this book will benefit radiation oncologists, medical physicists, medical dosimetrists, radiation therapists and senior nurses as well as medical oncologists and surgical oncologists who are interested in radiotherapy.
Contents
Part I. Introduction -- 1. Introduction and History of Stereotactic Body Radiation Therapy (SBRT) -- Part II. Basic Principles -- 2. Radiobiology of SBRT -- 3. Physics -- 4. Techniques -- 5. Quality Assurance (QA) -- Part III. Clinical Applications -- 6. Fixation -- 7. Respiratory motion management -- 8. Dose Prescription and Calculation -- 9. Treatment Planning -- 10. Verification of Target localization -- Part IV. Lung Cancer -- 11. Japanese Experiences -- 12. International Experience -- 13. Toxicity and Treatment Evaluation -- Part V. Liver Cancer -- 14. Liver Cancer (Hepatocellular Carcinoma; HCC) -- Part VI. Other Indications -- 15. Other Indications -- Part VII. Development of Machines -- 16. Development and Clinical Application of Vero4DRT System -- 17. Real time tracking radiotherapy (RTRT) system -- 18. Others: Four-dimensional Cone-Beam CT during SBRT -- Part VIII. Future Perspectives -- 19. Future of Stereotactic Irradiation: Dose Composition Radiotherapy (DCRT).
Format
e-Book
Location
Online
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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy : A Comprehensive Guide

https://libcat.nshealth.ca/en/permalink/provcat44471
Daniel M. Trifiletti, Samuel T. Chao, Arjun Sahgal, Jason P. Sheehan, editors. --Cham: Springer , c2019.
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This book is a comprehensive review of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): its physics, clinical evidence, indications, and future directions. The utilization of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) is increasing internationally because of several factors. First, it offers patients a local treatment option that has demonstrated effectiveness similar to traditional surgery without the morbidity of general anest…
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Other Authors
Trifiletti, Daniel M.
Chao, Samuel T.
Sahgal, Arjun
Sheehan, Jason P.
Responsibility
Daniel M. Trifiletti, Samuel T. Chao, Arjun Sahgal, Jason P. Sheehan, editors
Place of Publication
Cham
Publisher
Springer
Date of Publication
c2019
Physical Description
1 online resource (xix, 435 p.) : 131 illus., 111 illus. in color
ISBN
9783030169244
9783030169237 (Print ed.)
9783030169251 (Print ed.)
9783030169268 (Print ed.)
Subjects (MeSH)
Neoplasms - radiotherapy
Neoplasms - surgery
Radiosurgery - methods
Stereotaxic Techniques
Specialty
Radiotherapy
Surgical Oncology
Abstract
This book is a comprehensive review of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): its physics, clinical evidence, indications, and future directions. The utilization of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) is increasing internationally because of several factors. First, it offers patients a local treatment option that has demonstrated effectiveness similar to traditional surgery without the morbidity of general anesthesia and open surgical resection. Second, recent advancements in the quality of scientific evidence supporting a SRS or SBRT-containing approach in patients continues to evolve and demonstrate favorable disease-specific outcomes with little, if any, toxicity in various anatomic disease sites and for various conditions including cancer, benign tumors, and other psychiatric and neurologic conditions. Third, and most provocatively, is the notion that definitive local therapy (i.e. SRS or SBRT) in patients with cancer can boost the immune system to fight cancer in other sites throughout the body. While traditional medical knowledge would suggest that all patients with metastatic cancer are incurable, there is a mounting body of evidence that there is a subset of these patients that can be cured with definitive SRS or SBRT. This volume thus delves into each of these benefits and aspects of treatment, guiding physicians to the best treatment plan for their patients. Expert, international authors provide guidelines for SRS and SBRT use by clinicians. Chapters are divided into six main sections: Radiobiology of Radiosurgery and Stereotactic Body Radiation Therapy, Intracranial Radiosurgery Technique, Intracranial Radiosurgery by Indication, Stereotactic Body Radiation Therapy Technique, Stereotactic Body Radiation Therapy by Indication, The Future of Radiosurgery and SBRT. Overall physics are explained, as well as specific considerations for particular surgical tools (including the Leksell Gamma Knife and Accuray CyberKnife), techniques (including fractionated and charged particle radiosurgery), and anatomic sites (including brain metastases, pituitary tumors, and the prostate). Detailed images and charts enhance the chapters. This book provides physicians with a single, practical resource incorporating both of these broad categories of treatment, SRS and SBRT, and better defines the current role and the direction of radiosurgery.
Contents
Part I. Radiobiology of Radiosurgery and Stereotactic Body Radiation Therapy -- Vascular-Mediated Mechanisms and SRS/SBRT -- Radio-Immunology of Ablative Radiation -- Rationale for Fractionated SRS and Single SRS Session Approaches -- Part II. Intracranial Radiosurgery Technique -- Physics of Radiosurgery -- Leksell Gamma Knife Radiosurgery -- CyberKnife Robotic Stereotactic Radiosurgery -- Linear Accelerator-Based Radiosurgery: Technique -- Fractionated Radiosurgery -- Charged-Particle Proton Radiosurgery -- Part III. Intracranial Radiosurgery by Indication -- Stereotactic Radiosurgery for Brain Metastases -- Stereotactic Radiosurgery for Pituitary Adenoma -- Stereotactic Radiosurgery for Meningioma -- Stereotactic Radiosurgery for Intracranial Arteriovenous Malformations -- Radiosurgical Management of Trigeminal Neuralgia -- Radiosurgery for Vestibular Schwannomas -- Stereotactic Radiosurgery for Glial Tumors -- Part IV. Stereotactic Body Radiation Therapy Technique -- Physics of Stereotactic Body Radiotherapy -- Immobilization for SBRT: A Crucial Prerequisite Toward Accurate Treatment -- Motion Management in Stereotactic Body Radiation Therapy -- Charged Particle Stereotactic Body Radiation Therapy -- Part V. Stereotactic Body Radiation Therapy by Indication -- Stereotactic Body Radiation Therapy (SBRT) for Primary Lung Cancer -- Stereotactic Body Radiation Therapy (SBRT) for Lung Metastases -- Stereotactic Body Radiation Therapy (SBRT) for Spinal Tumors -- Stereotactic Body Radiation Therapy for Gastrointestinal Cancers -- SAbR for Primary Prostate Cancer -- Stereotactic Ablative Radiotherapy (SAbR) for Primary Renal Cell Carcinoma -- Head and Neck Stereotactic Body Radiation Therapy -- Pediatric Radiosurgery -- Part VI. The Future of Radiosurgery and SBRT -- Patient Selection in SBRT and SRS -- SRS and SBRT Complications and Management -- SRS and SBRT Integration with Supportive Care -- Targeted Agents and Immunotherapy -- Diagnostic Imaging Advances -- Comparative Effectiveness of SBRT.
Format
e-Book
Location
Online
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Textbook of Stereotactic and Functional Neurosurgery

https://libcat.nshealth.ca/en/permalink/provcat30215
Andres M. Lozano, Philip L. Gildenberg, Ronald R. Tasker (eds.). --Berlin, Heidelberg: Springer-Verlag , c2009.
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Available Online
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Other Authors
Lozano, Andres M.
Gildenberg, Philip L.
Tasker, Ronald R.
Responsibility
Andres M. Lozano, Philip L. Gildenberg, Ronald R. Tasker (eds.)
Place of Publication
Berlin, Heidelberg
Publisher
Springer-Verlag
Date of Publication
c2009
Physical Description
1 online resource
Series Title
Springer reference
ISBN
9783540699606
9783540699590 (print ed.)
Subjects (MeSH)
Nervous System Diseases - surgery
Neurosurgical Procedures
Stereotaxic Techniques
Format
e-Book
Location
Online
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8 records – page 1 of 1.