Advanced Systems in Radiotherapy

Dear Colleagues,

Radiotherapy has been used routinely for several decades as part of cancer treatment. Currently, about 60% of cancer patients undergo radiotherapy treatment. Due to the synergy of radiotherapy with other specialties, such as surgery, oncology, and the most modern and promising immunotherapy, this percentage is destined to grow in the near future. 

Since radiotherapy is based on ionizing radiations, it is not free from side effects such as the destruction of healthy cells adjacent to the treated volume. Over time, various hardware and software techniques have been developed to minimize such damage.

A first attempt to avert this effect was the introduction of 3D conformal radiation therapy (3DCRT), where the medical physicist had to place and manually adjust the multileaves collimator (MLC) in order to fit the beam with respect to the target and the surroundings organs at risk (OARs).

This technique is used daily, but it delivers an undesired dose to OARs when concave- or irregular-shaped lesions are treated; therefore, a new approach has been developed. The basic idea is to target the tumor from different angles in order to focus the radiation on the lesion, but at the same time spare the OARs. Due to the complexity of the process, it is managed by algorithms that take into account the target dose prescription and OAR dose limits.

This method is called “inverse planning”, where the algorithm modulates beams in order to accomplish the target/OAR goals. The inverse planning can be achieved in several ways such as the step-and-shoot radiotherapy, intensity-modulated radiation therapy (IMRT) and, in the last decade, volumetric-modulated arc therapy (VMAT).

However, therapeutic plans computed by the means of these innovative software are based on fixed images of the patients and do not take into account the natural organ motion. For example, in the case of lung cancer, the non-controlled or poorly managed motion due to respiration could lead to an incomplete curative session. Contrarily, in the case of left-breast cancer, the left anterior descending (LAD) artery could receive a harmful dose.

Regarding this, an important challenge in recent years has been the attempt to minimize damage related to the patient's breathing for targets such as the lung and breast, as well as the organ motion for targets such as the prostate and liver.

In this Special Issue, we want to depict the most innovative techniques, as well as software/hardware methods applied in radiotherapy.

Dr. Rosario Megna
Dr. Marcello Serra
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• innovative techniques
• cancer treatment
• radiation therapy