1. Human Biology
Radiobiology 1
Human Anatomy 1
Cell 4
Human Body Composition 9
Molecular Forces and Bonds 15
Tumor Biology 16

2. Radiation Physics
Atomic Structure 21
Electromagnetic Radiation 24
Radiation Units 26
Radiation Interaction with Tissue 27
Particle Interactions 34

3. Interaction of Radiation with Cell
Sequence of Radiation Events 38
Direct and Indirect Action 39
Radiolysis of Water 40
Characteristics of Actions of Radiation 42
Irradiation of Macromolecules 43
Effects of Radiation on Cell Division and Growth 47
Synchronous Cell Cultures 49
Radiation and Chromosome Damage 50
Biodosimetry 52

4. Cell Survival Curves
Radiation and Cell Death 54
Survival Fraction and Plating Efficiency 54
Survival Curve 55
Repair of Radiation Damage 61
Mechanism of Cell Death 63
Classification of Radiation Damage 65

5. Modification of Cell Survival Modifying Agents 68
Oxygen Effect 68
Relative Biological Effectiveness
Linear Energy Transfer 73
Cell Cycle Stage 76
Radiation Protectors 77
Radiation Sensitizers 79
Hyperthermia 80

6. Biological Effects of Radiation
Radiation Effects 84
Radiation Carcinogenesis 86
Heritable Effects 94

7. Normal Tissue Reactions of Radiation
Deterministic Effects 99
Radiation Effects on Tissues: Early and Late 99
Skin 101
Hematopoietic System 102
Gastrointestinal Tract 104
Reproductive Organs 105
Eye Lens 106
Other Tissues 107
Acute Radiation Syndrome 108
Radiation Effects on Embryo and Fetus 114

8. Biological Basis of External Beam Radiotherapy
Evaluation of Radiotherapy 120
Effect of Dose Fractionation on Cell Survival 121
Effect of Dose Rate on Cell Survival 122
Rationale for Fractionation in Radiotherapy 123
Dose-response Curves 127
Fractionation Strategies 130
Dose Fractionation Effects in External Beam Treatments 133

9. Biological Basis of Brachytherapy
Brachytherapy 135
LDR and HDR Brachytherapy 136
Dose Rate Effect in Brachytherapy 137
Role of 4 Rs in Brachytherapy 139
Clinical Implications 140
Therapeutic Ratio in Brachytherapy 144
Practical Issues in Radiotherapy 145

10. Time, Dose and Fractionation Models
Isoeffect Models 149
Cube Root Rule 149
Nominal Standard Dose 150
Cumulative Radiation Effect 151
Time-dose-fractionation Model 152
Linear Quadratic Model 153
Influence of Radiobiological Parameters 161
Dose-fractionation Effects in Gynecological Brachytherapy 162
Gaps in Radiation Treatment 164

11. Radiation Safety and Protection
Equivalent Dose and Effective Dose 168
Sources of Radiation 170
Principles of Radiation Protection 172
Regulatory Requirements 175
Personnel Monitoring 178

Index