Preface

Chapter 8 **Actinic Papillary Fibroelastoma of the Left Ventricle 125** Tomás Francisco Cianciulli and María Cristina Saccheri

**VI** Contents

The increasing numbers reflect improvement all over the cancer continuum, which includes early detection, supportive care, and therapeutic approaches. Despite the considerable mo‐ mentum that the topic of cancer survivorship has gained in the last few decades, an enor‐ mous amount of work remains to be done to achieve success throughout the cancer trajectory, which is detailed in the enclosed articles. This edition on cancer survivorship is the first issue in the IntechOpen Series, with its broad spectrum of articles devoted to cancer survivorship, and will provide an important update to survivors, clinicians, and researchers. When we initiated setting up the special edition, there were no previous examples to pursue and we were privileged that our editor-in-chief, Professor Dil Afroze, provided us the op‐ portunity to complete the book. Moreover, this issue will continue to provide the field with the attention that it so importantly deserves. Because cancer is becoming a chronic condition itself and the prevalence of chronic conditions in the world population is at an all-time high, this book aims to provide state-of-the-art articles on topics important to the management of cancer clinically and answer some of the questions related to the interface of cancer and co‐ morbidity that oncology practitioners face every day. We were directed by a number of principles, including that the articles should be evidence based, of the highest quality, and understandable by the practicing clinicians and oncologists. We also desired to guarantee that past advances at the molecular–clinical interface were covered, and that authors were also provided an opportunity to speculate on future opportunities. The resulting edition is a marvelous compendium of eight articles that cover a wide range of topics, including breast cancer: management and survivorship, rectal cancer intersphincteric resection, head and neck cancer diagnosis and radiotherapy, synthetic peptides as antitumor agents, and recent advances in thyroid cancer. It has been a wonderful opportunity to co-edit this special edi‐ tion. We are greatly appreciative of the work of all the contributors to the book who brought with them tremendous diversity of perspectives and fields truly reflective of the complexity of the topic and who, through coming together in this project, serve as the nidus of the mul‐ tidisciplinary collaboration in this field. Finally, we must acknowledge the thousands of can‐ cer patients who have participated in the studies that have provided the information that has advanced the field so greatly in recent years.

> **Dr. Dil Afroze** Professor and Head Advanced Centre for Human Genetics Sher-i-Kashmir Institute of Medical Sciences Soura-190011, Srinagar, J&K, India

**Chapter 1**

**Provisional chapter**

**Overview of Important "Organs at Risk" (OAR) in**

**Overview of Important "Organs at Risk" (OAR) in** 

Trinanjan Basu and Nithin Bhaskar

Trinanjan Basu and Nithin Bhaskar

http://dx.doi.org/10.5772/intechopen.80606

**Abstract**

**1. Introduction**

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

**Modern Radiotherapy for Head and Neck Cancer (HNC)**

With the advent of highly conformal and adaptive radiotherapy techniques, the significance of accurate delineation of organs at risk (OARs) is becoming more and more important. Techniques such as Intensity modulated radiotherapy (IMRT) and intensity/ volumetric modulated arc therapy (VMAT) has allowed for improved dose conformation within the target. It has also allowed for steep dose gradients around the target for better normal tissue sparing. The accurate contouring and delineation of the OARs are thus warranted as variation in delineation has been systematically reported in studies. All these facts have led to the development of contouring guidelines for OARs in various sites. Head and neck cancers (HNC) are a perfect example where outcome and quality of life (QOL) balance remains a therapeutic challenge. There are several OARs and thus the accurate delineation following a standard guideline becomes more important. This chapter looks into the published guidelines for the delineation of such structures.

The variation in the contouring and delineation of the different OAR's has been systematically reported in studies [1]. We will be discussing the standard available guidelines and a simple practical way to delineate OAR's in modulated radiotherapy for HNC. The OAR's have been divided into five subgroups viz. optic structures, salivation related structures,

**Keywords:** head and neck cancer, IMRT, VMAT, QOL, organs at risk

structures related to swallowing, brachial plexus and intra-cranial structures.

**Modern Radiotherapy for Head and Neck Cancer (HNC)**

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.80606

**Chapter 1 Provisional chapter**

#### **Overview of Important "Organs at Risk" (OAR) in Modern Radiotherapy for Head and Neck Cancer (HNC) Overview of Important "Organs at Risk" (OAR) in Modern Radiotherapy for Head and Neck Cancer (HNC)**

DOI: 10.5772/intechopen.80606

Trinanjan Basu and Nithin Bhaskar Trinanjan Basu and Nithin Bhaskar

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80606

#### **Abstract**

With the advent of highly conformal and adaptive radiotherapy techniques, the significance of accurate delineation of organs at risk (OARs) is becoming more and more important. Techniques such as Intensity modulated radiotherapy (IMRT) and intensity/ volumetric modulated arc therapy (VMAT) has allowed for improved dose conformation within the target. It has also allowed for steep dose gradients around the target for better normal tissue sparing. The accurate contouring and delineation of the OARs are thus warranted as variation in delineation has been systematically reported in studies. All these facts have led to the development of contouring guidelines for OARs in various sites. Head and neck cancers (HNC) are a perfect example where outcome and quality of life (QOL) balance remains a therapeutic challenge. There are several OARs and thus the accurate delineation following a standard guideline becomes more important. This chapter looks into the published guidelines for the delineation of such structures.

**Keywords:** head and neck cancer, IMRT, VMAT, QOL, organs at risk

#### **1. Introduction**

The variation in the contouring and delineation of the different OAR's has been systematically reported in studies [1]. We will be discussing the standard available guidelines and a simple practical way to delineate OAR's in modulated radiotherapy for HNC. The OAR's have been divided into five subgroups viz. optic structures, salivation related structures, structures related to swallowing, brachial plexus and intra-cranial structures.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
