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͑hardcover/clothbound͒. Three-dimensional ͑3-D͒ conformal and intensity modulated radiation therapy ͑IMRT͒ are among the most important advances in the field of radiation therapy. However, as with most new technologies, education is paramount to the widespread and safe adoption of these techniques. In this book, which arose from a series of meetings in 1999, the editors draw upon experts from 21 institutions to educate both the new and experienced user on 3-D conformal therapy and IMRT. The book begins with a number of chapters that introduce the tools needed to successfully implement a conformal IMRT program-CT simulation, methods of treatment plan evaluation, imaging techniques, and incorporation of treatment uncertainties into the planning process. Next, chapters on multileaf collimators, dose calculation algorithms, and an introduction to computer optimization and objective functions are presented. A series of chapters address manufacturer specific issues related to both IMRT planning systems and commissioning linear accelerators for IMRT. These chapters are especially useful as they allow the reader to benefit from the experience of others who have used their particular system. While the first 70% of the book focuses on physics issues, the remainder of the book highlights clinical experiences from a number of centers. Primarily, these experiences focus on the treatment of prostate and head and neck cancers. Most of the information presented are toxicity and local control data from individual institutions. A few chapters show representative treatment plans and dose-volume histograms ͑DVHs͒. Unfortunately, there is little information on site-specific contouring, input DVHs and plan evaluation criteria that would be essential to physicians, physicists, and dosimetrists starting an IMRT program. In addition, the book highlights only a limited number of disease sites. As more data become available on the use of IMRT for lung, breast, gastrointestinal malignancies, female pelvis, lymphoma, and sarcoma, hopefully these will be incorporated in future editions. Overall, this is a well-organized book that combines the expertise of many authors who have published seminal papers on their individual topics. It is an important addition to the library of any physicist who would like to gain knowledge on 3-D conformal and IMRT techniques.

PurposeAccelerated partial breast irradiation (APBI) using a single-lumen device is associated with better cosmetic outcomes if the spacing between the applicator and skin is > 7 mm. However, there are no reports addressing the late toxicity and clinical outcomes in patients treated with single-entry multi-lumen/catheter applicators who had close skin spacing (7 mm or less). We undertook this study to report clinical outcome, acute and late toxicity as well as cosmesis of early stage breast cancer patients with close skin spacing treated with APBI using multi-lumen or multi-catheter devices.Material and methodsThis is a retrospective study of all breast cancer patients who had undergone APBI using single-entry multi-lumen/catheter devices in a single institution between 2008 to 2012. The study was limited to those with ≤ 7 mm spacing between the device and skin.ResultsWe identified 37 patients and 38 lesions with skin spacing of ≤ 7 mm. Seven lesions (18%) had spacing of ≤ 3 mm. Median follow-up was 47.5 months. There was one case of ipsilateral breast recurrence and one ipsilateral axillary recurrence. Based on RTOG criteria, 22 treated lesions experienced grade 1 and 9 lesions experienced grade 2 toxicity. Twenty-one lesions experienced late grade 1 toxicity. One patient had to undergo mastectomy due to mastitis. Twenty-four treated breasts showed excellent and 11 had good cosmetic outcome. Overall cosmesis trended towards a significant correlation with skin spacing. However, all patients with ≤ 3 mm skin spacing experienced acute and late toxicities.ConclusionsAccelerated partial breast irradiation can be safely performed in patients with skin spacing of ≤ 7 mm using single-entry multi-lumen/catheter applicators with excellent cosmetic outcomes and an acceptable toxicity profile. However, skin spacing of ≤ 3 mm is associated with acute and late toxicity and should be avoided if possible.