Although you should never judge a book by its cover, the new second edition of ‘Radiotherapy principles to practice’ by Sue Griffiths is a welcome sight. It is shiny, square-edged and pristine, lacking the characteristic well-thumbed appearance of its predecessor with its folded down corners, highlighter marks, coffee stains and other assorted evidence of abuse. But the tatty appearance of most first edition issues demonstrates the book's original appeal. It has long been valued as one of the few hallowed ‘standard’ texts in radiotherapy with its clear explanations and wide-ranging discussion of quality issues in practice. So has the second edition anything else to offer?
When reading the new edition, it is immediately apparent that the author's distinctive clear writing style, useful diagrams, structure and patient-focus have thankfully been retained. The contents though, mirroring the radiotherapy world, have undergone drastic upheaval, expansion and restructuring to reflect changes in technology and practice. Most highly evident, perhaps, is the increased emphasis on imaging, which thanks to some restructuring and additional material can now boast an entire section instead of a mere chapter. Clearly responding to NRAG recommendations, this somewhat expanded section includes details of IGRT practice, including cone-beam and tomotherapy equipment. Another relevant expanded area is that of hadron therapy, which again receives more attention with a chapter on physical aspects and another on practical issues with interesting examples from clinical facilities around the world. This topic could perhaps have benefited from some more quality implications and more details on use of protons and light ions. But given the novelty, complexity and relative scarcity of the equipment this is understandable. The techniques and equipment discussed and evaluated range from the traditional to cutting edge and it is good to see that both are used to illustrate key quality issues. It is interesting to note that the original edition denoted conformal therapy as a ‘sophisticated technique’. The inclusion of 4D and adaptive radiotherapy demonstrates how rapidly technology and practices are progressing. The patient immobilisation devices are appraised in detail and have been updated to include new materials and techniques. In particular, there is clear consideration of both patient and target tissue positioning and corresponding evaluation of methods to stabilise both. Immobilisation and treatment techniques from a range of clinical centres are combined with recommendations from literature to illustrate points throughout. The breast section, for example, features different beam matching systems and different patient positioning protocols, making the book valuable to any department. The range of techniques covered is impressive and the technique-specific quality issues are fully explained and appraised. The final section on management issues also reflects the change in the profession with the four-tier structure, returners and expert practice all featuring while maintaining the emphasis on safety that is so relevant to today's environment.
To highlight all the updates and changes would warrant an edition of JRP in itself, but the second edition clearly presents a modern and relevant approach to quality. The text features useful diagrams and photos with a selection of colour images depicting isodoses and PET scans clearly. The accompanying CD adds further value with video clips and animations of novel treatment approaches and 4D target motion. The large range of useful references are now all collated into a large section at the end rather than after each chapter, making the work more concise and the sources easier to access. The literature used features a range from essential landmark articles to the most recent research.
Such a large scope covering quality and practical issues from across the full range of modern radiotherapy practice is a momentous undertaking. This either demands production of a family-sized textbook that can double as a step stool or the ability to summarise issues with clarity and focus. This book benefits from the latter approach, being large enough to be useful but with minimal risk of spinal injury from use. Where explanations are necessarily brief, the author makes good use of referencing to direct the reader to key essential further reading. In summary, the revised second edition should maintain its status as a well-respected and valuable text. The updates and restructuring align it strongly with trends in current practice and it is to be recommended as essential reading for anyone striving to improve quality of treatment delivery.
