Principles and Practice of Radiation Oncology [antikvár]

Approximately 60% of all cancer patients in the United States receive radiation therapy each year as therapy or for palliation, or as an adjunct to surgery or chemotherapy. In 1997, according to American Cancer Society estimates, 1.4 millión new cases of invasive cancer, 50,000 new cases of carcinoma in situ of the uterine cervix, 35,000 new cases of carcinoma in situ of the female breast, and 900,000 new cases of nonmelanomatous skin cancer were diagnosed in the United States. Approximately 70% of patients with invasive cancer present with disease apparently limited to the local region; 30% have metastases at the time of the initial presentation. Of those who present with locoregional disease, 56% will be cured and 44% will develop recurrent cancer. Unfortunately, at the present time 67% of the patients who die of or with cancer have persistent locoregional tumors. A substantial portion of the resources in cancer care is devoted to control of the locoregional tumor, and we should optimize use of radiation therapy in these patients. Management of the patient with cancer has evolved into a complex and close integration of fundamental concepts and sophisticated technology to evaluate and stage the tumor and, using various modalities, to obtain the best therapeutic results, emphasizing the quality of life of the patient. The third edition of Principles and Practice of Radiation Oncology is designed to provide a better understanding of the natural history of cancer, the physical methods of radiation application, the effects of irradiation on normál tissues, and the most judicious ways in which radiation therapy can be employed in the treatment of any particular patient, either as a single modality or as part of a multimodality treatment program. Chapters on basic radiation biology, radiation therapy physics and treatment planning, multimodal integrated programs for patient management, and such technical applications of irradiation as electron beam therapy, low- and high-dose rate brachytherapy, and high linear energy transfer radiations have been updated to incorporate newer concepts and solidify the basic foundations of clinical radiation oncology. Chapters reflecting recent technologic advances in totál body and hemibody irradiation, threedimensional and intensity-modulated conformal irradiation, concomitant chemotherapy and irradiation, stereotactic irradiation, and the physical aspects and clinical applications of remote control high-dose rate afterloading brachytherapy have been expanded substantially. To allow for more in-depth coverage of the subjects, new chapters on palliation of various lesions are included. To emphasize supportive and palliative care of patients with cancer, an excellent new chapter on pain management was added. The third edition alsó contains two excellent chapters on normál tissue effects of irradiation. The chapters discussing disease by anatomic site cover relevant background information on each tumor, including epidemiology, pathology, diagnostic workup, prognostic factors, treatment techniques, applications of surgery and chemotherapy, end results of treatment, and pertinent clinical trials. This edition was extensively revised to include updated reports on new techniques and results. We recognize that there is a great deal of individuality in the techniques of irradiation. We have attempted to include descriptions of various technical approaches, leaving to the individual reader the critical task of selecting the most appropriate one for the particular patient under consideration. The comprehensive and rigorous assessment of each tumor site set forth in this text provides the foundation for proper application of radiation therapy techniques and multimodal programs in the treatment of patients with cancer. We sincerely hope that Principles and Practice of Radiation Oncology will continue to advance clinical and research activities in cancer management and will be an invaluable resource to the student and the practitioner of oncology. It is our expectation that this updated and expanded edition will foster new knowledge that will improve delivery of radiation therapy and ultimately will result in a reduction in the time lost from other activities, in cost to the health care system, and in the humán suffering occasioned by cancer.