Principles and Practice of Radiation Oncology [antikvár]

PREFACE Radiation oncology is a discipline of humán medicine which addresses the causes, prevention, and treatment of humán cancer with special emphasis on the role of ionizing radiation. Approximately 60% of all cancer patients receive radiation therapy as a component of their treatment. 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 limited to the local region and 30% have metastases at the time of initial presentation. Of those who present with locoregional disease, 56% will be cured and 44% will develop recurrent cancer. Unfortunately, at the present time, 60% of the patients who die of or with cancer have persistent locoregional tumors. A substantial portion of the resources in cancer care are devoted to control of the locoregional tumor, and we should optimize use of radiation therapy in these patients. The management of the cancer patient involves a complex and close integration of biological and physical sciences in conjunction with sound clinical principles to obtain the best possible therapeutic results. The fourth edition of Principles and Practice ofRadiation Oncology is designed to provide the reader with a definitive, authoritative, and comprehensive review of the subject. The addition of two new editors to the book engendered a thoughtful review of the mission and vision of the text. A thorough restructuring of the chapters, their subject matter, and their authorship will, we hope, meet with the approval of our worldwide readership. There has been a generál evolution of our basic biologic understanding of ionizing radiation and its interactions with living tissue. Increasingly, the discipline of radiation biology has become embedded into a more catholic view of the role of radiation within the field of fundamental cancer biology. The fourth edition addresses the basic science of oncology with new chapters on molecular cancer biology, radiation biology, and the pathophysiology of solid tumors. Changes in the technology of radiation therapy have prompted us to expand our treatment of medical radiation physics. In addition to updated treatments of the standard topics of photon and electron beam dosimetry and treatment planning, new material has been added which comprehensively addresses three-dimensional conformal therapy and intensity modulated radiation therapy treatment planning. We have alsó called upon our team of authors to thoroughly update the chapters concerning techniques, modalities, and modifiers in radiation oncology. The reader will find a brand new chapter on the methodology of clinical trials- essential to the clinician's ability to appreciate evidence-based medicine. We have alsó added entirely new treatments of intraoperative radiation therapy and hyperthermia. The consistent evolution of clinical radiation oncology, abetted by multiple clinical trials, has prompted us to provide the fourth edition with a totally revised treatment of clinical radiation oncology. 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 treatment techniques and results. 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 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. The old chapter on Kaposi's sarcoma in the setting of Acquired Immuné Deficiency Syndrome (AIDS) has been replaced with a more complete treatment of malignant neoplasms associated with AIDS. We have alsó added an entirely new chapter on the role of combined radiotherapy and chemotherapy in the management of locally advanced squamous cell carcinoma of the head and neck. The treatment of breast cancer has been divided into three chapters which now provides adequate space to address the complexities of treatment of Tis tumors, T1-T2 tumors, and locally advanced malignancies. A fine new chapter on tumors of the liver and hepatobiliary tract has been provided by contributors from Taiwan. The constantly evolving treatment of lymphoma, hematologic malignancies, and pediatric cancers has received particular attention. An outstanding revised chapter on Hodgkin's disease compliments the fourth edition of this book as well as an exhaustive new chapter on non-Hodgkins lymphoma. New to the fourth edition is a chapter on the role of radiation therapy in the treatment of aduit and childhood leukemias.