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This is truly an exciting time in the field of neuro-oncology, particularly in the area of hi- grade gliomas. The management of patients with high-grade gliomas has historically been one of the most challenging and disheartening fields in medicine, where failure is the rule and longevity is the exception. The jaded often state that despite purported advances in surgical and radiotherapeutic techniques and a myriad of clinical trials of medical therapies, the s- vival statistics for glioblastoma have not changed in the last three decades. The nihilism associated with these tumors is such that some practitioners still advise against treatment or even biopsy, recommending palliative care with the diagnosis based only on history and an MRI scan. If the current state-of-the-art in the diagnosis and management of high-grade gliomas was truly so bleak, there would be no reason to compile and publish a monograph on the subject. The fact is that we have recently entered an era where real progress is being made in our understanding and treatment of high-grade gliomas that is directly benefiting some patients. We are slowly but surely chipping away at this problem. One approach has exploited correlations between particular molecular markers and therapeutic response. The first such “breakthrough” in high-grade glioma was the observation that loss of chromosomes 1p and 19q uniformly predict chemosensitivity in anaplastic oligodendrogliomas (1).
This book is a comprehensive and up-to-date compendium of all aspects of brain tumors in children. After introductory chapters on the epidemiology of brain tumors, the book will provide readers with state-of-the art chapters on the principals of radiation therapy, neurosurgery and neuroimaging. Subsequent chapters discuss the biology and treatment of specific types of brain tumors. The concluding chapters present critical information relevant to survivorship, neurocognitive and other late effects, and the global challenges to better diagnosis and treatment of brain tumors in children. This book is co-authored by experts in the treatment of pediatric brain tumors. All of the authors are internationally recognized authorities and they offer an evidence-based consensus on the biology and treatment of brain tumors. This handbook has far-reaching applicability to the clinical diagnosis and management of brain tumors in children and will prove valuable to specialists, generalists and trainees alike.
This atlas is a detailed guide to the imaging appearances of gliomas following treatment with neurosurgery, radiation therapy, and chemotherapy. Normal and pathological findings are displayed in detailed MR images that illustrate the potential modifications due to treatment. Particular emphasis is placed on characteristic appearances on the newer functional MR imaging techniques, including MR spectroscopy, diffusion-weighted imaging, and perfusion imaging. These techniques are revolutionizing neuroradiology by going beyond the demonstration of macroscopic alterations to the depiction of preceding metabolic changes at the cellular and subcellular level, thereby allowing earlier and more specific diagnosis. A key section comprising some 40 clinical cases and more than 500 illustrations offers an invaluable clinical and research tool not only for neuroradiologists but also for neurosurgeons, radiotherapists, and medical oncologists.
New Techniques for Management of 'Inoperable' Gliomas radically challenges the assumption that certain gliomas cannot be removed with modern techniques, contesting stereotypical thinking and establishing new paradigms in the field. Gliomas are primary brain tumors which are often fatal. Recent data has demonstrated that despite the fact that surgery cannot cure gliomas, patient survival is substantially improved by removing as much of the tumor as possible. This fact has raised the imperative that neurologists try to improve techniques to bring surgical resection to as many patients as possible. This book brings new insights and technologies to the forefront, giving hope to patients. - Provides the first comprehensive book to discuss techniques for removing gliomas that are traditionally deemed 'inoperable' - Presents a great reference tool that challenges stereotypical thinking by offering techniques by innovative surgeons - Includes chapters that are organized by different glioma types and surgery/techniques
This book describes the basics, the challenges and the limitations of state of the art brain tumor imaging and examines in detail its impact on diagnosis and treatment monitoring. It opens with an introduction to the clinically relevant physical principles of brain imaging. Since MR methodology plays a crucial role in brain imaging, the fundamental aspects of MR spectroscopy, MR perfusion and diffusion-weighted MR methods are described, focusing on the specific demands of brain tumor imaging. The potential and the limits of new imaging methodology are carefully addressed and compared to conventional MR imaging. In the main part of the book, the most important imaging criteria for the differential diagnosis of solid and necrotic brain tumors are delineated and illustrated in examples. A closing section is devoted to the use of MR methods for the monitoring of brain tumor therapy. The book is intended for radiologists, neurologists, neurosurgeons, oncologists and other scientists in the biomedical field with an interest in neuro-oncology.
Provides a summary of glioma biology, genetics and management, based on the world-leading Duke University Preston Robert Tisch Brain Tumor Center program.
This volume provides an introduction to the essential techniques required for studying the molecular biology of brain disease. The approaches and strategies for investigations of gene structure and regulation are described with reference to the molecular genetics of prion and Alzheimer's disease. The effects of aberrant gene regulation can also be examined at the protein level by immunocytochemistry and autoradiography. Improved understanding of basic biology has resulted in new approaches to animal models using transgenic techniques and new therapeutic approaches. The volume is structured to illustrate all these approaches and demonstrate the practice and promise of molecular neuropathology.
This book, now in its second edition, provides a comprehensive overview of current re-irradiation strategies, with detailed discussion of re-irradiation methods, technical aspects, the role of combined therapy with anticancer drugs and hyperthermia, and normal tissue tolerance. In addition, disease specific chapters document recent clinical results and future research directions. All chapters from the first edition have been revised and updated to take account of the latest developments and research findings, including those from prospective studies. Due attention is paid to the exciting developments in the fields of proton irradiation and frameless image-guided ablative radiotherapy. The book documents fully how refined combined modality approaches and significant technical advances in radiation treatment planning and delivery have facilitated the re-irradiation of previously exposed volumes, allowing both palliative and curative approaches to be pursued at various disease sites. Professionals involved in radiation treatment planning and multimodal oncology treatment will find it to be an invaluable aid in understanding the benefits and limitations of re-irradiation and in designing prospective trials.