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Treatment of patients with intracranial gliomas, especially high-grade neoplasms, usually requires postoperative adjuvant therapy. Significant progress in the understanding of tumor biology, technological advances in irradiation delivery, and development of novel antitumor drugs have led to an expansion of the therapeutic arsenal in neuro-oncology. This publication provides a unique review of the various options for adjuvant therapy. Special emphasis is on current evidence-based treatment standards and guidelines, and on perspectives of further improvement in long-term outcomes. Chapters review the histopathological and molecular features of gliomas and describe basic principles and clinical results of fractionated radiotherapy, stereotactic radiosurgery, brachytherapy, use of radiosensitizers, systemic chemotherapy and antiangiogenic therapy. Particular attention is paid to treatment of pediatric patients and to physical and psychological rehabilitation and supportive care at the end of life. This book and its accompanying volumes are mainly directed at neuro-oncologists, radiation oncologists, and other clinicians treating patients with brain tumors.
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
Non-thermal irreversible electroporation is a new minimally invasive surgical p- cedure with unique molecular selectivity attributes – in fact it may be considered the first clinical molecular surgery procedure. Non-thermal irreversible electro- ration is a molecular selective mode of cell ablation that employs brief electrical fields to produce nanoscale defects in the cell membrane, which can lead to cell death, without an effect on any of the other tissue molecules. The electrical fields can be produced through contact by insertion of electrode needles around the undesirable tissue and non-invasively by electromagnetic induction. This new - dition to the medical armamentarium requires the active involvement and is of interest to clinical physicians, medical researchers, mechanical engineers, che- cal engineers, electrical engineers, instrumentation designers, medical companies and many other fields and disciplines that were never exposed in their training to irreversible electroporation or to a similar concept. This edited book is designed to be a comprehensive introduction to the field of irreversible electroporation to those that were not exposed or trained in the field before and can also serve as a reference manual. Irreversible electroporation is broad and interdisciplinary. Therefore, we have made an attempt to cover every one of the various aspects of the field from an introductory basic level to state of the art.
At present most intracranial gliomas are considered incurable with current treatment strategies, and the search for new modalities that may effectively control tumor growth continues. The chapters in this volume describe basic principles and therapeutic possibilities of several innovative techniques, including photodynamic therapy, laser-induced interstitial thermotherapy, stereotactic cryodestruction, high-intensity focused ultrasound ablation, boron neutron capture therapy, proton and carbon ion irradiation, targeted therapy, immunotherapy, gene therapy, local chemotherapy, and alternating electric fields therapy. Potential applications of extracellular vesicles and nanotechnology for management of gliomas are highlighted as well. Many of these methods have already demonstrated antitumor efficacy in clinical testing, whereas others are still under development. The materials presented in this book are mainly directed at clinicians treating patients with brain tumors, as well as clinical and basic researchers working in the field of neuro-oncology.
This book is a practical, up-to-date guide to the treatment of patients with brain and spinal tumors. Leading experts in the field explain treatment techniques in detail, highlighting key considerations in the use of external beam radiation therapy, intensity-modulated radiation therapy, particle therapy, radiosurgery, and stereotactic body radiation therapy. Specific recommendations are described for different tumor types, and helpful information provided on other important issues, such as the interaction of radiotherapy and systemic therapy and the avoidance of treatment complications. With the development of modern technology, highly conformal radiotherapy techniques have become more complicated, yet also more widely employed. This book will equip readers with the knowledge required to set up practices to deliver quality brain and spinal radiation therapy appropriate to each patient. It will be of benefit to radiation oncologists, clinical oncologists, medical physicists, medical dosimetrists, radiation therapists, and senior nurses as well as medical oncologists and surgical oncologists with an interest in radiotherapy.
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.
Proton and Carbon Ion Therapy is an up-to-date guide to using proton and carbon ion therapy in modern cancer treatment. The book covers the physics and radiobiology basics of proton and ion beams, dosimetry methods and radiation measurements, and treatment delivery systems. It gives practical guidance on patient setup, target localization, and treatment planning for clinical proton and carbon ion therapy. The text also offers detailed reports on the treatment of pediatric cancers, lymphomas, and various other cancers. After an overview, the book focuses on the fundamental aspects of proton and carbon ion therapy equipment, including accelerators, gantries, and delivery systems. It then discusses dosimetry, biology, imaging, and treatment planning basics and provides clinical guidelines on the use of proton and carbon ion therapy for the treatment of specific cancers. Suitable for anyone involved with medical physics and radiation therapy, this book offers a balanced and critical assessment of state-of-the-art technologies, major challenges, and the future outlook of proton and carbon ion therapy. It presents a thorough introduction for those new to the field while providing a helpful, up-to-date reference for readers already using the therapy in clinical settings.
This book presents the latest research pertaining to the diagnosis, therapy and management of diffuse low-grade gliomas (DLGG) in adults, with a particular focus on the path towards individualised therapy for this kind of tumour. Recent research on the natural history of DLGGs and their interaction with the brain has led to new diagnostic and therapeutic strategies which increase survival and quality of life of the patient, and these methods are described in this book.