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In the past 10 to IS years there has been dramatic improvement in the survival of children with acute lymphoblastic leukemia. At the present time, over 50% of children with this disease will be alive and free of their disease at least 5 years from the time of their initial diagnosis. Although a number of factors have contributed to this improvement, perhaps none has been as important as the institution of central nervous system preventive therapy (eNS prophylaxis). However, despite the efficacy of eNS prophylaxis, the prevention and treatment of central nervous system leukemia continues to pose a formidable clinical challenge to the pediatric oncologist. Although successful in most cases, eNS preventive therapy remains ineffective for a small but significant subset of patients at high risk for developing eNS disease. Moreover, it has become increasingly evident that some methods of eNS preventive therapy are associated with long-term, adverse eNS sequelae. Thus, considerable controversy exists regarding the optimal method of eNS prophylaxis. Treatment of the patient who develops overt meningeal leukemia has not been as successful and continues to pose a major clinical challenge. Despite the ability of intrathecal chemotherapy and/or radiation therapy to induce eNS remission, most patients suffer subsequent relapse and ultimate survival is usually signifi cantly compromised. It is evident that newer approaches to treatment for this patient group must be identified before major improvement for this patient group is likely to occur.
Neuro-oncology has evolved substantially as a clinical and research discipline over the past few decades. Cancer Neurology in Clinical Practice: Neurologic Complications of Cancer and its Treatment, Second Edition provides clinicians from various backgrounds and levels of training with a reference to help focus the differential diagnosis, treatment strategy, and management plan for the cancer patient with neurologic symptoms and findings. The volume begins with an overview of the field of neuro-oncology and a review of the role of neuroimaging in the diagnosis of neuro-oncologic disease. Several chapters on interpretation and management of common neuro-oncologic symptoms follow. Subsequent sections contain chapters on the direct and indirect neurologic complications of cancer as well as complications of therapy. The final section focuses on the spectrum and management of neurologic disease in patients with cancer of specific organs. Cancer Neurology in Clinical Practice: Neurologic Complications of Cancer and its Treatment, Second Edition is an important new work that aims to broaden and deepen the familiarity of clinicians with the range and management of neuro-oncologic diseases in order to improve the quality of care for cancer patients.
This book provides a comprehensive and up-to-date review of all aspects of childhood Acute Lymphoblastic Leukemia, from basic biology to supportive care. It offers new insights into the genetic pre-disposition to the condition and discusses how response to early therapy and its basic biology are utilized to develop new prognostic stratification systems and target therapy. Readers will learn about current treatment and outcomes, such as immunotherapy and targeted therapy approaches. Supportive care and management of the condition in resource poor countries are also discussed in detail. This is an indispensable guide for research and laboratory scientists, pediatric hematologists as well as specialist nurses involved in the care of childhood leukemia.
Since the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits. At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on childrenâ (TM)s health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas.
This updated edition remains the essential text for pathologists seeking to make accurate diagnoses from the vast number of differentials.
The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.
Brain metastases are the most dreaded complication of systemic cancer, affecting some 170,000 people a year, a far greater incidence than primary brain tumors. This book presents current information on the presentation and management of patients with brain metastases, providing available data, giving guidelines that can be applied in day to day practice, updated information for neurosurgeons, radiation oncologists, medical oncologists, and neuron-oncologists, and as an overview for physicians in training.
This book reviews the principles and applications of radiotherapy in the management of pediatric brain tumors to allow the reader to gain a full appreciation of the major aspects involved in caring for these patients. Individual sections are devoted to basic principles, specific management for the full range of tumor entities, radiotherapy techniques, and potential toxicities and their management. The book is written and edited by world leaders in pediatric radiotherapy, and care has been taken to cover the latest advances in diagnosis and radiotherapy techniques. Pediatric brain tumors represent a diverse group of neoplasms that require carefully planned management for successful definitive treatment. Radiotherapy is one of the fundamental components in treatment for the majority of these vulnerable patients. The optimal radiation therapy approach will depend on multiple factors, including tumor type and location, extent of disease, age of the patient, and other therapies. A thorough understanding of the natural history of the disease, communication with the multidisciplinary team, full knowledge of available radiotherapy techniques, and consideration of potential acute and late toxicities are therefore essential for each patient.
In the past 10 to IS years there has been dramatic improvement in the survival of children with acute lymphoblastic leukemia. At the present time, over 50% of children with this disease will be alive and free of their disease at least 5 years from the time of their initial diagnosis. Although a number of factors have contributed to this improvement, perhaps none has been as important as the institution of central nervous system preventive therapy (eNS prophylaxis). However, despite the efficacy of eNS prophylaxis, the prevention and treatment of central nervous system leukemia continues to pose a formidable clinical challenge to the pediatric oncologist. Although successful in most cases, eNS preventive therapy remains ineffective for a small but significant subset of patients at high risk for developing eNS disease. Moreover, it has become increasingly evident that some methods of eNS preventive therapy are associated with long-term, adverse eNS sequelae. Thus, considerable controversy exists regarding the optimal method of eNS prophylaxis. Treatment of the patient who develops overt meningeal leukemia has not been as successful and continues to pose a major clinical challenge. Despite the ability of intrathecal chemotherapy and/or radiation therapy to induce eNS remission, most patients suffer subsequent relapse and ultimate survival is usually signifi cantly compromised. It is evident that newer approaches to treatment for this patient group must be identified before major improvement for this patient group is likely to occur.
This book provides a comprehensive overview of brain metastases, from the molecular biology aspects to therapeutic management and perspectives. Due to the increasing incidence of these tumors and the urgent need to effectively control brain metastatic diseases in these patients, new therapeutic strategies have emerged in recent years. The volume discusses all these innovative approaches combined with new surgical techniques (fluorescence, functional mapping, integrated navigation), novel radiation therapy techniques (stereotactic radiosurgery) and new systemic treatment approaches such as targeted- and immunotherapy. These combination strategies represent a new therapeutic model in brain metastatic patients in which each medical practitioner (neurosurgeon, neurologist, medical oncologist, radiation oncologist) plays a pivotal role in defining the optimal treatment in a multidisciplinary approach. Written by recognized experts in the field, this book is a valuable tool for neurosurgeons, neuro-oncologists, neuroradiologists, medical oncologists, radiation oncologists, cognitive therapists, basic scientists and students working in the area of brain tumors.