Principles of Neuro-Oncology
The only book to provide comprehensive coverage of all the clinical management strategies of tumors afflicting the nervous system! Provides the best and most logical synthesis between clinical information and the molecular and basic science principles of these diseases. With a strong focus on radiation therapy, this text features management guidelines for treatment, including dosages and preferred combination of chemotherapeutic drugs as well as coverage of patient follow-up care.
|Pubblicato:||2005 Hardback, 832 pages|
Genetic and molecular underpinnings Neuropathology
Principles of radiotherapy and radiosurgery
Principles of chemotherapy
Supportive care (corticosteroids, anticonvulsants, anticoagulants)
Oligodendrogliomas and mixed gliomas
Primary central nervous system lymphoma
Primary meningeal tumors
Primitive neuro-ectodermal tumors
Ependymomas & intraventricular tumors
Primary tumors of cranial nerves/skull base
Germ cell and pineal region tumors
Tumors associated with phakomatoses
Spinal cord and root tumors
Peripheral nerve tumors
Leptomeningeal disease and skull/dural mets
Indirect complications of cancer
Neuro complications of chemotherapy
Neuro complications of radiation therapy
Principles of Neuro-Oncology covers neuro-oncology in a thoughtful, methodical, and comprehensive manner. I found it easy and interesting enough to read that I finished the entire book over one weekend. The book clearly explained basic principles and laid out scientific rationale for future research. It is full of sound, up to date clinical advice that should be useful for residents, fellows, and even experienced clinicians.
The first section reviews pathology, translational applications from molecular biology, diagnostic workup, hereditary disorders, neuroimaging, and neuropathology, and then covers basic principles of surgery, radiation treatment, chemotherapy, supportive care, neuropsychiatric care, and trial design. Each section was well written and organized.
The second section of the book includes individual chapters that cover high-grade and low-grade astrocytomas, oligodendrogliomas/mixed tumors, brainstem gliomas, CNS lymphomas, meningeal neoplasms, pituitary/sellar tumors, PNETs, ependymomas/ventricular tumors, cranial-nerve/skull-base tumors, germ-cell tumors, spinal tumors, and spinal-root/peripheral nerve tumors. Each of these chapters struck a balance between thoroughness and brevity. However, the pituitary/sellar tumor chapter could have used a more thorough and balanced discussion of radiotherapy. For example, in discussing nonfunctional pituitary adenomas, the authors state: “In many cases, repeat transsphenoidal surgery for debulking is recommended before radiation therapy for cytoreduction and to ensure a margin of safety in targeting the tumor during radiation therapy (the tumor should be at least 3 mm away from the optic chiasm before administering radiation therapy).” The statement in parentheses needs to be put in context with a more thorough discussion of radiotherapy and radiosurgery. The authors should have explained that no clear evidence indicates that doses above 45 Gy in 25 fractions (which the optic chiasm can tolerate) lead to any better tumor control and that increasing the distance between tumor and chiasm from 1 mm to 3 mm provides an advantage only if IMRT or radiosurgery techniques can reduce the optic chiasm dose. Even then, most of the advantage lies in leaving room for repeat radiation, if it is needed in the future.
The last section includes chapters covering CNS metastases, paraneoplastic syndromes, and complications of radiotherapy. All were extremely well written.
In summary, editors Schiff and O’Neill, together with their co-contributors, have put together a comprehensive but readily available reference work for neuro-oncology. I recommend it to radiation oncology, neuro-oncology, and neuro-surgery residents, fellows, and experienced clinicians alike.