The growing knowledge on tumor-immune response interactions and on the tumor microenvironment did not translate so far into better control of cancer by anti-tumor vaccination. The percentage of patients who benefited from vaccination strategies is still too small to justify their general use. It is the aim of this book to present an alternative to the conventional approach of developing injected tumor vaccines to activate anti-tumor immunity, which will fight cancer. It is argued that in situ tumor ablation (destruction) that involves tumor antigen release; cross presentation and the release of danger associated molecular patterns (DAMPs) can make the tumor its own cellular vaccine. Tumor ablation methods using chemicals, radiation, photodynamic therapy, cryoablation, high-temperature, radiofrequency, high intensity focused ultrasound, and electric-based ablation have been developed for focal tumors. In this book experts will deal with two main topics: I. What are the principles of the various ablation modalities, and II. How each method affects the tumor cells and their microenvironment, and how these effects are responsible for the induction of specific anti-tumor immunity. The aims of this book are thus: 1. Familiarize the readers with various methods of in situ tumor ablation. 2. Review the literature and stimulate comparisons on the efficacy of different ablation methods for the treatment of tumors of different histotypes. 3. Review the literature on the effects of various ablation methods on systemic and local anti tumor immunity and on other manifestations of the interactions of tumors with their microenvironment. 4. Stimulate comparative studies on the immunostimulatory effects of different ablation modalities.

The work describes a new method of sphincter salvage in surgery of rectal cancer. Low tumors of the rectum are traditionally treated with amputation of the rectum. However, this operation is not well-received by patients, since it results in a permanent colostomy. By contrast, intersphincteric resection allows sphincter salvage even in low tumors and is now widely accepted among experts in the field of colorectal surgery. The book will describe the basics (pathology,physiology, radiology) as well as the surgical technique and its different modifications.

The aim of this book is to provide a uniquely comprehensive source of information on the entire field of radiation therapy physics. The very significant advances in imaging, computational, and accelerator technologies receive full consideration, as do such topics as the dosimetry of radiolabeled antibodies and dose calculation models. The scope of the book and the expertise of the authors make it essential reading for interested physicians and physicists and for radiation dosimetrists.

Since the discovery of X-rays and radioactivity, ionizing radiations have been widely applied in medicine both for diagnostic and therapeutic purposes. The risks associated with radiation exposure and handling led to the parallel development of the field of radiation protection.
Pioneering experiments done by Sanche and co-workers in 2000 showed that low-energy secondary electrons, which are abundantly generated along radiation tracks, are primarily responsible for radiation damage through successive interactions with the molecular constituents of the medium. Apart from ionizing processes, which are usually related to radiation damage, below the ionization level low-energy electrons can induce molecular fragmentation via dissociative processes such as internal excitation and electron attachment. This prompted collaborative projects between different research groups from European countries together with other specialists from Canada, the USA and Australia.
This booksummarizes the advances achieved by these research groups after more than ten years of studies on radiation damage in biomolecular systems.

An extensive Part I deals with recent experimental and theoretical findings on radiation induced damage at the molecular level. It includes many contributions on electron and positroncollisions with biologically relevant molecules. X-ray and ion interactions are also covered. Part II addresses different approaches to radiation damage modelling. In Part III biomedical aspects of radiation effects are treated on different scales. After the physics-oriented focus of the previous parts, there is a gradual transition to biology and medicine with the increasing size of the object studied. Finally, Part IV is dedicated to current trends and novel techniques in radiation reserach and the applications hence arising. It includes new developments in radiotherapy and related cancer therapies, as well as technical optimizations of accelerators and totally new equipment designs, giving a glimpse of the near future of radiation-based medical treatments."

This book is based on contributions presented at the 1st World Congress on Gallium-68 and Peptide Receptor Radionuclide Therapy, which examined recent developments in theranostics - the emerging field of molecular targeting of vectors that can be used for both diagnosis and therapy, when modified accordingly. The focus of this book is on the rapidly developing research into and clinical applications of gallium-68 and other generator-produced PET radionuclides in the personalized diagnosis and treatment of neuroendocrine tumors and other diseases. In addition, new PET radiopharmaceuticals are considered, and the latest ideas and concepts, presented. Theranostics embodies both molecular and personalized medicine. It is at the cutting edge of medicine, and the contents of this volume will be of interest to chemists, physicians, and investigators dealing with generators, PET radiochemistry, molecular imaging, and radionuclide therapy.

Treatment tolerance is a challenge for most cancer patients, and it is therefore essential that healthcare professionals (HCPs) are quick to recognize adverse events and implement management strategies to address them. Prevention of Nausea and Vomiting in Cancer Patients provides comprehensive guidance on managing nausea and vomiting, which are common and often severe adverse events experienced by patients receiving chemotherapy and radiotherapy. The book refers to the latest American Society of Clinical Oncology (ASCO), European Society of Medical Oncology (ESMO), and Multinational Association for Supportive Care in Cancer (MASCC) guidelines and will be a useful resource for oncologists, oncology fellows, general physicians, and other HCPs wishing to learn more about the effective management of chemotherapy-and radiotherapy-induced nausea and vomiting in cancer patients.

The events of September 11,2001 in the United States will always be r~membered with horror and sadness but also admiration for those who risked, and often lost, their lives attempting to save others. When the Fifth International Germ Cell Tumour Conference began, the US air space was closed and our American friends were unable to join us. We were faced with a programme that now had many gaps. What happened next was an illustration of the sense of community that prevails at the Germ Cell Tumour Conferences. Some of those who could not be there in person, such as Richard Foster and Craig Nichols, sent their slides by email, and we were indebted to those, such as Michael Jewett, Ben Mead and Malcolm Mason, who stepped into the breach to present them. Others gave impromptu, and often thought provoking, talks. The discussion periods were lively and it will come as no surprise to those who regularly attend the meeting that Tim Oliver won the prize for "Most Questions Asked", managing even to ask questions following his own presentations. The quality of the talks was outstanding. There was closer integration of the adult and paediatric sessions than in previous meetings. As a result, the differences and similarities between adult male, female and paediatric germ cell tumours became more apparent. This cross-fertilization of ideas from different groups will no doubt lead to further advances. As a result of all these efforts, the conference was a great success.

Molecular Determinants of Radiation Response includes chapters by expert authors who detail the present understanding of key DNA damage response pathways and proteins. The chapters include comprehensive discussions on where and how specific alterations in function of these pathways and proteins result in substantive modifications of cellular response to DNA injury. Given the importance of therapies that induce DNA injury in the management of human disease, this book is timely and relevant for basic and translational researchers, as well as clinicians alike.

In a condition of such complexity as bronchial carcinoma and at a time when the scientist's understanding of malignant disease is still incomplete, it is inevitable that views within the medical profession will proliferate. This book is an attempt to assemble these views in the light of 33 years of surgical experience and is intended for those specialists who will be concerned with the diagnosis and treatment of lung cancer in the foreseeable future. The wide clinical experience of the contributing authors has ena bled every aspect of this disease to be considered, with emphasis being placed on diagnostic techniques such as CT scanning and fine needle transpleural biopsy, as well as on the latest method of treatment by lasers. Bronchial carcinoma remains the major cause of cancer death in the United Kingdom, accounting for 60Jo of all deaths. While the incidence has decreased slightly in the male population, there has been an equivalent increase in the female population.

During the past four decades knowledge about biological effects of ionizing radiations on mammalian cells, normal tissues and tumours has increased enormously and has enabled radiotherapists to obtain a better insight into the advantages and disadvantages of cancer treatments with modified regimens of irradiations and combinations with chemotherapeutic agents. Even for the older scientists and clinicians who have wit nessed all these developments and have contributed to the vast amount of information, it is difficult to integrate this knowledge and to apply it in their daily work. For younger workers it is often difficult to select the important main concepts and results from the overwhelming number of publications. It is evident that a book which provides an integrated view of basic and applied radiation oncology can be of great value to students, scientists and, most importantly, to clinicians who can devote only part of their time to the task of understanding the radiobiological background of their application of radiation in cancer treatment. This book "Radiation Oncology" is written by a radiotherapist who has for a long time participated in the integration of basic knowledge and clinical experience. He has selected radiobiological information which is considered important to radiotherapy and in the description and interpretation of normal tissue tolerance and tumour eradication probability, he illustrates how basic knowledge can be applied clinically."

The seventh annual multidisciplinary symposium on clinical oncology organised by the Royal College of Radiologists discussed the subject of malignant brain tumours. It was held in London in February 1985 and this volume collects together the edited texts of the papers which were presented at the meeting. Primary tumours of the central nervous system account for about 9070 of all malignant diseases but as much as 20% of all paediatric neoplasms. The prognosis ranges from excellent for some of the less aggressive tumours, through good for children's tumours such as medulloblastoma, to appalling for the high-grade adult astrocytomas. Improvements in pathological diagnosis and surgical and radiothera peutic techniques have led to considerable sequential improvements in outcome over those obtained in the past. In contrast the response to chemotherapy over the whole range of tumours remains disappoint ing, and clearly awaits new drugs and methods of delivery. The relative rarity of individual types of tumours, apart from the commoner high-grade adult astrocytomas, has made progress in terms of clinical trials difficult to organise. In spite of this much investigative work is in progress. The symposium, and the present volume, were designed to provide a comprehensive overview of the subject by experts, with an emphasis on the possible routes to future progress. The topics included aspects of pathology, imaging, diagno sis and treatment of both the common and uncommon primary tumours. It is hoped the papers will stimulate further interest and activity in this difficult area of clinical therapy and investigation."

Neurosurgery o/the Future: Computers and Robots in Clinical Neurosurgical Practice and in Training - a Philosophical Journey into the Future Many present day neurosurgeons believe that they already obtain good results in operative surgery with the benefit of the operating microscope and other aids which have become available in the last three decades and that the introduction of computers and robots to the operating theatre is superfluous. However, it is clear from analogy with the function of the airline pilot, another profession where there are great demands on manual skill and on spatial awareness, that these devices do have much to offer neurosurgery. Classical neurosurgery, in the time of Cushing, Dandy and Scarff, was based on a three dimensional picture of the patient's brain formed in the surgeon's mind and often illustrated in elegant drawings. Such pictures were based on neuroradiological studies by pneumoencephalography, ventriculography or by angiography. Generally these stud ies showed the presence and position of a lesion by displacement of normal brain structures and the picture was built up by interference. This was then converted by the experienced neurosurgeon into a plan for the craniotomy site and the trajectory of the surgical approach. Once the brain was exposed further pre-operative information was obtained by visual inspection and by palpation with the brain needle. These classical forms ofneuroradiology have largely been superseded by computerised tomography and by magnetic resonance imaging."

Gamma knife radiosurgery has grown continually in importance in recent years. However, there was a lack of established clinical and physical quality standards and a good knowledge of the possibilities of radiosurgical treatment for brain lesions. This book fills the gap by giving an overview of the current status of European gamma knife radiosurgery. Leading european experts report on their specialities in this field which is a state-of-the-art summary of the possibilities and results of their current work. The book encompasses all important as well as the more rare indications. All relevant technical and clinical quality standards are addressed. Tailored planning strategies are described for different indications. All professionals who care for patients with neurosurgical disease, such as neurosurgeons, radiosurgeons, radiologists, radiation oncologists and neurologists will find the book highly useful for the management of patients with benign and malignant brain lesions in a multidisciplinary setting.

An introductory text on bone metastases written by experts from various disciplines. It covers the basic principles of surgery in bone cancer, classification, medical treatment, radiotherapy, surgical treatment, incidence and pain relief. The steady progress in diagnosis and treatment of bone cancer in the last decade has dramatically changed the prognosis of cancer patients, improving significantly the overall survival rate and quality of life. Multidisciplinary treatments that combine surgery, radiotherapy and chemotherapy, as described in this book, show significantly improved results and an above average survival rate. Some hematologic malignancies that involve bone may be cured with systemic chemotherapy or radiotherapy, but for most patients with bone metastases, pain relief is the goal of therapy.

An in-depth introduction to radiotherapy physics emphasizing the clinical aspects of the field. This second edition gradually and sequentially develops each of its topics in clear and concise language. It includes important mathematical analyses, yet is written so that these sections can be skipped, if desired, without compromising understanding. The book consists of seven parts covering basic physics (Parts I-II), equipment for radiotherapy (Part III), radiation dosimetry (Parts IV-V), radiation treatment planning (Part VI), and radiation safety and shielding (Part VII). An invaluable text for radiation oncologists, radiation therapists, and clinical physicists.

Scope and ideas of the workshop The workshop which took place at the University of Giessen from Oct. 3 to Oct. 7, 2002 and whose proceedings are collected in this volume started from the idea to convene a number of scientists with the aim to outline their "visions" for the future of radiation research on the basis of their expertise. As radiation research is a very wide field restrictions were unavoidable. It was decided to concentrate this time mainly on molecular and cellular biology because it was felt that here action is par-ticularly needed. This did not exclude contributions from neighbouring fields as may be seen from the table of contents. It was clearly not planned to have a c- prehensive account of the present scientif fic achievements but the results presented should only serve as a starting point for the discussion of future lines of research, with the emphasis on the "outreach" to other parts of life sciences. If you are interested in the future ask the young - we attempted, therefore, to invite mainly younger colleagues (with a few exceptions) who had, however, already left their marks in the field. They were asked to describe what they felt is important in radiation research and may have significant influences on other branches of life sciences. They were given the task to demonstrate what is lost for science "if we do no longer exist."

An in depth examination of many of the complex issues associated with planning and optimisation of intensity modulated radiotherapy treatment. It includes: a presentation of current practice, techniques and equipment used by medical physicists and others to deliver radiotherapy treatment; a systems modelling approach in the formulation of a beam model for optimisation, describing the effect of X-rays on human body tissues; a deterministic approach to the inverse problem in radiotherapy, based on weighted iterative least squares is modified to allow an adaptive scaling of the error to improve the performance of a general least squares algorithm; a guided random search methodology, based on genetic algorithms which is aimed at solving multi-objective optimisation problems is developed to optimise beam weight/wedge angle as well as coplanar beam orientation; the overall approach developed is demons trated practically using both traditional and modern measurement techniques.

While it is true that certain types of neoplasms, such as those of the pancreas and brain, are still lesions with a grave prognosis, there are many other common cancers for which appropriate treatment can be curative in substantial numbers of patients .. This hopeful aspect of cancer is insufficiently appreciated, even by the medical profession itself; too many pessimistic patients find themselves consulting equally pessimistic physicians. WHO Expert Committee on Cancer Treatment *. The aim of this monograph is to present the latest information on the treatment of cancer, and the words quoted above from the report of a WHO Expert Committee on Cancer Treatment form an appropriate introduction to the subject. The pessimism to which they refer is still all too often characteristic of the attitude towards cancer and its treatment. The various chapters have been specially written for this monograph by specialists of international repute, and it will be noted that some of them were participants in the meeting of the WHO Expert Committee on Cancer Treatment mentioned above."

When in the future improved and more flexible heating equipment becomes available, and when hyperthermia is applied more routinely, computerized simulations of treatments will become commonplace, as they are in radia tion therapy. For hyperthermia, however, such simulations will be used not only for the traditional role of planning patient treatment, but also for three other applications not needed in radiation therapy - the comparative evalu ation of equipment, feedback control during treatment, and the post-treat ment evaluation of therapy. The present simulations of hyperthermia are crude and simple when compared with what is required for these future ap plications, a fact which indicates the nedd for considerable research and de velopment in this area. Indeed, this research is proceeding rapidly within the hyperthermia community, whre three-dimensional power deposition and temperature calculations have just become available for realistic patief\t anatomies. Of equal significance are the even more rapid development in diagnostic imaging for the determination and display of patient anatomy and blood flow rates - information required for the planning of realistic hyperthermia treatment. These simulations will be very valuable tools which can be used to great ad vantage when combined with data obtained from treatments of patients."

Defining the Lung Cancer Problem 1 Lung cancer is the leading cause of cancer death in the world. It kills almost as many Americans as cancers of the breast, prostate, colon, rectum, pancreas, and 2 kidney combined, and accounts for 28.6% of all US cancer deaths. With an increase in the 5-year relative survival rate from 13% to only 16% in the more than 2 30 years from 1974 to the present, it will take us another 840 years to eradicate lung cancer deaths if we do not improve the current rate of progress. As discussed in this text, lung cancer prevention has received substantial att- tion. The decrease in smoking in recent decades has helped, but smoking is not the only problem. Lung cancer in people who have never smoked is currently the 5th 3 leading cause of cancer death in the United States. Several factors contribute to the lethality of lung cancer, including the rapidity of tumor growth, advanced stage at diagnosis (due to nonspecificity of early sy- toms and the uncertain efficacy of screening), early development of metastases, and resistance to therapy. Several chapters in this book discuss new molecular targets that may be potentially exploitable in the future, as well as discussing our track record to date in exploiting them.

Radiosurgery is a rapidly developing form of minimally invasive neurosurgery. Selected papers from the first meeting of the International Stereotactic Radiosurgery Society in Stockholm, June 1993, reflect current multidisciplinary approaches to difficult intracranial neurosurgical problems. Neurosurgeons, radiotherapists, oncologists, radiobiologists, physicists and representatives of several other clinical disciplines inform about the state-of-the-art of radiosurgical treatment of a multitude of intracranial problems such as arteriovenous malformations, pituitary and pineal tumors, vestibular schwannomas as well as metastatic brain tumors and gliomas.

In spite of great advance made by ENT and maxillofacial surgeons as well as radiotherapists to improve therapy of cancer of the oral cavity and oropharynx, it has not been possible in the past 4 decades to raise the chances of patient survival above 40%-45%. However, recent studies with different combination therapies indicate that better results can be expected in the future. In this volume, the current status and results of therapeutic studies are presented by distinguished clinicians in the three disciplines. The book provides up-to-date information and encourages interdisciplinary cooperation.

Increasing survival figures and the use of more intense combined treatment regimens in modern oncology have raised the problem of late therapeutic sequelae in long-term survivors after cancer. Recent scientific approaches to late sequelae concentrate on the evaluation of subclinical changes with sophisticated functional measurements and experimental investigation of the underlying pathophysiological mechanisms.
The objective of the book is to bring together these recent clinical and experimental data from different medical disciplines to give an overview of the most relevant problems of late sequelae. In clinical practice the book may help regarding estimation of risks, selection of diagnostic methods, and estimation of the prognosis of late sequelae.

Transplantation of syngeneic (donor is a monozygous twin) or allogeneic (donor is an HLA-identical sibling) marrow provides the opportunity for aggressive antileukemic therapy without regard to marrow toxicity. Until 1975, marrow transplantation was carried out only after failure of all other therapy. Consequently, most patients were in advanced relapse. Six of 16 recipients of syngeneic marrow and 13 of 100 recipients of allogeneic marrow are still in remission after 5. 5-10 years [3, 7]. An actuarial survival curve of the first 100 patients grafted in Seattle after conditioning with cyclophos phamide (60 mg/kg on each of 2 successive days) and total body irradiation (1,000 rad) showed three periods of interest: (1) The first 4 months showed a rapid loss of patients associated with advanced illness, graft-versus-host disease, infections (in particular interstitial pneumonias), and recurrent leukemia; (2) from 4 months to 2 years, the curve showed a much slower rate of decline attributable primarily to recurrent leukemia; and (3) from 2-10 years, the curve was almost flat with a negligible loss of patients and no recurrent leukemia. This flat portion of the curve corresponded to 13% of the patients and indicates a strong probability that the majority of these survivors are cured of their disease [8]. Attempts at reducing the incidence of leukemic relapse after transplantation were made by a number of marrow transplant groups by added chemotherapy.