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.

Breast cancer is the most common malignancy among the female population. With advances in systemic therapies and modern radiotherapy techniques, breast cancer patients can have a long life-expectancy. However, it is crucial that radiation therapy is carried out with minimum complications and with the utmost efficiency. Principles and Practice of Modern Radiotherapy Techniques in Breast Cancer provides practical and current theoretical knowledge to the planning and implementation of breast cancer radiation therapy. All aspects of breast cancer are covered, including epidemiology, molecular and biological basis and integrating systemic therapies during all steps of treatment. The illustrated section of this book identifies anatomical structures in daily practice by presenting target and critical structures in actual treatment positions. These images show and mark the anatomical points of the patient lying in the position that breast radiation therapy would be performed. This text serves as a valuable resource for clinicians, residents and fellows practicing and learning breast cancer radiotherapy.

Prostate brachytherapy has been the subject of heated debate among surgeons and the proponents of the various brachytherapy methods. This very first interdisciplinary book on the subject provides a comprehensive overview of innovations in low dose rate (LDR), high dose rate (HDR), and pulsed dose rate (PDR) interstitial brachytherapy for the management of local or locally advanced prostate cancer. In addition to detailed chapters on patient selection and the use of imaging in diagnostics, treatment guidance, and implantation control, background chapters are included on related medical physics issues such as treatment planning and quality assurance. The results obtained with the different treatment options and the difficult task of salvage treatment are fully discussed. All chapters have been written by internationally recognized experts who for more than a decade have formed the teaching staff responsible for the successful GEC-ESTRO/EAU Prostate Brachytherapy Teaching Course.

Current radiation protection standards are based upon the application of the linear no-threshold (LNT) assumption, which considers that even very low doses of ionizing radiation can cause cancer. The radiation hormesis hypothesis, by contrast, proposes that low-dose ionizing radiation is beneficial. In this book, the author examines all facets of radiation hormesis in detail, including the history of the concept and mechanisms, and presents comprehensive, up-to-date reviews for major cancer types. It is explained how low-dose radiation can in fact decrease all-cause and all-cancer mortality and help to control metastatic cancer. Attention is also drawn to biases in epidemiological research when using the LNT assumption. The author shows how proponents of the LNT assumption consistently reject, manipulate, and deliberately ignore an overwhelming abundance of published data and falsely claim that no reliable data are available at doses of less than 100 mSv.

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.

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."

Neutron capture therapy (NCT) is based on the ability of the non-radioactive isotope boron-10 to capture thermal neutrons with very high probability and immediately to release heavy particles with a path length of one cell diameter, which in principle allows for tumor cell-selective high-LET particle radiotherapy. This book provides a comprehensive summary of the progress made in NCT in recent years. Individual sections cover all important aspects, including neutron sources, boron chemistry, drugs for NCT, dosimetry, and radiation biology. The use of NCT in a variety of malignancies and also some non-malignant diseases is extensively discussed. NCT is clearly shown to be a promising modality at the threshold of wider clinical application. All of the chapters are written by experienced specialists in language that will be readily understood by all participating disciplines.

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.

Established as a classic text on nuclear chemistry and pharmacy, Fundamentals of Nuclear Pharmacy has been thoroughly revised with new information added covering innovations in imaging technology and clinical applications in the field. The Sixth Edition also eliminates outdated information from previous editions on radiopharmaceuticals now discontinued from the market. Dr. Gopal B. Saha's books have continually been praised for their clarity and accuracy while setting new standards for making complex theoretical concepts readily understandable to the reader. Like past editions, this book is intended to be used as a textbook on nuclear chemistry and pharmacy for nuclear medicine residents and students and as a reference book for nuclear medicine physicians and radiologists. New sections in the Sixth Edition include: * PET/CT and SPECT/CT * Digital Imaging * Exploratory IND * Nanoparticle Imaging * Treatment of liver cancer with 90Y-TheraSpheres and 90Y-SIR-Spheres * Treatment of Non-Hodgkin's lymphoma with 131I-Bexxar

Squamous cell carcinoma of the esophagus has a lower incidence than other gastrointestinal tract cancer; however, there are many difficult issued related to the choice of appropriate therapy for these patients. In recent years, the use of multimodal treatment has greatly improved the prognosis of patients affected by this disease but several aspects of the oncological and surgical management are still controversial. This book aims to give a homogeneous approach to esophageal cancer treatment, based on the author's lifetime experience in conjunction with exhaustive review of recent literature. In each chapter surgeons and oncologists will find appropriate tools for correct management of the diagnosis and therapy of this difficult disease. The book analyzes all the aspects of staging and treatment, such as modern diagnostic and staging techniques (MRI or PET-CT), endoscopic treatment of early cancer, new minimally invasive and open surgical techniques, and combined treatment. In addition, there are chapters dedicated to the postoperative course of these patients, as well as their quality of life, with indications for the correct follow-up and treatment of relapses.

The Fourth Edition of Dr. Gopal B. Saha's Physics and Radiobiology of Nuclear Medicine was prompted by the need to provide up-to-date information to keep pace with the perpetual growth and improvement in the instrumentation and techniques employed in nuclear medicine since the last edition published in 2006. Like previous editions, the book is intended for radiology and nuclear medicine residents to prepare for the American Board of Nuclear Medicine, American Board of Radiology, and American Board of Science in Nuclear Medicine examinations, all of which require a strong physics background. Additionally, the book will serve as a textbook on nuclear medicine physics for nuclear medicine technologists taking the Nuclear Medicine Technology Certification Board examination. The Fourth Edition includes new or expanded sections and information for: * PET/MR, including the attenuation correction method and its quality control tests; * accreditation of nuclear medicine and PET facilities; * solid state digital cameras; * time of flight and scatter correction techniques; * CT scanners and attenuation correction in SPECT/CT; * partial volume effects; * quality control of CT scanners; * ion chamber survey meters, proportional counters, and G-M counters.

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.

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."

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.

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.

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.

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.

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."

When compiling the present atlas our aim has been to provide the practis ing radiotherapist with a handbook which would help him to plan the radiation therapy of tumours of individual organs. Apart from a few ex ceptions, all isodose charts in this atlas show dose distributions resulting from external irradiation. Combination of external irradiation with intra cavitary radium therapy is presented in the treatment of carcinoma of the uterine cervix, in which case the two techniques are complementary. Thd immense material of the pertinent literature could, naturally, not have been included in the atlas. As a result of scrupulous selection, the isod-.: se charts shown may not invariably be the optimum ones, and some of them may not be the most modern. However, the usefulness of the information they provide has made us to keep them all the same. We did not intend to change the original charts in any way and stan dardization of the isodoses was not undertaken. Radiation parameters are given in the figure captions and, if available, information has also been provided on the phantoms used by the authors. Naturally, the isodoses presented will not automatically apply to all situ ations and all apparatuses without due attention to the individual patient:: Jnd technical details such as penumbra and source diameter. They merely serve as a starting point and will help to save time and work during treat ment planning also with the computer."

Material for this book was gathered in the early 1980's in Manchester, where a higher incidence than usual of complications in the gastro-intestinal and urinary tract was observed. Part I describes the principles and methods of radiotherapy for pelvic tumours, pathological features and radiological analysis of bowel and urinary tract changes. Parts II and III are devoted to clinical assessment and management, where the need for a multi-diciplinary approach is emphasized.

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.

2. Virological Findings. 90 3. Immunity. . . . . 90 C. Secondary Dengue: Dengue Hemorrhagic Fever and the Shock Syndrome 92 1. General Remarks. . . . . . . . . . . . . . 92 2. Clinical Course and Clinical Laboratory Findings 93 3. Virological and Serological Findings. . . 95 4. Immunopathology of Secondary Dengue. 98 XI. Immunization. . . . . . . . . . . . . . . 104 A. Anamnestic Immune Responses in Sequential Infections With Dengue and Other Group B Togaviruses . . . . . . . . 104 1. Results With Members of the Dengue Subgroup 104 2. Results With Dengue and Other Flaviviruses. 107 B. Dengue Vaccines for Use in Man 108 XII. Opportunities for the Future 113 Acknowledgments. 114 References. . . . . . . . . . . 114 I. Introduction Dengue fever is a mosquito-transmitted disease of man which has afflicted untold millions of people over the past two centuries. It is caused by viruses classified as a subgroup of the group B togaviruses. Along with other members of that group as well as group A, the dengue viruses have been investigated intensively during recent years. Certain unique aspects of their structure, composition, antigenicity, replication, and antigenic relationships have established the togavirus family as quite distinct from other families of enveloped RNA viruses (see recent review of PFEFFERKORN and SHAPIRO, 1974). The basic studies leading to this conclusion have coincided with epidemiological field investigations which have resulted in a continuing increase in the number of viruses now designated as group A or B togaviruses. This, in turn, has led to a growing appreciation of their immense importance as actual or potential pathogens of man and beast.

A great deal of new information has been obtained during the past four years, and this monograph provides a clear and well reviewed update on biochemical mechanisms and the results of important new clinical studies using the interferons. Reviews include what is presently known about the biosynthesis, physiological role and mechanisms of action of the interferons (alpha, beta, gamma). New biochemical information on interferon-receptor interactions and signalling pathways is provided. The pharmacokinetic considerations in treating leukemia, lymphoma, myeloma, neuroendocrine tumors and other solid tumors are reviewed with special emphasis on studies of adjuvant chemotherapy in malignancies of the immune system.