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Following recent developments in hypofractionated stereotactic
radiation therapy (SRT) for brain and spine tumors, this new
edition offers a fully updated and comprehensive "how-to" guidance
on hypofractionated SRT for brain and spine metastases, glioma,
benign tumors, and other tumor types. Presenting the state of the
art of the technology and practice, this book: * Discusses the pros
and cons of hypofractionated SRT compared to single-fraction
radiosurgery, providing a deeper understanding of radiosurgery and
radiobiology * Explains the toxicity and adverse effects of
hypofractionated SRT including the dosage of 24 Gy in two spine
SBRT fractionation schemes, aiding practitioners in communicating
the risks and benefits of treatment and in obtaining consent from
their patients * Outlines the current standards for safe practice,
including checklists for implementation * Explores new technologies
for brain and spine tumors including LITT, MR-guided focused
ultrasound, and Zap technology, with chapters authored by
well-recognized experts in the radiation, oncology, and
neurosurgery communities; this book delivers a level of
technological and clinical detail not available in journal papers
This book is suitable for radiation oncologists, neurosurgeons, and
medical physicists who specialize in brain and/or spine
radiosurgery or want to start a program and need a comprehensive
reference with key checklists for practice.
This book elucidates the radiation therapy protocols and procedures
for the management of adult patients presenting with primary benign
and malignant central nervous system tumors. With the development
of new treatment strategies and rapid advancement of radiation
technology, it is crucial for radiation oncologists to maintain and
refine their knowledge and skills. Dedicated exclusively to adult
CNS radiation oncology, this textbook explores CNS tumors ranging
from the common to the esoteric as well as secondary cancers of
metastatic origin. The first half of the book is organized
anatomically: tumors of the brain, spinal cord, leptomeninges,
optic pathway, ocular choroid, and skull base. The second half
covers primary CNS lymphoma, rare CNS tumors, metastatic brain
disease, vascular conditions of the CNS, radiation-associated
complications, and radiation modalities. Each chapter provides
guidance on treatment field design, target delineation, and normal
critical structure tolerance constraints in the context of the
disease being treated. Learning objectives, case studies, and
Maintenance of Certification Self-Assessment Continuing Medical
Education-style questions and answers are incorporated throughout
the book. This is an ideal guide for radiation oncologists,
residents, and fellows, but medical students may also find value in
the text.
This book is a comprehensive review of stereotactic radiosurgery
(SRS) and stereotactic body radiation therapy (SBRT): its physics,
clinical evidence, indications, and future directions. The
utilization of stereotactic radiosurgery (SRS) and stereotactic
body radiation therapy (SBRT) is increasing internationally because
of several factors. First, it offers patients a local treatment
option that has demonstrated effectiveness similar to traditional
surgery without the morbidity of general anesthesia and open
surgical resection. Second, recent advancements in the quality of
scientific evidence supporting a SRS or SBRT-containing approach in
patients continues to evolve and demonstrate favorable
disease-specific outcomes with little, if any, toxicity in various
anatomic disease sites and for various conditions including cancer,
benign tumors, and other psychiatric and neurologic conditions.
Third, and most provocatively, is the notion that definitive local
therapy (i.e. SRS or SBRT) in patients with cancer can boost the
immune system to fight cancer in other sites throughout the body.
While traditional medical knowledge would suggest that all patients
with metastatic cancer are incurable, there is a mounting body of
evidence that there is a subset of these patients that can be cured
with definitive SRS or SBRT. This volume thus delves into each of
these benefits and aspects of treatment, guiding physicians to the
best treatment plan for their patients. Expert, international
authors provide guidelines for SRS and SBRT use by clinicians.
Chapters are divided into six main sections: Radiobiology of
Radiosurgery and Stereotactic Body Radiation Therapy, Intracranial
Radiosurgery Technique, Intracranial Radiosurgery by Indication,
Stereotactic Body Radiation Therapy Technique, Stereotactic Body
Radiation Therapy by Indication, The Future of Radiosurgery and
SBRT. Overall physics are explained, as well as specific
considerations for particular surgical tools (including the Leksell
Gamma Knife and Accuray CyberKnife), techniques (including
fractionated and charged particle radiosurgery), and anatomic sites
(including brain metastases, pituitary tumors, and the prostate).
Detailed images and charts enhance the chapters. This book provides
physicians with a single, practical resource incorporating both of
these broad categories of treatment, SRS and SBRT, and better
defines the current role and the direction of radiosurgery.
Bone and brain metastasis are of great importance because they can
profoundly affect a patient's quality of life and function.
Complications of metastasis include pain, neurologic dysfunction
and, in cases of bone metastasis, fractures and resulting loss of
mobility. In particular for brain metastasis, personality and
cognitive changes can affect the patient's performance status which
can jeopardise further systemic therapies aimed at prolonging
survival. Ultimately, both conditions are very frightening for the
cancer patient and their families. This book highlights the
importance of expertise in the management of bone and brain
metastasis.
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