The contemporary management of patients with cancers of the head and neck is under careful scrutiny and major changes are being introduced in order to improve the potenti al not only for long-term control but also for less in the way of disfiguring and distres sing complications associated with the treatment programs. In 1988, the American Cancer Society estimates that there will be 42400 new cases of malignant tumors of the head and neck diagnosed with 12 850 deaths. In general, the prognosis for patients with malignant tumors of the head and neck re gion depends upon the site of origin, the local and regional extent of the tumor, the Kar nofsky status of the patient as well as the patient's general medical condition. The poten tial for cure for early stage tumors is extremely high particularly for those lesions involving the vocal cord, oral cavity, and the anterior two-thirds of the tongue. Major advances have been made in the management of head and neck cancer by the innovative utilization of surgery with radiation therapy. Small tumors can be cured by ei ther surgery or radiation therapy with equally good results. However, far advanced tu mors are more complicated and more difficult to cure requiring combined, integrated, multimodal programs of management. Therefore, the previously general poor prognosis for advanced tumors is becoming better with more aggressive treatment regimens."

The series "Medical Radiology - Diagnostic Imaging and Radiation Oncology" is the successor to the well known "Encyclopedia of Medical RadiologyjHandbuch der medizinischen Radiologie." This international handbook with its unique compila tion of data in more than fifty volumes lags behind the fast developing knowledge in radiology today. "Medical Radiology" brings the state of the art on special topics in a timely fashion. The first volume of the series was "Lung cancer," edited by Scarantino. This volume "Innovation in Radiation Oncology," edited by H.R. Withers and L.J. Peters, presents data on the development of new therapeutic strategies in different oncologic diseases. 57 authors wrote 32 chapters covering a broad range of topics. The innovations are at various levels of development, but were all chosen with the practicing radiation oncologist in mind. Perhaps not all of the innovations will survive the test of time, others have now become well established standard procedure in some centers. Also discussed is the assessment of the effectiveness of standard treat ment and how it effects the quality of a patient's survival. The contributions have been grouped into 9 broad sections as outlined in the table of contents. We think the second volume, as the whole series, will provide valuable reading for the general community of radiation oncologists."

The emphasis on cancer management in the past was based primarily on control rates from multidisciplinary input in management. There has always been a recognition that one would like to achieve the best result with the least complication, but never has there been any major emphasis on evidence-based outcome studies, nor on functional preservation and quality of life. The authors of this book have dealt very effectively with the various tumor types in head and neck cancer with the experts in the ? eld of management. The contents range from epidemiology and treatment outcome, treatment techniques with the potential impact on the quality of life such as dysphagia, to the various options relative to high technology radiation therapy programs for mana- ment. The potential for improving form and function through surgical care as an integrated part of the program is dealt with very effectively as well as the potentials for chemotherapy and the use of targeted agents have on quality of life issues. The volume also addresses toxicity, quality of life, and techniques for prevention of adverse effects, as well as the potentials for rehabilitation and supportive care. The authors have clearly done an extraordinarily good job in addressing the mul- plicity of problems that impact upon the functional preservation and quality of life in head and neck radiation therapy. Philadelphia Luther W.