Tumour therapy depends essentially on being able to destroy the clonogenic activity of tumour cells while keeping the damage to the normal tissue low. Clinical experience shows that tumour response varies greatly even if tumours with the same localisation, clinical, and histopathological staging are compared. Some tumours appear to be resistant to conventional radiotherapy (X-rays, y-rays or fast electrons) or chemotherapy. In these cases new therapy modalities are necessary. Combined therapy modalities seem to have advan- tages for some resistant tumours; one possibility of such a treatment is to combine radiotherapy or chemotherapy with hyperthermia. This means that the local tumour, the tumour region or even the whole body of the patient has to be heated to temperatures between 40 to 45 C (in case of whole body hyperthermia to 42 C maximal) for a certain time (usually 30-60 min are adequate). Hyperthermia has a long tradition in medicine as a treatment modality for various diseases. Inscriptions of the old Egyptians and texts of the Greeks have pointed out its importance. Usually whole body hyperthermia has been used by the induction of fever. Local hyperthermia began around 1900 when Westermark treated unre- sectable cervix carcinomas with hot water in a metallic coil. By the beginning of this century an increase of radiation effects was hy- pothesised with hypothermia and later observed. However, only in the 1960s and 1970s were systematic investigations started which showed radiosensitisation and chemosensitisation by hyperthermia in cells and tissues including tumours.

Conformal radiation therapy represents a new challenge for radiation oncologists. It offers the prospect of either increasing the radiation dose to target tissues while delivering a similar dose to organs at risk, or reducing the dose to organs at risk while maintaining the dose to target tissues. First, lymph node areas at risk are established using the available data from pathological examination of surgical specimens and/or pattern of locoregional relapse. Then, based on a three-dimensional description of the anatomical regions where the areas at risk are located, guidelines for the delineation of the clinical target volumes are proposed. The data presented should enable the reader to make appropriate decisions regarding the selection and delineation of the target volumes when confronted with the most frequent tumor types and sites.The book will contribute to paving the way for more effective radiation oncology in the twenty-first century.

Given that treatment with curative intent is possible in only one-half of cancer victims, and that such treatment frequently fails, the majority of patients with cancer will require relief of symptoms and signs caused by their disease. In this book, the specific contribution of radiation therapy to palliation is considered within the context of multidisciplinary management. Individual chapters are devoted to palliative radiation therapy for primary tumours and metastases at different sites. The management of pain is discussed, and chapters are also devoted to end of life care, the management of complications of radiation therapy, and useful medications. This book will prove useful to radiation oncologists and medical students.

This volume discusses the background and various clinical applications of radiation therapy in the treatment of non-malignant diseases. It documents the radiobiological and physical principles of treatment and the rationale underlying the use of radiotherapy for various disorders of the CNS, head and neck, eye, skin and soft tissues, bone and joints, and vascular system. In so doing, it draws attention to and elucidates the scope for application of radiotherapy beyond the treatment of malignancies. Both the risks and the benefits of such treatment are fully considered, the former ranging from minor clinical problems to life-threatening diseases.

Given that treatment with curative intent is possible in only one-half of cancer victims, and that such treatment frequently fails, the majority of patients with cancer will require relief of symptoms and signs caused by their disease. In this book, the specific contribution of radiation therapy to palliation is considered within the context of multidisciplinary management. Individual chapters are devoted to palliative radiation therapy for primary tumours and metastases at different sites. The management of pain is discussed, and chapters are also devoted to end of life care, the management of complications of radiation therapy, and useful medications. This book will prove useful and interesting not only to radiation oncologists but also to medical students of all ages and to doctors from all disciplines who are concerned with the relief or prevention of suffering in patients with cancer.

This volume discusses the background and various clinical applications of radiation therapy in the treatment of non-malignant diseases. It documents the radiobiological and physical principles of treatment and the rationale underlying the use of radiotherapy for various disorders of the CNS, head and neck, eye, skin and soft tissues, bone and joints, and vascular system. In so doing, it draws attention to and elucidates the scope for application of radiotherapy beyond the treatment of malignancies. Both the risks and the benefits of such treatment are fully considered, the former ranging from minor clinical problems to life-threatening diseases.

The American Cancer Society anticipates that 16,500 patients will be diagnosed with primary malignant tumors of the central nervous system in 2000, with about 200,000 individuals presenting with brain metastases. The advances in the treatment of solid tumors have contributed significantly to the major increase in metastatic cancers to the brain. Of the primary malignant tumors of the brain, more than 50% are high-grade gliomas; the incidence has been increasing among older patients over the past decade. Major developments in new technologies in the treatment of primary brain tumors as well as metastatic disease are covered in depth. Even though management is difficult, advances are being made. This book is a concerted effort to present data regarding basic science research efforts alongside their translation into clinical practice using combined, integrated multimodal programs of treatment. Progress has been made, but innovatice approaches need to be pursued.