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Advanced Renal Cell Carcinoma (RCC) cannot be cured by surgery
alone. Its resillience to irradiation and chemotherapy demands a
new approach to the management of this disease. This book provides
an overview of the scientific and clinical developments of RCC, and
clarifies the fields ofimmunotherapy and immunobiology. The book
contains a compilation of approaches that will enhance the
effectiveness of the management of advancedRCC, even in the absence
of definitive pre-clinical data. These require additional study and
will stimulate the reassessment of preliminary results.Furthermore,
preliminary results of already implemented clinical trials
withbiological modifiers are presented. Of special interest are the
current achievements in the field of immunotherapy using topically
and subcutaneously low dosage combinations of cytokines. This
concise volume will benefit those seeking a thorough review of the
research and the clinical aspects of RCC simultaneously.
The purpose of this book is to provide some basic information
regarding the fundamentals of magnetic resonance (MR) for all those
who are less familiar with the technique and interested in MR
spectroscopy and its possible applications in research and clinical
practice. It will stimulate the reader to look more closely at the
various topics covered by the contributors to this volume: tumor
cell metabolism, kidney function, organ viability. Finally, several
applications of high-field spectroscopy and imaging are
illustrated. The book focusses on proven and possible clinical
applications of MR in nephrourology: renal cell carcinoma,
metabolic investigation of the kidney and pretransplant assessment
of organ viability. The examples are thoroughly discussed and
abundantly illustrated. The reader will benefit from this book by
receiving a review of research and clinical aspects of MR
simultaneously.
The management of advanced renal cell carcinoma is still
problematic. Surgery, although the therapy of choice for locally
advanced renal tumors, is still controversial as the treatment for
metastases. The role of surgery in the management of patients with
pulmonary, bony, and liver metastasis is one of the subject matters
discussed in this book. Our results with series of patients
undergoing resection of metastases from the lung, bone, and liver
show that surgery may be appropriate in selected patients with a
good performance status, although most of them certainly cannot be
cured by this procedure alone, i.e., in the absence of effective
adjuvant therapies. As recent developments show, new strategies for
immunotherapy of renal cell carcinoma represent a modest advance
over traditional approaches in the treatment of this cancer, such
as chemo- and radiotherapy. Clinical trials employing recombinant
interferon-a and interleukin 2 produced response rates in up to 30%
of patients treated, as evidenced by the European Immunotherapy
Trials Program. The adverse reactions and the lack of efficacy in
the majority of patients warrants the search for new
immunotherapeutic approaches.
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