Index

Principles and Management of Cancer Tejinder Kataria, Hemant Singhal , Dinesh Chand Doval

CHAPTER 1:Radiobiology of Radiation Therapy
- INTRODUCTION
- THE TIME-SCALE OF EFFECTS IN RADIATION BIOLOGY
- DNA DAMAGE
- DIRECT ACTION
- INDIRECT ACTION
  - Types of Damage
- DNA REPAIR
- ACUTE AND LATE EFFECTS OF RADIATION
- CELL DEATH
  - Programmed Cell Death (Apoptosis)
  - Mitotic Catastrophe
- THE FIVE “RS” OF RADIOBIOLOGY
- LINEAR ENERGY TRANSFER
- RELATIVE BIOLOGIC EFFECTIVENESS
- OXYGEN ENHANCEMENT RATIO
- DOSE RATE EFFECT IN RADIOTHERAPY
  - Mechanism of Dose Rate Effect and Inverse Dose Rate Effect
- DOSE FRACTIONATION IN RADIOTHERAPY
- THE CONCEPT OF THERAPEUTIC INDEX
  - Tumor Control Probability
    - Normal Tissue Complication Probability
CHAPTER 2:Radiation Pathology
- INTRODUCTION
- EPITHELIAL AND PARENCHYMAL LESIONS
- STROMAL LESIONS
- HEART
  - Radiation Pericarditis
- LUNGS
- TREATMENT AND PROGNOSIS
  - QUANTEC Constraints
- LIVER
- KIDNEY
- BRAIN
  - Cerebral Radionecrosis
- SALIVARY GLANDS
CHAPTER 3:Brachytherapy
- INTRODUCTION
- HISTORY
- PRINCIPLES OF BRACHYTHERAPY
- CLINICAL APPLICATIONS OF BRACHYTHERAPY
- CLASSIFICATION OF TYPES OF BRACHYTHERAPY
- PROPERTIES OF AN IDEAL SOURCE
- RADIONUCLIDES AND THEIR PROPERTIES
- ROOM SHIELDING
- DOSIMETRY UNITS AND SOURCE SPECIFICATION
- SOURCE SPECIFICATION
- DOSE RATES
- IMPLANT DOSIMETRY SYSTEMS
- DOSE SPECIFICATION AND REPORTING
- ADVANCES IN BRACHYTHERAPY
- CONCLUSION
CHAPTER 4:Advances in Radiotherapy Techniques
- INTRODUCTION
- HISTORY
- TWO-DIMENSIONAL (2D) RADIOTHERAPY (CONVENTIONAL RADIOTHERAPY)
- THREE-DIMENSIONAL (3D) RADIOTHERAPY
- INTENSITY-MODULATED RADIOTHERAPY
- INTENSITY MODULATED ARC THERAPY
- VOLUMETRIC MODULATED ARC THERAPY
- IMAGE-GUIDED RADIOTHERAPY
- ADAPTIVE RADIOTHERAPY
- STEREOTACTIC RADIOTHERAPY
  - Tomotherapy
  - Cyberknife
- PARTICLE THERAPY/HADRON THERAPY
- BRACHYTHERAPY
  - Gynecological Malignancies
  - Prostate Cancer
- CONCLUSION
CHAPTER 5:Image-guided Radiation Therapy
- INTRODUCTION
- ROLE OF IMAGING IN RADIATION ONCOLOGY
- IMAGE-GUIDED RADIATION THERAPY: THE CONCEPT
- ERRORS AND MARGINS
- OFFLINE VERSUS ONLINE CORRECTIONS
- IGRT TECHNOLOGY SOLUTIONS
  - Nonradiation-based Systems16–22
  - Radiation-based Systems
    - Hybrid Systems for Real-time 4D Tracking
    - Combination Alignment Systems: Optical Imaging and 2D KV Orthogonal Imaging
- GUIDELINES FOR MEDICAL PERSONNEL AND IMPLEMENTATION
- IMAGE-GUIDED RADIATION THERAPY: CLINICAL BENEFITS
- CONCERNS WITH IGRT
- CLINICAL APPLICATIONS: CURRENT AND FUTURE
CHAPTER 6:Lasers in Head and Neck Surgery
- INTRODUCTION
- TYPES OF SURGICAL LASERS
- LASER SAFETY
- LARYNGEAL MALIGNANCIES
- BENIGN LARYNGEAL LESIONS
- OFFICE-BASED USE OF LASERS
- RECENT ADVANCES
- CONCLUSION
CHAPTER 7:Emergencies in Cancer
- INTRODUCTION
- STRUCTURAL OR OBSTRUCTIVE EMERGENCIES
- METABOLIC EMERGENCIES
  - Hypercalcemia
  - Syndrome of Inappropriate Secretion of the Antidiuretic Hormone
- TREATMENT-RELATED EMERGENCIES
  - Tumor Lysis Syndrome
  - Anaphylactic Reactions
CHAPTER 8:Nutrition and Cancer
- INTRODUCTION
- GOALS OF NUTRITION THERAPY IN CANCER
- CANCER TREATMENT AND ITS NUTRITIONAL IMPLICATIONS
- NUTRITION MANAGEMENT OF SYMPTOMS
CHAPTER 9:Central Nervous System Tumors
- INTRODUCTION
- WHO CLASSIFICATION
- LOW-GRADE GLIOMAS
- HIGH-GRADE GLIOMAS
- EPENDYMOMA
- MENINGIOMAS
CHAPTER 10:Surgical Management of Head and Neck Cancer
- INTRODUCTION
- PRINCIPLES OF SURGICAL TREATMENT
  - Criteria of Unresectability
    - Primary Disease
    - Nodal Disease
- SURGERY OF PRIMARY LESION
- SURGICAL TREATMENT OF NECK
- MANAGEMENT OF N0 NECK
- CLINICALLY NODE POSITIVE NECK
- CONSERVATION OF ORGAN VERSUS PRESERVATION OF ORGANS
- COMPLICATIONS IN HEAD AND NECK SURGERY
- CONCLUSION
CHAPTER 11:Radiation in Treatment of Head and Neck Cancer
- INTRODUCTION
- THREE-DIMENSIONAL CONFORMAL THERAPY
- INTENSITY-MODULATED RADIOTHERAPY
- IMAGE-GUIDED RADIOTHERAPY
- BRACHYTHERAPY IN HEAD AND NECK CANCER
- CONCLUSION
CHAPTER 12:Principles of Breast Cancer Surgery
- INTRODUCTION
- DIAGNOSIS AND STAGING
- PLANNING OF BREAST CANCER SURGERY
- BREAST CONSERVING SURGERY
- CONTRAINDICATIONS OF BREAST CONSERVING SURGERY
- SURGICAL CONSIDERATIONS IN PLANNING BREAST CONSERVING SURGERY
- SALIENT FEATURES OF BREAST CONSERVING SURGERY
- MASTECTOMY
- TYPES OF RECONSTRUCTION
- RISK-REDUCING MASTECTOMY
- SENTINEL NODE BIOPSY
- COMPLICATIONS IN BREAST SURGERY
- POSTOPERATIVE FOLLOW-UP AND MONITORING
- SUMMARY
CHAPTER 13:Carcinoma of Breast
- INTRODUCTION
- LOBULAR CARCINOMA IN SITU
  - Risk Factors
  - Presentation
  - Magnetic Resonance Imaging as a Screening Tool
  - Management for LCIS
  - Evidence for the Role of Chemoprevention
- PAGET’S DISEASE
  - Origin
  - Epidemiology
  - Clinical Presentation
  - Pathology
  - Associated Malignancy
  - Mammographic Findings
  - Clinical Evaluation
  - Management
- EVIDENCE FOR CONSERVATIVE APPROACH
- DUCTAL CARCINOMA IN SITU
  - Risk Factors
  - Presentation
  - Epidemiology
  - Radiology
  - Pathology and Biology
  - Therapy Recommendations for DCIS
    - General
  - Evidence for the Role of Radiotherapy after Lumpectomy
  - Evidence for Role of Observation after Lumpectomy
  - Evidence for Role of Tamoxifen
  - Treatment of Axilla
  - Radiation Therapy Dose Fraction Schedule
- RISK FACTORS
  - Age
  - Child Bearing/Parity/Breastfeeding
  - Ovarian Function (Long Menstrual History; Early Menarche, Late Menopause)
  - Exogenous Hormone/Oral Contraceptive Pill
  - Family History/BRCA
  - Personal History of Breast Cancer and History of “Benign” Breast Biopsy
  - Radiation Exposure
  - Body Mass Index, Physical Activity, Diet, Alcohol
  - Mammographic Density
  - Familial Breast Cancer
- BREAST CANCER PREVENTION STRATEGIES
  - Tamoxifen/Raloxifene
  - Prophylactic Surgery
- NATURAL HISTORY
  - Axillary Involvement
  - Internal Mammary Nodes
  - Supraclavicular Spread
  - Impact of Local Control on Systemic Metastasis and Breast Cancer Mortality
- SCREENING IN BREAST CANCER
  - X-ray Screening Mammography
  - Magnetic Resonance Imaging Screening
- PROGNOSTIC AND PREDICTIVE FACTORS
  - Prognostic Marker
  - Predictive Marker
  - Prognostic Factors for Survival and Metastasis
- MANAGEMENT OF BREAST CANCER
  - Mastectomy
    - Skin-Sparing Mastectomy
  - Breast Conservative Treatment
  - Breast Conservation Surgery
  - Surgical Management of Axilla
    - Clinically Negative Axilla (cN0)
    - Clinically Positive Axilla (cN+)
  - Rates of Axillary Failure
  - Sentinel Lymph Node Dissection
  - SLND in Special Circumstances
  - Trials of Equivalence of SLND to Axillary Dissection in cN0 Axilla
  - Subset of Patients in which Completion ALND can be omitted after Positive SNB
  - Radiation Therapy to Breast
  - Randomized Studies Comparing BCS Plus Radiation Therapy to Mastectomy
  - Prognostic Factors for Local Relapse Following BCS Plus Radiation Therapy
  - Radiation Therapy Techniques
    - Conventional Two-dimentional Tangent
    - Three-dimensional Conformal or Intensity-modulated Radiation Therapy
  - Radiation Management of the Regional Lymphatics
  - Internal Mammary Node Chain Irradiation
  - Sequencing Chemoradiation in the Conservative Management of Breast Cancer
- TECHNICAL ISSUES IN RADIATION MANAGEMENT OF EARLY STAGE BREAST CANCER
  - Treatment Position
  - Treatment Volume
  - Doses of Radiation and Fractionation
  - Radiation Beams
- ACCELERATED PARTIAL BREAST IRRADIATION
  - Multicatheter Interstitial Accelerated Partial Breast Irradiation
  - MammoSite Radiation Therapy System for Accelerated Partial Breast Irradiation
  - Three-Dimensional Conformal External Beam Radiation Therapy for Accelerated Partial Breast Irradiation
  - Intraoperative Accelerated Partial Breast Irradiation
  - Patient Selection
  - American Society of Therapeutic Radiology and Oncology (ASTRO) Consensus Statement79
  - Cautionary Candidates: Any of these Criteria should Invoke Caution and Concern when Considering APBI
  - Unsuitable Candidates
- FOLLOW-UP OF PATIENTS TREATED WITH BREAST CONSERVATION SURGERY AND IRRADIATION
  - Radiographic Findings after Breast Conservation Therapy
- SEQUELAE OF IRRADIATION IN BREAST CANCER
  - Lymphedema/Breast Edema
  - Brachial Plexopathy
  - Pulmonary Sequelae
  - Cardiac Sequelae
  - Risk of Stroke with Supraclavicular Radiation
  - Contralateral Breast Cancer and Irradiation
- ENDOCRINE THERAPY
  - Biology of Endocrine Therapy
  - Adjuvant Therapy with Selective Estrogen Receptor Modulators
  - Aromatase Inhibitors
    - Upfront Therapy with Aromatase Inhibitors
  - Sequential Adjuvant Therapy with Aromatase Inhibitors Following Tamoxifen
  - Extended Adjuvant Hormonal Therapy
    - Extended Adjuvant Therapy with Tamoxifen
    - Extended Adjuvant Therapy with Aromatase Inhibitors
  - Adjuvant Ovarian Ablation
  - Sequencing Tamoxifen and Radiation Therapy in Conservatively Managed Patients
- EPIDEMIOLOGY
- NATURAL HISTORY
- CLINICAL PRESENTATION
- DIAGNOSTIC WORKUP
  - Staging
- GENERAL MANAGEMENT AND TREATMENT RESULTS FOR LOCALLY ADVANCED BREAST CANCER
  - Breast Conservation Therapy after Neoadjuvant Chemotherapy
  - Postmastectomy Radiation Therapy
  - Postmastectomy Radiation Therapy after Neoadjuvant Chemotherapy
  - Radiation Treatment Techniques after Mastectomy
  - Systemic Therapy
  - General Management and Treatment Results for Inflammatory Breast Cancer
  - Outcome
  - Recurrent Breast Cancer
  - Metastatic Breast Cancer
CHAPTER 14:Lung Cancer
- INTRODUCTION
- ETIOLOGY
- PATHOLOGY
  - Routes of Spread
- CLINICAL PRESENTATION
  - Locoregional Manifestation of Disease
  - Systemic Manifestation of Disease
- WORKUP AND STAGING
  - Imaging
  - Invasive Procedures
- STAGING
  - AJCC Tumor, Node, Metastasis (TNM) Classification of Lung Cancers (NSCLC and SCLC), 7th Edition13
    - T Staging
    - N Staging
  - AJCC Stage Groupings
- PROGNOSIS
- GENERAL MANAGEMENT
  - Non-Small Cell Carcinoma of Lung
  - Small Cell Lung Cancer
CHAPTER 15:Carcinoma of Esophagus
- INTRODUCTION
- ETIOLOGY
- APPLIED ANATOMY
- PATTERNS OF SPREAD
- DIAGNOSTIC STAGING
- STAGING
- DIAGNOSTIC INVESTIGATIONS
- STAGING INVESTIGATIONS9
  - Role of EUS10,11
  - Role of PET-CECT
- PROGNOSTIC GROUPS
- PROGNOSIS OF ESOPHAGEAL CANCER
- PRINCIPLES OF MANAGEMENT
- DEFINITIVE RADIATION AND CHEMORADIATION THERAPY
  - Key Points
- RADIOTHERAPY TECHNICAL DETAILS
CHAPTER 16:Gastric Cancer
- EPIDEMIOLOGY AND ETIOLOGY
- ANATOMY
- PATHOLOGY
- DOSE AND TREATMENT DELIVERY
  - Role of IMRT in Gastric Cancer
CHAPTER 17:Carcinoma of Anal Canal
- INTRODUCTION
- ETIOLOGY
- ANATOMICAL ASPECTS
- PATHOLOGICAL ASPECT
- CLINICAL FEATURES
- STAGING INVESTIGATIONS
- TNM STAGING
- MANAGEMENT
  - Concurrent Chemoradiation
  - Radiotherapy Techniques
    - Simulation
    - Target Volume Definition
- CONCLUSION
CHAPTER 18:Carcinoma of Rectum
- INTRODUCTION
- ANATOMICAL CONSIDERATIONS
- ETIOLOGY
- CLINICAL PRESENTATIONS
- PATHOLOGY
- STAGING
- MANAGEMENT
  - Digital Rectal Examination
  - Imaging Studies
- SURGERY
- TOTAL MESORECTAL EXCISION
- ABDOMINOPERINEAL RESECTION
- LOW ANTERIOR RESECTION
- RADIATION THERAPY TECHNIQUE
- TARGET VOLUME DEFINITION
  - Preoperative/Neoadjuvant Radiotherapy
  - Postoperative Radiotherapy
- DOSE-FRACTIONATION
  - Preoperative Radiotherapy
  - Postoperative Radiotherapy
- IMPORTANT DISCUSSIONS REGARDING RADIOTHERAPY IN RECTAL CARCINOMA
CHAPTER 19:Surgical Principles in the Management of Pancreatic Cancer
- INTRODUCTION
- PREOPERATIVE APPROACH TO THE PATIENT
- SURGICAL MANAGEMENT
- COMPLICATIONS OF PANCREATIC SURGERY
- SUMMARY
- ACKNOWLEDGMENT
CHAPTER 20:Pancreatic Cancer
- EPIDEMIOLOGY
- PREVENTION AND EARLY DETECTION
- BIOLOGY AND MOLECULAR MECHANISMS
- PATHOLOGY AND PATHOGENESIS
  - Pathology
  - Pathways of Spread
- CLINICAL EVALUATION
  - Patient Evaluation
- STAGING
- PRIMARY THERAPY
  - Surgery
    - Prognostic Factors Associated with Surgery
    - Patterns of Failure after Surgery
- ADJUVANT THERAPY
- LOCALLY ADVANCED DISEASE
- PALLIATION AND SUPPORT
  - Best Supportive Care
- IRRADIATION TECHNIQUES
- TREATMENT ALGORITHM, CONTROVERSIES AND FUTURE POSSIBILITIES
CHAPTER 21:Hepatobiliary Malignancies
- INTRODUCTION
- EPIDEMIOLOGY
- ETIOLOGY
- PREVENTION AND EARLY DETECTION
- BIOLOGIC CHARACTERISTICS
- PATHOLOGY AND PATHOGENESIS
- CLINICAL EVALUATION
- PRIMARY THERAPY
- LOCALLY ADVANCED DISEASE AND PALLIATION
- IRRADIATION TECHNIQUES
  - Dose-Limiting Organs
  - Irradiation Technique
    - Liver
    - Gallbladder and Extrahepatic Cholangiocarcinoma
- TREATMENT ALGORITHM AND FUTURE DIRECTIONS
CHAPTER 22:Radiation Therapy in Hematologic Malignancies
- INTRODUCTION
- ACUTE LEUKEMIAS
- CHRONIC LEUKEMIAS
  - Chronic Myelogenous Leukemia
  - Chronic Lymphocytic Leukemia
- LYMPHOMAS
- GENERAL RADIATION THERAPY GUIDELINES
- CLASSIC RADIATION FIELDS
- NON-HODGKIN’S LYMPHOMA
CHAPTER 23:Principles of Care of Pediatric Malignancies
- INCIDENCE
- GENETIC BASIS FOR CANCER
- PRINCIPLES OF ASSESSMENT AND INVESTIGATIONS IN A CHILD WITH SUSPECTED CANCER
  - Specific Tests for Some Pediatric Cancers
- PRINCIPLES IN THE MANAGEMENT OF CHILDHOOD CANCERS
- SUPPORTIVE CARE IN PEDIATRIC MALIGNANCIES
- CONCLUSION
CHAPTER 24:Radiation Therapy in Gynecologic Cancers
- INTRODUCTION
- CERVICAL CANCER
- ENDOMETRIAL CANCER
- VULVAR CANCER
- VAGINAL CANCER
CHAPTER 25:Prostate Cancer
- INTRODUCTION
- DIAGNOSIS AND PROGNOSIS
- SURVEILLANCE
- SURGERY
- ANDROGEN DEPRIVATION THERAPY
- BRACHYTHERAPY
- DOSE ESCALATION AND INTENSITY-MODULATED RADIATION THERAPY
- IMAGE-GUIDED RADIATION THERAPY
- HYPOFRACTIONATION AND STEREOTACTIC BODY RADIATION THERAPY
- PROTON THERAPY
- POSTPROSTATECTOMY RADIATION THERAPY
- PALLIATIVE RADIATION
- SUMMARY AND CONCLUSION
CHAPTER 26:Castration-resistant Prostate Cancer
- INTRODUCTION
- RATIONALE AND MOLECULAR PATHWAYS
- CONCLUSION
CHAPTER 27:Ocular Malignancies: An Overview
- INTRODUCTION
- ANATOMY
- CLASSIFICATION
- METASTATIC CARCINOMA TO THE POSTERIOR UVEA
- MALIGNANT MELANOMA OF THE POSTERIOR UVEA
  - Callender's Classification of Uveal Melanoma
  - TNM Classification of Uveal Melanoma (International Union Against Cancer UICC)21
- RETINOBLASTOMA
- RADIATION TOXICITIES TO EYE
CHAPTER 28:Soft Tissue Sarcoma
- INTRODUCTION
- ETIOLOGY AND EPIDEMIOLOGY
  - Environmental Etiologic Factors
  - Molecular Pathogenetic Mechanisms
- PATHOLOGY
  - Classic Pathology Classification
  - Grade
- PATHOLOGIC FEATURES AND NATURAL HISTORY
- MANAGEMENT
- PRIMARY THERAPY
CHAPTER 29:Drug Discovery and Clinical Trial Process
- INTRODUCTION
- WHY DO WE NEED CLINICAL TRIALS?
- DRUG DISCOVERY PROCESS—A LONG JOURNEY
- PRECLINICAL TESTING
- CLINICAL TESTING
- CLINICAL TRIAL ENDPOINT/OUTCOME
- GENERAL ENDPOINT CONSIDERATIONS IN ONCOLOGY CLINICAL TRIALS
- MOLECULAR BIOLOGY AND GENETICS IN ONCOLOGY
- CLINICAL RESEARCH MARKET (SIZE AND TRENDS)
- CLINICAL TRIALS—Dr DC doval's EXPERIENCE
CHAPTER 30:Quality Assurance of High Dose Rate: Brachytherapy (Remote Afterloading Unit)
- INTRODUCTION
- NEED FOR QUALITY ASSURANCE IN RADIOTHERAPY
- TEST FREQUENCIES
  - Daily Quality Assurance
  - Monthly Quality Assurance in Linac (Infinity/Synergy-S)
- DAILY QUALITY ASSURANCE
  - Monthly Quality Assurance (At the Time of Source Replacement or Source Calibration)
- DAILY QUALITY ASSURANCE
- MONTHLY QUALITY ASSURANCE
CHAPTER 31:Pain Management in Cancer Patients
- INTRODUCTION
- COMMON TERMINOLOGIES AND CONCEPTS IN PAIN
- MANAGEMENT OF PAIN

INDEX

TOC
Index

Chapter Notes