Radiation Oncology. Radiobiological and Physiological Perspectives. the Boundary Zone between Clinical Radiotherapy and Fundamental Radiobiology And

About this book

An optimum complication-free tumour control is a cardinal principle in cancer management. Radiotherapy, alone or in combination with chemotherapy and/or surgery, is increasingly used in cancer management. The second edition of this book highlights the progress made in our knowledge of clinical radiobiology and radiophysics and points out the impact of such progress in improving the results of cancer treatment both as regards tumour control and tissue morbidity. This is in continuity of the policy adopted in the first edition which emphasized the need to identify the "boundary zone" between the rapidly developing knowledge in fundamental radiobiology and radiotherapeutic oncology. This task has become increasingly difficult in view of the complexity of the acquired knowledge in both cancer biology and basic radiobiology. Nevertheless, an attempt is made, in the present edition, to simplify modern findings and concepts without losing depth of knowledge.

The book is addressed to readers from a number of disciplines involved in cancer treatment and related research. For the practicing radiotherapist, the main focus is on the genesis and development of normal tissue damage, methods to minimize such damage, fractionation and adding different radiotherapy schedules, treatment gaps and re-irradiation. Optimization of the use of modern high accuracy radiation therapy procedures, optimization of multiple modality cancer treatment and prediction of normal tissue and tumour response are of special concern to radiotherapists engaged in clinical research. For radiobiologists having interest in cancer treatment the problem of prediction of normal tissue and tumour response is of special concern. In addition, biologists are interested in preclinical studies dealing with agents that either enhance the tumour response or protect normal tissues. The book also addresses medical oncologists dealing with combined chemoradiotherapy. Diagnostic imaging, including nuclear scanning procedures are, at present, increasingly used in cancer diagnosis, staging and treatment planning. The book is addressing these possibilities. The role of the physicists in development of treatment planning systems, 4-dimensuional treatment planning, securing treatment accuracy and radiation protection are also main topics.

Written for: Radiotherapy oncologists, medical oncologists, radiobiologists, diagnostic radiologists and nuclear medicine specialists, oncology research workers particularly those engaged in clinical trials, cancer biologists, radiation physicists, and surgical oncologists.

Keywords:

• Oncology
• Radiation protection
• Radiobiology
• Radiotherapy
• Translational cancer research

Table of contents

Part I Development of Radiation Damage from the Initial Physical Events to the Expression of the Clinical Response

Chapter I.1 The Overall Radiobiological Effect: the Evolution of Radiation damage

Part II Radiobiological Background

Chapter II.1 Evolution of Radiation-Induced Damage:

Part I. Signal Transduction, DNA Damage and Repair

Chapter II.2 Evolution of Radiation-induced damage:

Part II: Cell Cycle Arrest

Chapter II.3 Evolution of Radiation-Induced Damage:

Part III: Chromosomal Aberrations and Cell Death

Part III. Radiation-Induced Normal Tissue Damage: General Aspects

Chapter III.1 Dose-Survival Relationships in Mammalian Cells: Forms and Interpretations

Chapter III.2 Early and Late Normal Tissue Reaction: Pathogenesis

Chapter III.3 Dose-Time Response Relationships for Normal Tissue Reactions - The Volume Effect

Chapter III.4 Individual Variation of Normal Tissue Radiosensitivity: Prediction and the Genetic Factor.

Part IV Biological and Clinical Aspects of Radiation Response of Normal Tissues: Specific Examples

Chapter IV.1 Early Reacting Tissues: Skin

Chapter IV.2 Early Reacting Tissues: The Haematopoietic Tissues

Chapter IV.3 Early Reacting Tissues: The Digestive Tract: 0rodigestive mucosa and Salivary Glands

Chapter IV.4 Early Reacting Tissues: Stomach and Intestines

Chapter IV.5 Early Reacting Tissues: The Testes

Chapter IV.6 Radiation Effects on the Ovary: a Nonrenewable System

Chapter IV.7 Late Reacting Tissues: Radiation-Induced Lung Damage

Chapter IV.8 Late Reacting Tissues: The Urinary Tract

Chapter IV.9 Late Reacting Tissues: Radiation-Induced Liver Damage

Chapter IV.10 Late Reacting Tissues: Radiation-Induced Damage to the Central Nervous System

Chapter IV.11 Late Reacting Tissues: Radiation-Induced Heart Damage

Part V Radiation Response of Tumours

Chapter V.1 Tumour Growth: Organization of Tumour Proliferative Activity

Chapter V.2 Tumour Growth Pattern and Measurements - Gene-Expression Signature (cDNA Microarray)

Chapter V.3 Growth parameters of Tumours: Clinical Implications

Chapter V.4 Tumour Response to Single and Multifraction Radiotherapy. Prediction

Chapter V.5 Brachytherapy

Chapter V.6 Hypoxia

Chapter V.7 Estimate of the Outcome of Radiotherapy. Accuracy Requirement

Part VI Combined Modality Treatment

Part VI.1 Chemoradiotherapy

Part VI.2 Combinations with Surgery

Concluding Remarks