Radiotherapy, Surgery, and Immunotherapy

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Cancer, a compresensive treatise 6

ISBN: 1468427415
ISBN 13: 9781468427417
Herausgeber: Frederick Becker
Verlag: Springer Verlag GmbH
Umfang: xvi, 544 S., 31 s/w Illustr., 544 p. 31 illus.
Erscheinungsdatum: 12.12.2012
Auflage: 1/1977
Produktform: Kartoniert
Einband: KT

InhaltsangabeRadiotherapy.- 1 Present Status of Radiation Therapy of Cancer: An Overview.- 1. Historical Introduction.- 2. General Clinical Considerations.- 3. Technical Considerations in Radiotherapy.- 4. Clinical Responses, Tissue Reactions, and Complications.- 5. Contemporary Results of Radiotherapy for Malignant Disease.- 6. Directions of Future Promise.- 7. References.- 2 Physics of Radiation Therapy.- 1. Introduction.- 2. Measurement of Radiation.- 3. Absorbed Dose to the Patient.- 4. External Beam Therapy.- 5. Brachytherapy.- 6. Review of Measurement and Calculation Methods.- 7. Conclusion.- 8. References.- 3 Molecular and Cellular Biology of Radiation Lethality.- 1. Introduction.- 2. Radiation Lethality of Prokaryotes.- 2.1. Evidence Implicating DNA.- 2.2. DNA Lesions and Their Repair.- 2.3 Physical and Chemical Parameters Affecting DNA Lesion Production and Stabilization.- 2.4. DNA-MembraneTargets.- 3. Radiation Lethality of Mammalian Cells.- 3.1. Damage and Repair Related to Survival.- 3.2. Targets Containing DNA.- 3.3. Inhibition of Sublethal Damage Repair.- 3.4 Fluorescent-Light Killing of Cells Containing 5-Bromodeoxyuridine.- 3.5. DNADamage.- 3.6. Hyperthermia and Repair of DNA.- 3.7 DNA Repair after Fluorescent-Light Exposure of BUdR-Containing Cells.- 3.8. Misrepair, a Hypothesis for Radiation Cell Killing.- 3.9. General Features of Mammalian Cell Killing and Summary.- 4. References.- 4 Cell Proliferation Kinetics and Radiation Therapy.- 1. Introduction.- 2. Response to Single Doses of Radiation.- 2.1. Sensitivity through the Cell Cycle.- 2.2. Hypoxic Cells in Tumors.- 3. Response to Fractionated Irradiation.- 3.1. Reassortment.- 3.2. Repopulation.- 3.3. Hypoxia and Reoxygenation.- 3.4. Repair Processes.- 4. Cell Proliferation Studies.- 4.1. Solid-Tumor Kinetics.- 4.2. Changes in Tumor Kinetics after Irradiation.- 4.3. Normal Tissue Kinetics: Changes after Irradiation.- 5. Conclusions.- 6. References.- 5 Radiation Effects on Normal Tissues.- 1. Introduction.- 2. Dose-Response Curves.- 2.1. Lethality Studies in Animals.- 2.2. Functional Tests.- 2.3. Cell Survival Clonal Assays.- 2.4. Clinical Studies.- 3. Time of Expression of Damage.- 3.1. Phases of Radiation Response.- 3.2. Late Effects in Radiotherapy.- 4. A Comparison of Human Tissue Radiosensitivities with Those of the Experimental Animal.- 5. Analysis of Clinical Tolerance Levels.- 6. Changes in Therapeutic Modalities.- 6.1. Fractionation Schedules.- 6.2. Hypoxia and Radiation Modifiers.- 6.3. High-LETRadiation.- 6.4. Modification of Injury by Drugs and Other Factors.- 6.5. Hyperthermia and X-Rays.- 7. Prophylactic Irradiation.- 7.1. Normal Tissue Tolerance to Prophylactic Irradiation.- 7.2. Metastases in Irradiated Normal Tissues.- 7.3. Carcinogenesis.- 8. References.- 6 Hypoxic Cell Sensitizers for Radiotherapy.- 1. Introduction.- 1.1. Adjunctive Agents, Potentiating Agents, and Radiation Sensitizers.- 1.2. Classification of Radiation Sensitizers.- 2. Methods of Overcoming the Hypoxia Problem.- 2.1. Optimum Fractionation.- 2.2. High-LET Radiation.- 2.3. Hyperbaric Oxygen.- 2.4. Electron-AffmicSensitizers.- 3. Development of Electron- Affinic Sensitizers.- 3.1. TheElectron-AffinicRelationship.- 3.2. The Search for Mammalian Cell Sensitizers.- 4. The Nitroimidazoles.- 4.1. Basic Structure.- 4.2. Metronidazole.- 4.3. The 2-NitroimidazoleRo-07-0582.- 5. Criteria for the Application of Sensitizers in Radiotherapy.- 5.1. Differential Sensitization with Respect to Normal Tissue.- 5.2 Wide Distribution in Tissues.- 5.3. Stability with Respect to Tumor Penetration.- 5.4. Acceptable Toxicology.- 5.5. Effectiveness of Sensitization and Position in the Cell Cycle.- 5.6. Sensitization with Fractionated Radiation.- 6. Clinical Studies.- 6.1. Metronidazole.- 6.2. Ro-07-0582: Single-Dose Studies.- 7. Future Developments.- 7.1. Differential Toxicity to Hypoxic Cells.- 7.2. Combination of Sensitizers and High-LET Radiation.- 7.3. Shoulder Effects.- 7.4. Mechanisms and the Search for N

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Beschreibung

The history of the development of cancer therapy has been marked by a recurring pattern, one of initially exciting and encouraging results as new methods were introduced, followed by dismaying failures. The extremity of the disease and its high mortality have dictated that each means of damaging tumor cells would be rapidly explored and exploited as a mode of therapy, long before the correspond ing theory and technique were completely understood and perfected. Thus radiation was used as an antitumor agent almost immediately following recogni tion of its cytodestructive capability. Equally constant, following the rapid utilization of new therapeutic methods, has been a period of significant technical improvements. This second aspect of the pattern is also illustrated by the field of radiotherapy. New radiation sources, new methods of dosimetry, use of high-energy radiation, and other new techniques allowed the therapist to better focus upon the tumor and to improve the geometry of exposure. Thus, with each technical advance, the "reach" of radiotherapy was increased and damage to normal tissues was decreased. Inevitably, however, a limit was reached, a point at which clinicians and researchers realized they could go no further without returning to a more fundamental search, one based on the biology of the tumor cell itself.

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