By Robert G. Parker MD, Nora A. Janjan MD, Michael T. Selch MD (auth.)
Given that therapy with healing purpose is feasible in just one-half of melanoma sufferers, and that such remedy often fails, the vast majority of sufferers with melanoma would require aid of indicators and indicators brought on by their sickness. during this publication, the explicit contribution of radiation treatment to palliation is taken into account in the context of multidisciplinary administration. person chapters are dedicated to palliative radiation treatment for basic tumours and metastases at assorted websites. The administration of ache is mentioned, and chapters also are dedicated to finish of lifestyles care, the administration of problems of radiation remedy, and worthwhile medicinal drugs. This publication will turn out priceless and fascinating not just to radiation oncologists but in addition to scientific scholars of every age and to medical professionals from all disciplines who're interested by the comfort or prevention of ache in sufferers with cancer.
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American Cancer Society, Atlanta 3. Posner JB (1992) Management of brain metastases. Rev NeuroI148:477-487 4. De Angelis LM, Cairncross JG (1997) Approach to the patient with tumors of the central nervous system. In: Kelley WN (ed) Textbook of internal medicine. Lippincott-Raven, Philadelphia, pp 2331-2339 5. Delattre JY, Krol G, Thaler HT, Posner JB (1988) Distribution ofbrain metastases. Arch NeuroI45:741-744 6. Cairncross JG, Posner JB (1983) The management ofbrain metastases. In: Walker MD (ed) Oncology of the nervous system.
4. 5. 6. 7. 8. metastases to the brain. The most frequent sources in adults are primary cancers of the lung and breast, melanomas, and those of unknown origin. In children they are osteosarcomas, rhabdomyosarcomas, Ewing's tumors, and germ cell tumors. More than two-thirds of these patients will develop tumor-related neurologie symptoms or signs. Metastases to the brain must be differentiated from primary brain tumors, infarcts, focal hemorrhages, or abscesses. Radiation therapy, usually teletherapy with highenergy photons, has been the mainstay of treatment.
Therefore, prevention of such fractures should be a major objective of management. In the RTOG 7402 study , pathologie fractures were reported in 13% of lesions in long bones and 6% in vertebral sites. The rate of fracture was slightly higher for those with a solitary meta stasis after a prolonged rather than a short course of irradiation. This finding may have been dose related. 5 cm in the neck, subtrochanteric, intertrochanterie, or supracondylar regions of the femur; there is diffuse involvement of bone in high-stress sites, especially in the presence of pain.
Radiation Oncology for Cure and Palliation by Robert G. Parker MD, Nora A. Janjan MD, Michael T. Selch MD (auth.)