Normal Tissue Reactions in Radiotherapy and Oncology

Reviewed by:


W Dörr et al
Published by Karger (2002)
ISBN: 3-8055-7284-0.  200 pages plus index.
RRP: US$171.50

Experimental studies of the biological effects of radiotherapy began soon after the discovery of x-rays in 1895. Holthusen published the first clinical study on chronic normal tissue damage in 1936. However, there is still much that is unknown. Today, in the era of radiation dose-escalation and combined therapies (with their synergistic and supra-additive effects), it is increasingly critical that our knowledge of this area is furthered.

Normal Tissue Reactions in Radiotherapy and Oncology, by Wolfgang Dörr et al, is a compendium of current experimental concepts and evolving knowledge of the effects of radiotherapy on normal tissue. It is part of the Frontiers of Radiation Therapy and Oncology series.

It is comprised of 25 valuable and well-structured papers by 72 contributors, all of which were presented at the International Symposium on Normal Tissue Reactions in Radiotherapy and Oncology held in Marburg in April 2000.

The central focus of these papers is the understanding of the mechanisms involved in the biological effects of radiation at the cellular and molecular levels, and the management of these side effects aimed at improving the therapeutic ratio overall. A major prerequisite in current day management of such effects is the detailed and appropriate scoring of acute and late toxicities, if necessary, supplemented with additional diagnostic procedures, eg ultrasound for skin changes and FDG PET for lung changes. Clinical management approaches to dealing with various side effects of radio- and radiochemotherapy must be explored and designed for the individual organs affected. A few examples of this have been presented in the book.

The various categories into which the papers fall include current concepts in radiation biology, anaemia-associated fatigue in cancer patients, clinical management of side effects, radiation protection, stereotactic radiosurgery, and radiation physics and IMRT. The final two chapters deal specifically with the application of such techniques in head and neck, and prostate cancer.

The papers are written by a consortium of clinicians and scientists, and therefore one of the limitations from which the book inevitably suffers is the inconsistent writing styles, and the fact that the book does not appear to “flow” in a logical sequence of chapters.

Nevertheless, it benefits from the enormous advantage of the accumulated expertise of several leading scientists and specialists in the area of radiation research. The book is pitched at a broad audience, one that includes specialist radiation oncologists and clinical oncologists, medical and radiation physicists, radiation technicians, specialist cancer nurses, and cancer research scientists involved in the translational research chain. In particular, I recommend it as a valuable resource to be included in the radiobiology reading list of trainee radiation oncologists in Australasia.

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