The Fourth Edition of this landmark work features nine new chapters and has been thoroughly revised and updated to reflect contemporary findings. It is the only text that covers every important aspect of radiation oncology?from basic cancer biology, radiation biology, and radiation therapy physics to state-of-the-art treatment regimens for all cancer sites and tumor types and discussions of results. Principles and Practice of Radiation Oncology is designed to provide a better understanding of the natural history of cancer, the physical methods of radiation application, the effects of irradiation on normal tissues, and the most judicious ways in which radiation therapy can be employed in the treatment of cancer patients. This encyclopedic text places greater emphasis on the use of radiation oncology in palliative and supportive care, in addition to therapy. Included in the new edition: chapters on molecular biology and physiology, technology assessment and cost benefit, combined chemotherapy and irradiation in head and neck cancer, breast: stage Tis, pancreas, leukemias (adult and childhood), retinoblastoma, unusual tumors in childhood, and endovascular brachytherapy. This edition also features expanded coverage of new 3-D techniques and IMRT and a greater emphasis on pediatric concerns.

Contributors Preface TNM Cancer Staging Acknowledgments 1 The Discipline of Radiation Oncology 1 2 Biologic Basis of Radiation Therapy 96 3 Molecular Cancer and Radiation Biology 137 4 Molecular Pathophysiology of Tumors 163 5 Principles of Radiologic Physics, Dosimetry, and Treatment Planning 180 6 Photon External-Beam Dosimetry and Treatment Planning 219 7 Electron-Beam Therapy: Dosimetry, Planning, and Techniques 252 8 Three-Dimensional Conformal Radiation Therapy: Physics, Treatment Planning, and Clinical Aspects 283 9 Intensity-Modulated Radiation Treatment Planning, Quality Assurance, Delivery, and Clinical Application 314 10 Altered Fractionation Schedules 337 11 Late Effects of Cancer Treatment on Normal Tissues 357 12 Methodology of Clinical Trials 391 13 Magna-Field Irradiation 400 14 Stereotactic Irradiation 410 15 Intraoperative Radiation Therapy 428 16 Particle Beam Radiotherapy: Clinical Perspective 457 17 Physics and Biology of Brachytherapy 472 18 Clinical Applications of Brachytherapy I. LDR and PDR 538 19 Physics and Dosimetry of High-Dose-Rate Brachytherapy 604 20 Clinical Aspects of High-Dose-Rate Brachytherapy 619 21 Nonsealed Radionuclide Therapy 636 22 Radioimmunoglobulins in Cancer Therapy 653 23 Radiation Response Modulation 663 Pt. A Chemical Sensitizers and Protectors Pt. B Biological Response Modifiers 24 Hyperthermia 699 25 Basic Concepts of Chemotherapy and Irradiation Interaction 736 26 Skin 757 27 Malignant Neoplasms Associated with the Acquired Immunodeficiency Syndrome (AIDS) 776 28 Brian, Brain Stem, and Cerebellum 791 29 Pituitary 839 30 Spinal Canal 860 31 Eye and Orbit 876 32 Ear 897 33 The Role of Combined Radiation Therapy and Chemotherapy in the Management of Locally Advanced Squamous Carcinoma of the Head and Neck 905 34 Nasopharynx 918 35 Nasal Cavity and Paranasal Sinuses 962 36 Salivary Glands 976 37 Oral Cavity 997 38 Oropharynx (Tonsillar Fossa, Faucial Arch, and Base of Tongue) 1022 39 Hypopharynx 1071 40 Larynx 1094 41 Unusual Nonepithelial Tumors of the Head and Neck 1117 42 Head and Neck: Management of the Neck 1158 43 Thyroid 1179 44 Lung 1201 45 Mediastinum and Trachea 1244 46 Esophagus 1282 47 Tumors of the Heart and Great Vessels 1305 48 Breast: Stage Tis 1315 49 Breast: Stage T1 and T2 Tumors 1331 50 Breast: Locally Advanced (T3 and T4) and Recurrent Tumors 1502 51 Stomach 1554 52 Cancer of the Pancreas 1574 53 Liver and Hepatobiliary Tract 1589 54 Colon and Rectum 1607 55 Anal Canal 1630 56 Kidney, Renal Pelvis, and Ureter 1649 57 Bladder 1664 58 Prostate Cancer 1692 59 Testis 1763 60 Penis and Male Urethra 1785 61 Uterine Cervix 1800 62 Endometrium 1916 63 Ovary 1934 64 Fallopian Tube 1958 65 Vagina 1967 66 Female Urethra 1994 67 Carcinoma of the Vulva 2003 68 Retroperitoneum 2023 69 Adrenal Gland 2036 70 Hodgkin's Disease 2043 71 Non-Hodgkin's Lymphoma 2064 72 Cutaneous T-Cell Lymphoma 2112 73 Leukemia 2125 74 Myeloma and Plasmacytomas 2157 75 Bone 2168 76 Soft Tissue Sarcomas (Excluding Retroperitoneum) 2185 77 Central Nervous System Tumors in Children 2206 78 Wilms' Tumor 2238 79 Neuroblastoma 2247 80 Rhabdomyosarcoma 2261 81 Ewing's Sarcoma 2277 82 Lymphomas in Children 2285 83 Unusual Tumors in Childhood 2308 84 Radiation Treatment of Benign Disease 2332 85 Endovascular Brachytherapy 2352 86 Palliation of Brain and Spinal-Cord Metastases 2373 87 Palliation of Bone Metastases 2385 88 Palliation of Visceral Recurrences and Metastases 2405 89 Pain Management 2412 90 Supportive Care and Quality of Life in Radiation Oncology 2426 91 Technology Assessment, Cost Benefit, Outcome Research, and Evidence-Based Medicine 2443 92 Ethics, Professional Values, and Legal Considerations in Radiation Oncology 2461 Index 2471