Induction Chemotherapy Integrated Treatment Programs for Locally Adv
Induction chemotherapy, as part of an integrated plan of management for locally advanced cancers, is being practised throughout the world in independent, isolated departments in universities, teaching hospitals, and clinical schools. Frequently, however,
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Karl Reinhard Aigner • Frederick Oscar Stephens (Editors)
Induction Chemotherapy Integrated Treatment Programs for Locally Advanced Cancers
Editors Prof. Dr. Karl Reinhard Aigner Abt. Onkologische Chirurgie Medias Klinikum GmbH & Co. KG Krankenhausstrasse 14a 84489 Burghausen Germany [email protected] [email protected]
Prof. Frederick Oscar Stephens University of Sydney Inkerman Street 16 2088 Mosman, NSW Australia [email protected]
ISBN 978-3-642-18172-6 e-ISBN 978-3-642-18173-3 DOI 10.1007/978-3-642-18173-3 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2011925993 © Springer-Verlag Berlin Heidelberg 2011 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover design: eStudioCalamar, Figueres/Berlin Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
Induction chemotherapy is chemotherapy used as the first modality of an integrated-treatment program. It can be an effective method of reducing locally advanced or aggressive primary cancers to improve their prospects of cure by planned follow-up surgery and/or radiotherapy. The simplest and most readily available method of administering induction chemotherapy is by systemic delivery, but in some situations a greater chemotherapy impact can be achieved by delivering a more concentrated dose of effective anti-cancer agents more directly to the region containing the cancer. This regional chemotherapy is usually best achieved by delivering the chemotherapy directly into the arterial blood supply of the cancer. However intra-thoracic, intra-peritoneal or intra-thecal delivery may be more appropriate in some situations. To achieve an advantage by intra-arterial delivery, the tumour must be fully contained in tissue supplied by one or more arteries that can be effectively cannulated and infused. The cancer must also be of a type that will respond better to concentrated doses of anticancer agents over a limited period and the m
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