John Han-Chih Chang, MD
University of Pennsylvania Health System
Last Modified: November 1, 2001
Authors/Editors: Edward Halperin, MD; Louis Constine, MD; Nancy Tarbell, MD; Larry Kun, MD|
Publisher: Lippincott William & Wilkins, 1999
The authors of this text hail from the departments of radiation oncology at Duke University Medical Center, University of Rochester Medical Center, Massachusetts General Hospital (Harvard Medical School) and the St. Jude Children's Research Hospital. They endeavored to create a volume that was comprehensive yet concise to deal with the subject of pediatric oncology with particular attention to radiation treatment. The intended audience is the medical professional and, in particular, radiation oncologists.
The text begins with a chapter on the epidemiology of cancer in children. There are discussions concerning incidence and relative frequencies of different malignancies. Mortality rates, the meaning of cure and issues surrounding quality of life are addressed. The subsequent 17 chapters address specific pediatric malignancies. The chapters are designed such that there is a natural progression in the discussion of the cancer care process. Each chapter begins with epidemiology and etiology followed by descriptions of the natural history of the tumor, diagnostic work-up, staging systems, prognostic factors and various aspects of cancer treatment. Surgery, chemotherapy and radiation therapy are discussed extensively followed by summaries of the published results of treatment. As this is a text written by radiation oncologists, special attention is paid to radiation techniques and strategies. Precautions during and after treatment along with the sequelae of treatment are also discussed.
The final four chapters provide a unique strength to the manuscript. In chapters 19 and 20, the authors detail the possible devastating long term effects of treatment including the occurrence of secondary cancers due to treatment. Dr. D'Angio, one of the "founding fathers" of pediatric radiation oncology has often been heard to state that, "Cure is not enough." This is grounded in the philosophy that since more and more children are being "cured" of their malignancies, much more attention must be paid to preventing these secondary toxicities of treatment. The final two chapters address some of the important technical issues regarding radiation therapy (immobilization and anesthesia for external beam radiation treatment for children).
The organization of the book is very efficient and effective. The text is filled with tables, charts and figures to help clarify the written text. Each chapter is concise and provides an easy-to-read summary of each topic.
From the first edition published in 1989 to the current text, the authors have succeeded in providing an excellent reference in the arena of pediatric malignancies. Despite the radiation oncology slant of the text, it can be an invaluable resource to any physician interested in the malignancies that plague the pediatric population.