Gokhan Ozyigit (editor) - Prevention and Management of Acute and Late Toxicities in Radiation Oncology: Management of Toxicities in Radiation Oncology

This Springer imprint is published by the registered company Springer Nature Switzerland AG

The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

The role of radiation oncologists in multidisciplinary care is gradually becoming essential and more involved in patient care in the current era of improving technology and individualized management. As the patients awareness and their participation in treatment decisions increase, the clinicians have been discussing more and more about the quality of life issues in addition to outcome matters. Therefore, acute and late toxicity management is more crucial than ever in our clinical practice in comparison to a decade ago. We have planned to provide a structured and comprehensive book to deliver a current evidence-based and/or practice-proven management tool to feel confident in prescribing the innovative treatments with a goal of functionally unimpaired patient during and after radiotherapy.

In this context, our book covers prevention and current management of acute and late toxicities of radiation therapy in a wide range of malignancies, while each chapter focuses on a particular anatomic site with information on normal sectional anatomy, contouring of target volumes and organs at risk, dose constraints, the pathophysiology of radiation toxicity, and treatment approaches for each potential toxicity; given under the variability of planning and delivery of intensity-modulated radiation therapy, volumetric modulated arc therapy, stereotactic radiosurgery, and stereotactic body radiotherapy.

Overall, this book will enable the selection of appropriate, evidence-based management options in individual patients who experience radiation toxicities, taking into account the organ-specific pathophysiology of radiation injury, for practicing clinical and radiation oncologists, radiotherapists, fellows, residents, and nurses.

We hope to encourage the clinicians through practical and theoretical aspects of acute and late toxicity management in modern radiation oncology, and we extend our most sincere gratitude to our patients, who stand side by side with us to fight with their cancer, and who teach us invaluable lessons to brace our faith to succeed.

The editors are indebted to Gesa Frese and Wilma McHugh from Springer DE and Niveka Somasundaram and Mariesha Justin from SPi Global/Springer Nature for their assistance in preparingPrevention and Management of Acute and Late Toxicities in Radiation Oncology. We extend our most sincere gratitude to our colleagues and friends at Hacettepe University, Ko University, and Baskent University as well as our families.

The central nervous system (CNS) consists of the brain and the spinal cord (SC). The spinal cord is a single structure, whereas the adult brain can be defined by four major regions: the cerebrum, the diencephalon, the brain stem, and the cerebellum. The main functions of the CNS include receiving, processing, and responding to sensory information.

Embryologically, the brain is composed of the prosencephalon (forebrain), the mesencephalon (midbrain), and the rhombencephalon (hind brain). The prosencephalon forms the two hemispheres (telencephalon) and the diencephalon (interbrain) during the later stages of embryogenic life [].

The cavities within the cerebral hemispheres are called as the right and the left lateral ventricles, which communicate with the third ventricle via interventricular foramen (foramen of Monro). The first and the second ventricles lie within the hemispheres of the brain, and the third ventricle is located in the interbrain. The space between the pons, bulbus, and the cerebellum is called as the fourth ventricle. These ventricles are continuous with one another and with the central canal of the spinal cord. The inner surface of the ventricles is lined by ependymal cells, and protruding into each ventricle is a choroid plexus which functions in the production of cerebrospinal fluid (CSF). About 300400 mL of CSF is produced daily. The CSF forms a liquid cushion for the brain, and helps to nourish the brain.

The brain and spinal cord is covered by three membranes which are called the meninges. The dura mater is the outermost layer of the meninges, lying directly underneath the bones of the skull and vertebral column. Inside the dura mater there is the arachnoid mater. Arachnoid mater consists of layers of connective tissue. It is avascular, and does not receive any innervation. Underneath the arachnoid mater is the sub-arachnoid space which contains CSF. The pia mater is located underneath the sub-arachnoid space. It is very thin, and is tightly adhered to the surface of the brain and spinal cord. It follows the contours of the brain. Like the dura mater, pia mater is highly vascularized with blood vessels perforating through the membrane to supply the underlying neural tissue. Therefore the dura mater and pia mater are very sensitive to pain.