Tumors of the Brain and Spine

It is frequently stated that progress in the management of tumors of the brain and spine has not occurred in the past 25 years. Such statements seriously underestimate and misrepresent progress in managing various central nervous system tumors, the tremendous technologic enhancements that have revolutionized the imaging of the tumors and the host organ, the multitude of surgical adjuncts such as computerized imaging guidance and functional mapping of the brain and its tracts that are routinely used in the modern neurosurgical operating room, and the highly conformal delivery of radiation to the tumor mass with remarkable sparing of the surrounding nervous tissue. Underlying these technologic improvements are the changes in philosophy that have resulted in a true multidisciplinary approach. Equally significant is the molecular revolution that is identifying key markers behind the genesis of brain tumors, their proliferation, and their resistance to therapy. These molecular discoveries have ushered in the era of molecular targeted therapy, as first demonstrated by the extraordinary success story in chronic myelogenous leukemia of imatinib (Gleevec). The rational combination of targeted agents will revolutionize the way che- therapy is given, either alone or in conjunction with radiotherapy. Lastly, focused attention to patients’ well-being has emphasized all measures of quality of life, has encouraged greater participation by patients and their caregivers in the decision-making process, and has encouraged the development of a variety of quality-of-life measurement tools to ensure that adverse effects of treatment are recognized and addressed.

Our rapidly increasing knowledge about tumors of the brain and spine has rendered these tumors more treatable than ever before. In the new world of central nervous system oncology, maximally complete resection is followed by conformal radiotherapy and often by chemotherapy, the selection of which is based on the tumor’s susceptibility to drugs that have biological actions known to interact with the tumor’s particular molecular signature.

The chapters of this book collectively weave a tapestry depicting the range of medical, surgical, and radiotherapeutic approaches to neuro-oncology as it is practiced at M. D. Anderson Cancer Center, along with the diversity of disciplines needed for effective therapy. M. D. Anderson faculty describe their current approaches to patient assessment, decision making, and management of central nervous system tumors, including treatment for either palliation or for cure.

Tumors of the Brain and Spine is the sixth book in the M. D. Anderson Cancer Care Series. This book, like the others in this series, highlights integrated care and focuses on treating the patient through the entire spectrum of the disease.

This thorough, practical volume, which includes more than 70 illustrations and 30 tables, is an essential clinical guide for oncologists, surgeons, and other health care providers involved in the care of patients with central nervous system tumors.