Gunderson & Tepper’s Clinical Radiation Oncology

1. Introduction - p. 422 2. Proton Therapy - p. 422 3. Central Nervous System Tumors - p. 423 4. Ocular Melanoma and Eye Disease - p. 428 5. Head and Neck Malignancies - p. 428 6. Thoracic Malignancies - p. 430 7. Breast Cancer - p. 431 8. Gastrointestinal Malignancies - p. 432 9. Gynecologic Malignancies - p. 435 10. Genitourinary Malignancies - p. 435 11. Lymphoma and Hematological Malignancies - p. 437 12. Sarcoma - p. 437 13. Pediatric Malignancies - p. 438 14. Metastatic and Radiorecurrent Disease - p. 439 15. Cost Effectiveness of Proton Therapy - p. 440 16. Carbon Ion Radiation Therapy - p. 441 17. Neon Ion Radiotherapy - p. 442 18. π-Meson Radiotherapy - p. 443 19. Helium Ion Radiotherapy - p. 443 20. Conclusions - p. 443 21. 27. Radiopharmaceutical Therapy - p. 445 22. 28. Radiotherapy and Immunotherapy - p. 458 23. 29. Stereotactic Irradiation: CNS Tumors - p. 464 24. 30. Stereotactic Body Irradiation: Extracranial Tumors - p. 472 25. 31. Metastatic Disease: Bone, Spinal Cord, Brain, Liver, and Lung - p. 478 26. Bone Metastases - p. 478 27. Stereotactic Body Radiation Therapy for Nonspine Bone Metastases - p. 488 28. Spinal Cord Compression - p. 489 29. Brain Metastases - p. 490 30. Liver Metastases - p. 493 31. Lung Metastases - p. 495 32. Section 3. Disease Sites - p. P3 33. Part A. Central Nervous System Tumors - p. S4 34. 32. Central Nervous System Tumors: Overview - p. 497 35. 33. Low-Grade Gliomas - p. 500 36. 34. High-Grade Gliomas - p. 512 37. Introduction - p. 512 38. Etiology and Epidemiology - p. 512 39. Prevention and Early Detection - p. 513 40. Pathology Characteristics and Molecular Classification - p. 513 41. Clinical Manifestations, Patient Evaluation, and Staging - p. 515 42. Primary Therapy - p. 515 43. Recurrent Disease - p. 523 44. Radiotherapy Techniques and Toxicities - p. 525 45. Treatment Algorithms, Controversies, Challenges, and Future Possibilities - p. 527 46. 35. Benign Brain Tumors: Meningiomas and Vestibular Schwannomas - p. 530 47. MENINGIOMA - p. 531 48. Etiology and Epidemiology - p. 531 49. Prevention and Early Detection - p. 531 50. Biologic Characteristics/Molecular Biology - p. 531 51. Pathology and Pathways of Spread - p. 531 52. Clinical Manifestations/Patient Evaluation/Staging - p. 532 53. Primary Therapy - p. 532 54. Higher Risk Patients (WHO Grades 2/3) - p. 535 55. WHO Grade 3 - p. 536 56. Radiation-Induced Meningioma (RIM) - p. 536 57. Neurofibromatosis-Related Meningioma - p. 536 58. Systemic Therapy - p. 536 59. Irradiation Techniques and Tolerance - p. 537 60. Treatment Algorithm - p. 538 61. VESTIBULAR SCHWANNOMA - p. 538 62. Etiology and Epidemiology - p. 538 63. Biologic Characteristics - p. 538 64. Pathology and Pathways of Spread - p. 539 65. Clinical Manifestations, Patient Evaluation, and Staging - p. 539 66. Irradiation Techniques and Tolerance - p. 546 67. Treatment Algorithms, Challenges, and Future Directions - p. 548 68. 36. Pituitary Tumors and Craniopharyngiomas - p. 550 69. Introduction - p. 550 70. Etiology and Epidemiology - p. 551 71. Biologic Characteristics and Molecular Biology - p. 551 72. Anatomy, Pathways of Spread, and Pathology - p. 551 73. Clinical Manifestations, Patient Evaluation, and Staging - p. 552 74. Primary Therapy - p. 555 75. Treatment Strategies for Specific Tumors - p. 559 76. Locally Advanced Disease and Palliation - p. 567 77. Irradiation Techniques and Tolerance - p. 567 78. Treatment Algorithms, Challenges, Controversies, Future Possibilities, and Clinical Trials - p. 568 79. Craniopharyngioma - p. 569 80. Targeted Therapy - p. 572 81. Conclusions - p. 572 82. 37. Spinal Cord Tumors - p. 574 83. Epidemiology and Etiology - p. 574 84. Prevention and Early Detection - p. 575 85. Biologic Characteristics and Molecular Biology - p. 575 86. Anatomy, Pathology, and Pathways of Spread - p. 576 87. Clinical Manifestations, Patient Evaluation, and Staging - p. 577 88. Primary Therapy - p. 580 89. Locally Advanced Disease and Palliation - p. 581 90. Radiotherapy Techniques and Tolerance - p. 581 91. Primary Therapy by Tumor Type - p. 584 92. Treatment Algorithm, Challenges, and Future Possibilities - p. 592 93. 38. Ocular, Orbital, and Optic Nerve Tumors - p. 595 94. Introduction - p. 595 95. Etiology and Epidemiology - p. 595 96. Optic Nerve Tumors - p. 596 97. Benign Ocular Conditions - p. 596 98. Biologic Characteristics/Molecular Biology - p. 596 99. Pathology and Pathways of Spread - p. 597 100. Clinical Manifestations/Patient Evaluation/Staging - p. 598 101. Primary and Adjuvant Therapy - p. 603 102. Locally Advanced Disease and Palliation - p. 609 103. Techniques of Radiation Therapy - p. 610 104. Intensity-Modulated Radiation Therapy - p. 611 105. Proton Therapy - p. 611 106. Tolerance Issues - p. 611 107. Conclusions and Future Possibilities - p. 616 108. Part B. Head and Neck Tumors - p. S5 109. 39. Overview - p. 617 110. 40. Oral Cavity - p. 626 111. Etiology and Epidemiology - p. 626 112. Prevention and Early Detection - p. 627 113. Oral Care - p. 627 114. Molecular Biology - p. 627 115. Lip Cancer - p. 627 116. Floor of Mouth - p. 631 117. Oral Tongue Cancers - p. 637 118. Buccal Mucosa - p. 642 119. Gingiva/Alveolar Ridge - p. 644 120. Retromolar Trigone - p. 647 121. Hard Palate - p. 649 122. Conclusions and Future Possibilities - p. 651 123. 41. Oropharyngeal Cancer - p. 653 124. Introduction - p. 653 125. Etiology and Epidemiology - p. 654 126. Prevention and Early Detection - p. 655 127. Biologic Characteristics and Molecular Biology - p. 656 128. Pathology and Pathways of Spread - p. 656 129. Clinical Manifestations, Patient Evaluation, and Staging - p. 660 130. Definitive Treatment - p. 662 131. Locoregionally Advanced Disease and Palliation - p. 668 132. RT Techniques and Tolerance - p. 675 133. Fractionation - p. 675 134. Hyperfractionation - p. 677 135. Acceleration Without Dose Reduction - p. 677 136. Acceleration With Dose Reduction - p. 677 137. Fractionation Summary - p. 677 138. RT Treatment Planning - p. 677 139. Brachytherapy - p. 679 140. Treatment-Related Side Effects - p. 679 141. Circulating Tumor HPV DNA - p. 681 142. Conclusions - p. 682 143. 42. Nasopharyngeal Carcinoma - p. 684 144. Etiology and Epidemiology - p. 684 145. Prevention and Early Detection - p. 685 146. Pathology - p. 685 147. Anatomy and Pathways of Spread - p. 686 148. Biological Characteristics and Molecular Biology - p. 688 149. Clinical Manifestations, Patient Evaluation, and Staging - p. 688 150. Primary Therapy - p. 691 151. Locally Recurrent or Persistent Disease - p. 695 152. Irradiation Techniques and Tolerance - p. 697 153. Treatment Algorithm, Conclusions, and Future Possibilities - p. 704 154. 43. Larynx and Hypopharynx Cancer - p. 707 155. Epidemiology and Etiology - p. 708 156. Prevention and Early Detection - p. 708 157. Pathology and Pathways of Spread - p. 709 158. Molecular Biology - p. 711 159. Clinical Manifestations, Patient Evaluation, and Staging - p. 711 160. Primary Therapy - p. 715 161. Locally Advanced Carcinomas - p. 719 162. Metastatic Disease - p. 722 163. Irradiation Techniques and Tolerance - p. 723 164. Treatment Algorithm, Controversies, Challenges, and Future Possibilities - p. 727 165. 44. Sinonasal Cancer - p. 732 166. Etiology and Epidemiology - p. 733 167. Prevention and Early Detection - p. 733 168. Nasal Vestibule - p. 735 169. Nasal Cavity and Ethmoid Air Cells - p. 738 170. Esthesioneuroblastoma (Olfactory Neuroblastoma) - p. 740 171. Maxillary Sinus - p. 743 172. Sinonasal Undifferentiated Carcinoma - p. 744 173. Sinonasal Neuroendocrine Carcinoma - p. 744 174. Sinonasal Mucosal Melanoma - p. 745 175. Sinonasal Adenoid Cystic Carcinoma - p. 746 176. Sinonasal Adenocarcinoma - p. 747 177. Sphenoid Sinus - p. 747 178. Frontal Sinus - p. 747 179. Radiation (RT) Target Volumes and Dose Fractionation Schedule - p. 747 180. Palliation - p. 748 181. Patient Setup and Field Arrangement - p. 748 182. Patient Care During and After Radiotherapy (RT) - p. 748 183. Future Possibilities - p. 750 184. Follow-Up - p. 750 185. Treatment Algorithms and Conclusions - p. 751.e1 186. 45. Salivary Gland Malignancies - p. 752 187. Etiology and Epidemiology - p. 752 188. Prevention and Early Detection - p. 753 189. Biologic Characteristics and Molecular Biology - p. 753 190. Salivary Gland Genetic and Molecular Biology - p. 753 191. Salivary Gland Tumor Microenvironment - p. 757 192. Clinical Manifestations, Patient Evaluation, and Staging - p. 759 193. General - p. 759 194. Radiographic studies - p. 759 195. Laboratory studies - p. 759 196. Primary Therapy - p. 760 197. Radiotherapy - p. 762 198. Locally Advanced Disease and Palliation - p. 764 199. Techniques of Radiotherapy - p. 768 200. Treatment Algorithm, Conclusions, Controversies, and Future Possibilities - p. 771 201. 46. Thyroid Cancer - p. 773 202. Etiology and Epidemiology - p. 774 203. Prevention and Early Detection - p. 775 204. Anatomy - p. 776 205. Biologic Characteristics/Molecular Biology - p. 776 206. Pathology and Pathways of Spread - p. 776 207. Clinical Manifestations, Patient Evaluation, and Staging - p. 777 208. Papillary Thyroid Carcinoma - p. 780 209. Follicular Thyroid Carcinoma and Oncocytic Carcinoma - p. 781 210. Medullary Thyroid Carcinoma - p. 782 211. Anaplastic Carcinoma - p. 783 212. Primary Therapy - p. 783 213. Thyroid Lymphoma and Anaplastic Thyroid Carcinoma - p. 789 214. Irradiation Techniques and Tolerance - p. 790 215. Treatment Algorithm, Conclusions, and Future Possibilities - p. 792 216. 47. Unknown Head and Neck Primary Site - p. 795 217. 48. Management of the Neck - p. 801 218. Anatomy of the Lymphatic System of the Neck - p. 801 219. Imaging of the Neck - p. 804 220. Staging of Neck Node Metastases - p. 805 221. Incidence and Distribution of Neck Node Metastases - p. 806 222. Recommendations for Selection of Target Volumes in the Neck - p. 811 223. Neck Node Dissection Procedures and Sentinel Node Biopsy - p. 813 224. Neck Node Delineation and Radiotherapy Techniques - p. 815 225. Control of the N0 Neck - p. 816 226. Control of the N1 to N3 Neck - p. 819 227. Late Complications After Neck Treatment - p. 826 228. Management of Recurrent Neck Disease - p. 827 229. 49. Cutaneous Carcinoma - p. 830 230. 50. Melanoma - p. 844 231. Part C. Thoracic Neoplasms - p. S6 232. 51. Overview - p. 853 233. 52. Small-Cell Lung Cancer - p. 861 234. 53. Non-small Cell Lung Cancer - p. 871 235. Introduction - p. 871 236. Epidemiology and Etiology - p. 872 237. Early Detection and Prevention - p. 872 238. Pathology and Molecular Biology of Lung Cancer - p. 873 239. Carcinogenesis and Pathways of Spread - p. 876 240. Clinical Manifestations, Patient Evaluation, and Staging - p. 878 241. Primary Therapy - p. 882 242. Radiation Treatment Planning and Techniques - p. 894 243. Systemic and Local Management of Metastatic Disease - p. 898 244. Palliation - p. 901 245. Controversies - p. 903 246. Conclusions - p. 903 247. 54. Uncommon Thoracic Tumors - p. 904 248. Thymic Tumors - p. 904 249. Pulmonary Carcinoid Tumors - p. 914 250. Mesothelioma - p. 919 251. Summary - p. 930 252. Part D. Gastrointestinal Tumors - p. S7 253. 55. Gastrointestinal Tumors Overview - p. 932 254. 56. Esophagus-Gastric Cancer - p. 936 255. Introduction - p. 937 256. Epidemiology and Etiology - p. 937 257. Prevention and Early Detection - p. 938 258. Biologic Characteristics and Molecular Biology - p. 938 259. Pathology and Pathways of Spread - p. 941 260. Primary Therapy - p. 942 261. Locally Advanced Disease and Palliation - p. 959 262. Irradiation Techniques and Tolerances - p. 960 263. Treatment Algorithm, Challenges, and Future Possibilities - p. 967 264. 57. Pancreatic Cancer - p. 973 265. Epidemiology and Risk Factors - p. 974 266. Pathology - p. 975 267. Anatomy and Patterns of Spread - p. 976 268. Molecular Genetics - p. 977 269. Clinical Manifestations, Patient Evaluation, and Staging - p. 979 270. Management of Resectable Disease - p. 982 271. Management of Borderline Resectable Disease - p. 987 272. Management of Locally Advanced Disease - p. 990 273. Management of Metasatic Disease - p. 993 274. Radiation Therapy Techniques - p. 994 275. Conclusions and Future Directions - p. 995 276. 58. Hepatobiliary Cancer - p. 998 277. Introduction - p. 998 278. Hepatocellular Carcinoma - p. 998 279. Cholangiocarcinoma - p. 1008 280. Gallbladder Cancer and Extrahepatic Cholangiocarcinoma - p. 1014 281. Hepatobiliary Cancer Irradiation Techniques and Tolerance - p. 1017 282. Hepatobiliary Cancer Treatment Algorithm and Future Directions - p. 1020 283. 59. Colon Cancer - p. 1021 284. 60. Rectal Cancer - p. 1037 285. Introduction - p. 1037 286. Epidemiology and Etiology - p. 1037 287. Prevention and Early Detection - p. 1038 288. Pathology and Pathways of Spread - p. 1038 289. Clinical Manifestations, Patient Evaluation, and Staging - p. 1038 290. Biological Characteristics and Molecular Biology - p. 1039 291. Treatment of Rectal Cancer - p. 1040 292. Locally Advanced Rectal Cancer - p. 1042 293. Locally Advanced Unresectable Primary or Locoregionally Recurrent Disease - p. 1055 294. Oligometastatic Rectal Cancer - p. 1058 295. Microsatellite Instability High (MSI-High)/Mismatch Repair Deficient (dMMR) Rectal Cancer - p. 1058 296. Radiation Treatment Planning - p. 1060 297. Conclusions - p. 1064.e1 298. 61. Anal Carcinoma - p. 1065 299. Part E. Genitourinary Tumors - p. S8 300. 62. Overview - p. 1083 301. 63. Prostate Cancer - p. 1086 302. Epidemiology and Etiology - p. 1086 303. Prevention and Early Detection - p. 1088 304. Pathology and Pathways of Spread - p. 1090 305. Histology - p. 1090 306. Pathology of Prostate Cancer - p. 1091 307. Clinical and Pathologic Stage Grouping - p. 1092 308. Predictive Factors - p. 1094 309. Clinical Manifestations, Patient Evaluation, Staging - p. 1097 310. Primary Therapy - p. 1103 311. Surgical Therapy - p. 1121 312. Locally Advanced Disease - p. 1124 313. Metastatic Disease - p. 1135 314. Irradiation Techniques - p. 1138 315. Future Directions - p. 1143 316. 64. Bladder Cancer - p. 1145 317. Etiology and Epidemiology - p. 1146 318. Prevention and Early Detection - p. 1146 319. Biologic Characteristics and Molecular Biology - p. 1146 320. Antibody Drug Conjugates (ADCs) in Bladder Cancer - p. 1147 321. Pathology and Pathways of Spread - p. 1147 322. Clinical Manifestations, Patient Evaluation, and Staging - p. 1148 323. Primary Therapy - p. 1148 324. Techniques of Irradiation - p. 1156 325. Treatment Algorithms - p. 1159 326. Future Possibilities - p. 1159 327. 65. Testicular Cancer - p. 1161 328. Etiology and Epidemiology - p. 1161 329. Biologic Characteristics and Molecular Biology - p. 1163 330. Pathology and Pathways of Spread - p. 1163 331. Pathways of Spread - p. 1165 332. Clinical Presentation, Patient Evaluation, and Staging - p. 1166 333. Primary Therapy - p. 1167 334. Nongerm Cell Testicular Tumors - p. 1175 335. Irradiation Techniques and Dose - p. 1177 336. Treatment Algorithms, Conclusions, and Future Possibilities - p. 1179 337. 66. Kidney and Ureteral Carcinoma - p. 1181 338. Introduction - p. 1182 339. Etiology and Epidemiology - p. 1182 340. Prevention and Early Detection - p. 1183 341. Biologic Characteristics and Molecular Biology - p. 1183 342. Pathology and Pathways of Spread - p. 1184 343. Clinical Manifestations, Patient Evaluation, and Staging - p. 1184 344. Complete History and Physical Examination - p. 1185 345. Primary Therapy - p. 1186 346. Locally Advanced Disease and Palliation - p. 1191 347. Palliation and Metastatic Disease - p. 1192 348. Techniques of Irradiation - p. 1195 349. Treatment Algorithms, Controversies, Future Probabilities - p. 1198 350. 67. Penile Cancer - p. 1202 351. Part F. Gynecological Tumors - p. S9 352. 68. Overview - p. 1213 353. 69. Cervical Cancer - p. 1216 354. Epidemiology and Etiology - p. 1217 355. Prevention and Early Detection - p. 1217 356. Pathology and Pathways of Spread - p. 1218 357. Molecular Biology - p. 1219 358. Clinical Manifestations, Patient Evaluation, and Staging - p. 1220 359. Primary Therapy - p. 1222 360. Locally Advanced Disease - p. 1233 361. Irradiation Techniques and Tolerance - p. 1235 362. Summary - p. 1246 363. 70. Endometrial Cancer - p. 1248 364. Epidemiology and Etiology - p. 1249 365. Prevention and Early Detection - p. 1250 366. Biological Characteristics/Molecular Biology - p. 1250 367. Pathology and Pathways of Spread - p. 1253 368. Mesenchymal Tumors - p. 1254 369. Mixed Epithelial and Mesenchymal Tumors - p. 1254 370. Clinical Manifestations, Patient Evaluation, and Staging - p. 1254 371. Primary Therapy Including Adjuvant Therapy - p. 1257 372. Locally Advanced Disease and Palliation - p. 1266 373. Systemic Therapy for Recurrent or Metastatic Disease - p. 1269 374. Irradiation Techniques and Tolerance - p. 1272 375. Treatment Algorithm, Conclusions, and Challenges - p. 1278 376. 71. Cancers of the Vulva and Vagina - p. 1282 377. Vulvar Cancer - p. 1284 378. Etiology and Epidemiology - p. 1284 379. Early Detection, Treatment, and Prevention - p. 1284 380. Pathology and Pathways of Spread - p. 1285 381. Biology and Prognostic Factors - p. 1287 382. Clinical Manifestations, Patient Evaluation, and Staging - p. 1288 383. Primary Therapy - p. 1289 384. Locally Advanced Disease and Palliation - p. 1299 385. Irradiation Techniques and Tolerance - p. 1301 386. Challenges, Controversies, and Future Possibilities - p. 1305 387. Miscellaneous Vulvar Malignancies - p. 1305 388. Vaginal Cancer - p. 1306 389. Etiology and Epidemiology - p. 1306 390. Prevention and Early Detection - p. 1307 391. Pathology and Pathways of Spread - p. 1307 392. Clinical Manifestations, Patient Evaluation, and Staging - p. 1307 393. Primary Therapy - p. 1308 394. Locally Advanced Disease and Palliation - p. 1310 395. Irradiation Techniques and Tolerance - p. 1311 396. Treatment Algorithm and Future Possibilities - p. 1314 397. Nonsquamous Vaginal Malignancies - p. 1315 398. 72. Ovarian Cancer - p. 1317 399. Introduction - p. 1318 400. Epidemiology and Etiology - p. 1318 401. Prevention and Early Detection - p. 1319 402. Biologic Characteristics and Prognostic Factors - p. 1320 403. Pathology and Pathways of Spread - p. 1320 404. Clinical Manifestations, Patient Evaluation, and Staging - p. 1322 405. Primary Treatment of Ovarian Epithelial Cancer - p. 1323 406. Locally Advanced Disease and Palliation - p. 1325 407. Nonepithelial Ovarian Tumors - p. 1336 408. Irradiation Techniques - p. 1339 409. Treatment Algorithms, Challenges, and Future Possibilities - p. 1339 410. Challenges and Future Possibilities - p. 1339 411. Part G. Breast Cancer - p. S10 412. 73. Overview - p. 1342 413. 74. Noninvasive Breast Cancer - p. 1356 414. 75. Breast Cancer: Stages I and II - p. 1365 415. Introduction - p. 1365 416. Pretreatment Evaluation - p. 1365 417. Surgical Techniques - p. 1366 418. Breast-Conserving Surgery With Radiation Therapy - p. 1366 419. Breast-Conserving Surgery Without Radiation Therapy - p. 1369 420. When to Use Nodal Irradiation - p. 1371 421. Treatment Techniques - p. 1372 422. Radiotherapy Scheduling and Dose Parameters - p. 1376 423. Partial-Breast Irradiation - p. 1378 424. Acute and Chronic Complications and Cosmetic Results - p. 1380 425. Patient Follow-Up - p. 1383 426. Treatment of Locoregional Failure - p. 1384 427. Conclusions - p. 1384 428. 76. Locally Advanced and Inflammatory Breast Cancer - p. 1386 429. Part H. Sarcoma and Benign Disease - p. S11 430. 77. Soft-Tissue Sarcoma - p. 1404 431. Etiology and Epidemiology - p. 1405 432. Prevention and Early Detection - p. 1405 433. Biologic Characteristics and Molecular Biology - p. 1405 434. Pathology and Pathways of Spread - p. 1406 435. Fibroblastic and Myofibroblastic Tumors - p. 1409 436. Adipocytic Tumors - p. 1409 437. Smooth Muscle Tumors - p. 1409 438. Skeletal Muscle Tumors - p. 1409 439. Gastrointestinal Stromal Tumors - p. 1409 440. Vascular Tumors - p. 1409 441. Perivascular tumors - p. 1409 442. Peripheral Nerve sheath tumors - p. 1409 443. Pathways of Spread - p. 1410 444. Clinical Manifestations, Patient Evaluation, and Staging for Extremity STS - p. 1410 445. Primary Therapy for Extremity STS - p. 1413 446. Intraabdominal STS - p. 1422 447. STS of Uncommon Sites - p. 1425 448. Atypical-Behaving STS Subtypes - p. 1426 449. Salvage Treatment and Palliation - p. 1427 450. 78. Benign Diseases - p. 1431 451. Definition and Classification of Benign Diseases - p. 1431 452. Radiobiological Aspects - p. 1431 453. Benign Disorders of the Head and Neck and Central Nervous System - p. 1432 454. Benign Disorders of the Eye and Orbit - p. 1435 455. Benign Diseases of the Heart - p. 1437 456. Benign Diseases of Joints and Tendons - p. 1437 457. Benign Diseases of Connective Tissue and Skin - p. 1437 458. Benign Disorders of Bony Tissues - p. 1440 459. Functional and Behavioral Disorders - p. 1442 460. Part I. Childhood Cancers - p. S12 461. 79. Overview - p. 1446 462. 80. Central Nervous System Tumors in Children - p. 1450 463. Introduction - p. 1450 464. Clinical Evaluation - p. 1450 465. Molecular Classification of Pediatric Brain Tumors - p. 1450 466. Modern Pediatric Radiation Delivery - p. 1455 467. Clinical Management of Pediatric Brain Tumors - p. 1456 468. Normal Tissue Tolerance and Side Effects - p. 1467 469. Conclusions - p. 1469 470. 81. Pediatric Soft Tissue Sarcomas - p. 1471 471. 82. Pediatric Sarcomas of Bone - p. 1482 472. 83. Wilms’ Tumor - p. 1494 473. 84. Retinoblastoma - p. 1506 474. 85. Neuroblastoma - p. 1516 475. 86. Pediatric Leukemia and Lymphoma - p. 1524 476. 87. Pediatric Hodgkin Lymphoma - p. 1533 477. Introduction - p. 1534 478. Etiology and Epidemiology - p. 1535 479. Pathology and Pathways of Spread - p. 1535 480. Staging, Clinical Manifestations, Patient Evaluation, and Prognostic Factors - p. 1536 481. Principles of Primary Therapy - p. 1539 482. Treatment Approaches by Risk Groups - p. 1543 483. Radiotherapy Considerations - p. 1545 484. Treatment Approaches for Unique Circumstances - p. 1549 485. Summary - p. 1551 486. 88. Rare Pediatric Tumors - p. 1553 487. Part J. Lymphoma and Hematologic Malignancies - p. S14 488. 89. Overview - p. 1568 489. 90. Hodgkin Lymphoma - p. 1572 490. 91. Non-Hodgkin Lymphoma - p. 1586 491. Introduction - p. 1586 492. Etiology and Epidemiology - p. 1586 493. Prevention and Early Detection - p. 1587 494. Biological Characteristics and Pathology - p. 1588 495. Mature B-cell neoplasms (Hodgkin lymphoma and plasma cell dyscrasias omitted) - p. 1589 496. Mature T-cell and NK-cell leukemias - p. 1589 497. Primary cutaneous T-cell lymphomas - p. 1589 498. Intestinal T-cell and NK-cell lymphoid proliferations and lymphomas - p. 1589 499. Hepatosplenic T-cell lymphoma - p. 1589 500. Anaplastic large cell lymphoma - p. 1589 501. Nodal T-follicular helper (TFH) cell lymphoma - p. 1589 502. Other peripheral T-cell lymphomas - p. 1589 503. EBV-positive NK/T-cell lymphomas - p. 1589 504. EBV-positive T- and NK-cell lymphoid proliferations and lymphomas of childhood - p. 1589 505. Clinical Manifestations, Patient Evaluation, and Staging Classification - p. 1593 506. General - p. 1594 507. Imaging Studies - p. 1594 508. Special Tests - p. 1594 509. Laboratory Studies - p. 1594 510. Prognostic Factors - p. 1594 511. Principles of Management - p. 1595 512. Management of Distinct Disease Entities - p. 1597 513. Conclusion - p. 1611 514. 92. Multiple Myeloma and Other Plasma Cell Neoplasms - p. 1613 515. 93. Mycosis Fungoides - p. 1624 516. Etiology and Epidemiology - p. 1625 517. Biologic Characteristics and Molecular Biology - p. 1625 518. Pathology and Pathways of Spread - p. 1626 519. Clinical Manifestations - p. 1627 520. Variants of Mycosis Fungoides - p. 1630 521. Related Cutaneous T-Cell Lymphoproliferative Disorders - p. 1630 522. Prognosis and Staging - p. 1632 523. Patient Evaluation - p. 1633 524. Primary Therapy - p. 1634 525. Palliation - p. 1639 526. Techniques of Irradiation - p. 1640 527. Treatment Controversies, Problems, Challenges, and Future Possibilities - p. 1643 528. Index - p. 1647