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The recent demonstration of a survival advantage associated with the addition of temozolomide to conventional radiotherapy for patients with newly diagnosed glioblastoma multiforme marks the first significant increment of progress for patients afflicted with these devastating tumors in over 30 years. Thus, the temozolomide–radiotherapy regimen has become the new standard of care and heralds a new therapeutic era in the field of neuro-oncology. Analogously, Principles of Neuro-Oncology represents a new textbook standard to help guide us forward into this new era.
Several words come to mind after reviewing the first edition of Principles of Neuro-Oncology, edited by David Schiff and Brian Patrick O’Neill, but chief among them is refreshing. Others include needed, current, well organized, and relevant. The editors and the esteemed contributing authors deserve high accolades for the efforts that resulted in this impressive and comprehensive compendium.
The text includes 750 pages divided into four major parts: Overview and Principles (12 chapters), Specific Tumors (13 chapters), Metastatic Disease (4 chapters), and Indirect Complications of Cancer (3 chapters). The text itself is highly readable and interspersed with informative graphics and tables. In addition, a series of beautiful color plates present stunning, detailed graphics in two sections of the book. Each chapter is organized in a user-friendly format. For example, the Specific Tumors chapters are all consistently organized into subsections including epidemiology, genetics and molecular biology, clinical presentation, diagnostic evaluation, histopathology, prognosis, treatment, and future directions. Thus, in addition to the panoptic review provided in each chapter, the logical and consistent organization of each chapter makes it easy for the reader to quickly purview a specific aspect of a given tumor or series of tumors. A noteworthy and thought-provoking feature of this textbook is the succinct synopsis provided at the start of each chapter that highlights not only key points, but also critical controversial issues that are relevant to each chapter.
Neuro-oncology is a somewhat unique field in that a series of subspecialties is required to contribute as a team to provide optimal care for patients. Representative input from each discipline, including neurology, oncology, neurosurgery, radiotherapy, diagnostic imaging, and pathology, must be melded to generate an appropriate workup and treatment plan for most patients. Similarly, Principles of Neuro-Oncology melds critical input from each of these representative fields, both in chapters dedicated to these disciplines and within the other chapters. Thus, this text is of significant value to members of each of these fields involved in the care of neuro-oncology patients.
In addition, the chapters are organized to describe the foundation of historical background information that has led to contemporary issues, controversies, and breakthroughs. Thus, this textbook offers appeal to both those in training as well as those still learning in the everyday practice and care of neuro-oncology patients. For example, a chapter on CNS tumor epidemiology not only provides a contemporary overview of prevalence and incidence statistics, as well as data on expected genetic and environmental influences, but also includes subsections committed to electromagnetic field emissions and cell phones. Similarly, the excellent neuroimaging chapter thoroughly reviews standard imaging approaches, as well as provides updates on the attributes and limitations of special imaging studies such as positron emission tomography, magnetic resonance spectroscopy, and diffusion and perfusion magnetic resonance imaging.
Another major attribute of Principles of Neuro-Oncology is that its content effectively spans the spectrum from basic science through clinical sciences to actual practical clinical care issues. The chapter “Translational Applications of Molecular Biology in Neuro-Oncology,” by Joon Uhm, provides a state-of-the-art review of not only the important advances achieved in the laboratory over the last decade, but more importantly, how this knowledge is shaping current and future patient care. Furthermore, many chapters include subsections dedicated to defining how basic science and molecular biology advances are impacting clinical practice in the field. Similarly, the chapter “Clinical Trial Design in Neuro-Oncology,” by Judith O’Fallon and Jan Buckner, provides an exceptional description of the fundamentals of current clinical trial design and implementation that serves as a solid foundation for both novice and experienced clinical researchers. Finally, the chapters titled “Supportive Care” and “Neuropsychological Issues,” by Herbert Newton and by Elana Farace and Mark Shaffrey, respectively, update these important aspects of patient outcome in the modern day.
The only deficiency of Principles of Neuro-Oncology is the lack of a compact disc or electronic version of the manuscript in order to facilitate ease and convenience for readers. That, we can hope, will be addressed by McGraw-Hill.
In short, Principles of Neuro-Oncology, by Schiff and O’Neill, will prove a valuable addition to the library of any member of the medical team caring for neuro-oncology patients. However, I suspect it will spend more time on the desktop than the shelf for most of us.