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Developments in the Treatment of Gastric Cancer in EuropeMetastatic gastric cancer is a relatively chemosensitive disease. With current regimens, 25% to 40% of patients can be expected to respond, and median survival of 6 to 8 months is
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Long-Term Efficacy and Toxicity of the FEC100 RegimenAdjuvant chemotherapy has been shown to be beneficial in patientswith breast cancer, and anthracycline-containing regimens are more effectivethan non–anthracycline-containing ones. The French AdjuvantStudy Group (FASG) compared FEC100 and FEC50 (fluorouracil[5-FU]/epirubicin [Ellence]/cyclophosphamide [Cytoxan, Neosar])in patients with node-positive breast cancer, with an end point of overallsurvival. After a median follow-up of 10 years, the benefit/risk ratio of theFEC100 regimen in patients with positive axillary nodes is strongly positive.Furthermore, a medicoeconomic study showed that the cost per yearof life saved was very low-approximately 1,000 euros.
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Synergizing Radiation Therapy and Immunotherapy for Curing Incurable CancersRadiation is often considered immunosuppressive, an activity that is most likely a result of the complex interplay of hormesis and the abscopal effect. The abscopal effect, also called the “distant bystander” effect, is a paradoxical effect of radiation on cellular systems whereby local radiation may have an antitumor effect on tumors distant from the site of radiation.
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Malignant Melanoma: Biology, Diagnosis, and ManagementCutaneous malignant melanoma is a relatively common neoplasm. In the United States in 1995, an estimated 34,000 cases of melanoma will be diagnosed, and 7,200 persons will die of melanoma [1]. Early primary melanoma is highly curable, but once the disease becomes disseminated, it is nearly always fatal. The overall survival rate has more than doubled from 40% in the 1960s to more than 80% today, but this increase is attributable to earlier diagnosis rather than to treatment advances [2].
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ACR Appropriateness Criteria® Borderline and Unresectable Pancreas CancerThese guidelines review the use of radiation, chemotherapy, and surgery in borderline and unresectable pancreas cancer. Radiation technique, dose, and targets were evaluated, as was the recommended chemotherapy, administered either alone or concurrently with radiation. This report will aid clinicians in determining guidelines for the optimal treatment of borderline and unresectable pancreatic cancer.
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The Impact of CAR T-Cell Therapy on Hematological MalignanciesJae Park, MD, discussed the use of CAR T-cell therapy across the hematologic malignancies space.
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Epirubicin, Cisplatin, Oral UFT, and Calcium Folinate in Advanced Gastric CarcinomaUFT (uracil and tegafur in a 4:1 molar ratio) plus calcium folinate treatment has favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. High response rates have been reported in patients with
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Epirubicin, Cisplatin, Oral UFT, and Calcium Folinate in Advanced Gastric CarcinomaUFT (uracil and tegafur in a 4:1 molar ratio) plus calcium folinate treatment has favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. High response rates have been reported in patients with
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Fluid ComplicationsMalignant pleural effusion complicates the care of approximately 150,000 people in the United States each year.
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Jaffer A. Ajani, MD, Discusses the Approval of Nivolumab Combinations in Esophageal Squamous Cell CarcinomaJaffer A. Ajani, MD, spoke about the recent approvals of nivolumab plus ipilimumab and nivolumab plus chemotherapy for patients with esophageal squamous cell carcinoma.
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PALB2-Positive Breast Cancer in a 40-Year-Old ManIn July 2003, an asymptomatic 40-year-old man presented to his primary care physician for routine care and was found to have a palpable right axillary lymph node.
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The Role of Radiotherapy in Node-Positive Prostate CancerThis article summarizes the existing literature on use of radiotherapy for node-positive prostate cancer, as well as the associated outcomes.
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The UFT/Leucovorin/Etoposide Regimen for the Treatment of Advanced Gastric CancerGastric cancer is the most chemosensitive adenocarcinoma among digestive neoplasms. A few years ago, we performed a phase II trial with the FLEP regimen, in which fluorouracil (5-FU) and leucovorin are combined
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Role of Obesity and Exercise in Breast Cancer SurvivorsAfter malignancies of the skin, breast cancer is the most common cancer
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Curbing Potential Radiation-Induced Cancer Risks in Oncologic Imaging: Perspectives From the ‘Image Gently’ and ‘Image Wisely’ CampaignsThe purpose of this review is to provide the oncology community with knowledge about the doses used in medical imaging, radiation-induced cancer risks from imaging, and considerations to keep in mind when balancing imaging benefits and risks in pediatric and adult oncologic settings.
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Current Status and Future Potential of Advanced Technologies in Radiation OncologyPart 2. State of the Science by Anatomic SiteOn November 30–December 2, 2006, the Radiation Research Program of the Division of Cancer Treatment and Diagnosis of the National Cancer Institute (NCI) hosted a workshop entitled “Advanced Technologies in Radiation Oncology: Evaluating the Current Status and Future Potential of Proton and Other Heavy Charged-Particle Radiation Therapy, Intensity Modulated Radiation Therapy and Stereotactic Radiation Therapy.”
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Comparing Radical Prostatectomy and Brachytherapy for Localized Prostate CancerRadical prostatectomy and ultrasound-guided transperinealbrachytherapy are both acceptedtreatment options for men with clinicallylocalized prostate cancer.Investigators continue to argue overthe relative effectiveness of each ofthese procedures, not only from thestandpoint of cure, but also with regardto how each treatment affectsquality of life. With the recent closureof a prospective, randomized trial addressingthese issues (the SurgicalProstatectomy Interstitial RadiationIntervention Trial, or SPIRIT) due tolack of patient accrual, it is unlikelythat a direct comparison of these techniqueswill be performed in the foreseeablefuture.
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Can Risk-Adapted Treatment Recommendations Replace the ‘One Size Fits All’ Approach for Early-Stage Thyroid Cancer Patients?There is uniform agreement that initial treatment of high-risk thyroid cancer should include total thyroidectomy, compartmental neck dissection of clinically involved cervical lymph nodes, and radioactive iodine (RAI) remnant ablation.
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The REMS Publication ParadoxThe introduction of mandatory risk evaluation and mitigation strategy (REMS) programs, in which patients must participate in order to receive a new therapy, provides an opportunity to examine an issue affecting ethical oversight and publication of scientific study results.
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Combined Radiation and Chemotherapy for Carcinoma of the Anal CanalSphincter-preserving treatment with combined radiation and chemotherapy has replaced abdominoperineal resection as the standard of care for patients with carcinoma of the anal canal. Randomized studies have shown
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3D Treatment Planning and Intensity-Modulated Radiation TherapyThree-dimensional (3D) image-based treatment planning and new delivery technologies have spurred the implementation of external beam radiation therapy techniques, in which the high-dose region is conformed much
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MD Anderson Manual of Medical OncologyIt is an unusual oncologist in the United States who has not had a patient receive a second opinion at the M. D. Anderson Cancer Center (MDA). Long a respected and well-known force in cancer research and patient care, MDA has exerted significant national and international influence not only with scientific publications but also through its training programs and large clinical operation. This book will add to that influence with concise disease-oriented chapters covering the patient population a medical oncologist will see in practice. The MD Anderson Manual of Medical Oncology is not a small handbook. Rather, it is a hardbound text of more than 1,000 pages authored by nearly 100 MDA clinicians.
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Clinical Relevance of Laboratory and Animal Data on TamoxifenTamoxifen is being evaluated in clinical trials as a preventive agent in women at high risk for breast cancer. This new, potentially long-term therapeutic role has generated some concerns regarding safety, based on the results of
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Benefits of Tamoxifen Outweigh Endometrial Cancer RiskAn expert panel of nine international cancer researchers and practicing oncologists met in Boston to discuss the past, present, and future uses of antiestrogens in the treatment of breast cancer. The first article in this series, based on the symposium presentations, focused on the optimal duration of tamoxifen use (October 1996). This month, the panel explores the noncancer benefits of tamoxifen, as well as the potential risk of endometrial cancer. The symposium was sponsored by Zeneca Pharmaceuticals.
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Current Issues in the Treatment of Resistant Bloodstream InfectionsBloodstream infections cause significant morbidity and mortality for patients with hematologic malignancy. Antimicrobial drugs are the most reliable currently available treatment for infection, but several issues must be
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It's Time to Have ‘The Talk’: Cost Communication and Patient-Centered CareBarriers to cost discussions fall into three categories: inaccessible cost data, ethical concerns, and insufficient training.
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Current Clinical Trials of Molecularly Targeted Agents in Children With Cancer, Part 2A number of molecularly targeted agents directed at critical cell survival and cell proliferation pathways have recently entered clinical evaluation in children with cancer. These agents offer the potential for more effective anticancer therapy while simultaneously diminishing acute and long-term toxic effects. Systematic evaluations of targeted agents are essential to achieving continued improvements in outcome for children with cancer. Brief summaries of the rationale for conducting studies of several agents in children are provided below. Following these summaries is a listing of phase I, phase I/II, phase II, and pilot studies of these and other agents in pediatric populations.
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Consider Thrombotic Microangiopathy in Pediatric and Hematopoietic Stem Cell Transplant PatientsThe article by Dr. George is of great use to the practicing clinician, not only in the hematology-oncology setting but also in general practice or emergency medicine.
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Principles of Chemoradiation: Theoretical and Practical ConsiderationsChemotherapy agents known to enhance the effects of radiation in preclinical studies have been used concurrently with radiotherapy in numerous clinical trials with the prospect of further enhancing radiation-induced
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Radiation Oncologist Strives to Improve the Patient Experience“As a field, we’re trying to push hard to make [radiation] patient-centered, and because of that, the field is the future of the field is pretty bright,” James B. Yu, MD, MHS, FASTRO, stated.
