ONCOLOGY Vol 10 No 5

Radiation therapy targeted at the cellular level can halt the advance of lymphoma while avoiding the major drawbacks of chemotherapy, according to a Stanford University study in the March 1996 issue of Clinical Cancer Research.

Molecular oncology, as it relates to cancer formation, growth, metastasis, and treatment, is a rapidly progressing and exciting field. Its forward movement is so fast that even scientific journals, because of publication delays, are unable to keep readers informed in a timely manner. What, therefore, is the role of a textbook on molecular oncology?

Screening for colon colon by any of several different strategies is highly cost effective, but nonetheless expensive. It is unclear whether American society--in the form of the federal government, private insurers, managed care organizations, or individual

Areview of major clinical trials strongly supports the value of mammography screening for women in their 40s. The review showed a 24% decrease in deaths from breast cancer among women who underwent screening mammograms compared to

On May 26, 1995, Philip Morris USA* announced a voluntary recall of 36 cigarette product lines (approximately 8 billion cigarettes) because, during production, the company detected unusual tastes and peculiar odors and identified methyl

ImClone Systems has initiated an additional phase Ib/IIa clinical trial of C225, the company's epidermal growth factor (EGF)-receptor antagonist. The dose-escalation study will evaluate C225 in conjunction with the chemotherapeutic agent paclitaxel

Researchers presented the first comprehensiveresults of Neoprobe Corporation's pivotal multicenter studies of its RIGScan product at The Society of Surgical Oncology's (SSO) 49th Annual Cancer Symposium in Atlanta on March 22.

Even couples who have been happily married for decades can suffer negative health effects from the stress of marital arguments, a new study suggests.

Aspecifically designed monoclonal antibody has been shown to reduce tumors in patients with late-stage breast cancer, according to a new study by scientists at Memorial Sloan-Kettering Cancer Center.

Pediatric cancer specialists at The University of Texas Southwestern Medical Center at Dallas plan to bring an old cancer-fighter off the bench and test its effectiveness in a new generation of children with leukemia.

This report was prepared by a special committee of the Royal College of Radiologists. It provides a British perspective on how to manage this potential complication of breast irradiation.

The article by Hambleton provides a compendium of the causes of hematopoietic defects in HIV-infected individuals. For the busy practicing physician who treats patients with HIV, these defects are not trivial. Cytopenias are a continuous problem that impact on most clinical decisions. For example, anemia and neutropenia are more common in patients with 100 CD4 cells/mcL or less. In general, these patients also have the highest titers of virus and are at greatest risk of developing symptomatic Mycobacterium avium or cytomegalovirus infection. Thus, physicians often find themselves trying to decide which patients should undergo a more extensive evaluation and which should receive "less" myelosuppressive therapy.

For all the vast literature concerning survival after treatment for cancer, few articles provide long-term follow-up. At best, most provide 5-year survival statistics, the majority being actuarial, which means that many of the patients included do not even have 5-year follow-up. A few articles give 10-year data and call these long-term. But 5 or even 10 years is not a very long time for a child or young adult hoping for a normal life span, or for clinicians wishing to be able to predict a patient's prognosis after treatment.

Benign and aggressive intracranial meningiomas, as the authors state, are seemingly simple tumors (even with benign histology) that can behave in a clinically malignant fashion solely by location. Clinicians with experience in the management of patients with aggressive, recurrent, or malignant meningiomas are all too well aware of the difficulties of recommending effective therapy beyond surgery and radiation therapy. Clearly, there is much room for improvement in the treatment of recurrent or malignant meningiomas with local or systemic chemotherapy and/or biologic therapies.

Drs. Dresler and Goldberg review the role of resection of metastatic tumors to the lung. It is a difficult topic, with the exception of osteosarcoma, for which the practice of secondary resection is common and clearly of benefit. For lung metastases from other tumors, however, the use of resection is based largely on sporadic and anecdotal reports.

The diagnosis and treatment of children with brain tumors has changed radically over the last 50 years. Cross-sectional imaging, CT and MRI, has displaced angiography and pneumoencephalography. These newer imaging modalities have facilitated early diagnosis, preoperative planning, and surgical approach, resulting in an increased likelihood of achieving complete surgical extirpation. The operating microscope has improved the experienced surgeon's ability to discriminate between tumor and normal brain, making radical resection more frequent. Chemotherapy has been introduced into the arsenal of the neuro-oncologist, albeit with only modest success. The one nearly constant treatment modality has been external-beam irradiation.

Meningioma is a prime example of a tumor requiring a multimodality approach. This tumor is usually benign and often grows slowly. Under many circumstances, such a benign tumor would never attract the attention of the oncologist or even require treatment at all. However, a meningioma is a benign tumor in a malignant location. In the closed space of the skull, there is no room for expansion of even a benign lesion; thus, effective treatment of this potentially neurologically devastating lesion is necessary. Neurosurgeons, neuroradiologists, radiotherapists, and medical oncologists are all directly involved in treatment decisions. Rapidly expanding knowledge concerning the etiology and natural history of meningiomas may now also involve epidemiologists, molecular geneticists, and endocrinologists. Despite this concentration of expertise, numerous questions remain unanswered or incompletely answered.

Hematologic complications of HIV disease are commonly encountered by physicians and other health-care workers caring for patients infected with this virus. Ineffective hematopoiesis, infiltrative diseases of the bone

Usually considered benign tumors, meningiomas can display aggressive behavior characterized by multiple recurrences and invasion of the brain, dura, and adjacent bone. The aggressive or malignant phenotype is difficult

Lung parenchyma is the most common site of metastases from either carcinomas or sarcomas. Depending on the status of the original primary, resection of lung metastases may be curative. Multiple variables must be

Outcome is described for 1,034 children who received radiation treatment in the management of a brain tumor at the University of Toronto Institutions from 1958 to 1995. The 5-, 10-, 20-, and 30-year relapse-free (or

The appearance of metastases is generally thought to herald widespread dissemination of a primary cancer. At this point, surgery usually is either not indicated or palliative. Thus, it is somewhat surprising that surgical resection of metastases has become an accepted treatment modality in several clinical situations. This is due, in part, to the unique biology of several types of cancers and to well-defined clinical presentations that can be identified. Drs. Dresler and Goldberg succinctly review the indications for and results of resection of pulmonary metastases.