ONCOLOGY Vol 11 No 6 | Oncology

Use of Adjuvent Analgesics Profiled at Pain Conference

June 01, 1997

The last decade has seen a dramatic increase in the availability of nonopioid analgesics for the management of chronic pain. The change has been especially great in the area of adjuvant analgesics, the diverse group of drugs that have other primary

Bacterial Infection in Patients With Cancer: Focus on Prevention

June 01, 1997

Patients with cancer have a significant risk for infection due to their treatment with chemotherapy, radiation, or surgery," stated Debra Wujcik, RN, MSN, AOCN, clinical director at Vanderbilt Cancer Center in Nashville, Tennessee, at the 1996

Docetaxel in Combined Modality Therapy for Breast Cancer

June 01, 1997

Since the emergence of paclitaxel (Taxol) in 1983, clinical developmentof the taxoids has progressed at a rapid pace, with the introduction ofdocetaxel (Taxotere) into clinical trials in 1990, and international phaseII studies in 1992. Although these two taxoids are related, increasingclinical experience indicates that paclitaxel and docetaxel should notbe considered interchangeable.

Role of Diet in Cancer Hard to Study, Expert Says

June 01, 1997

Although it is clear that diet plays a role in the etiology of many cancers, making dietary recommendations to reduce risk is highly complicated, if, indeed, it is possible at all, according to an international cancer prevention expert. With 30% to 50%

Anti-HIV Effects of Viracept Persist During Long Periods of Combination Therapy

June 01, 1997

Agouron Pharmaceuticals reported that the profound anti-HIV effects of its protease inhibitor nelfinavir mesylate (Viracept), when taken in combination with other anti-HIV drugs, continue to be observed after 10 months of treatment. Nelfinavir was

University of Minnesota Researchers Find Evidence of Genetic Link to Breast Density

June 01, 1997

Researchers at the University of Minnesota Cancer Center have found evidence that mamographic breast density, a measure of the relative proportions of fat, connective tissue, and glandular epithelial tissue in the breast that is a strong, independent

Guidelines for the Early Referral of Patients to Cancer Specialists

June 01, 1997

Several years ago, during Dr. Gardner's tenure as President of the Society of Surgical Oncology (SSO), the SSO's Executive Council agreed to the development of practice guidelines for early referral of potential cancer patients. This move

New Drugs May Brighten Ovarian Cancer Picture

June 01, 1997

With its poor prognosis, ovarian cancer remains a disease in search of definitive treatment. Although paclitaxel (Taxol) has improved the outlook, advanced ovarian cancer still has a 5-year mortality rate of 65%. The real problem, according to

Researchers Hope Function of BRCA1 Gene Holds Key to New Treatments

June 01, 1997

New knowledge about the normal function of the BRCA1 gene, various mutations of which have been shown to cause breast and ovarian cancers, may help researchers develop treatments for both hereditary and sporadic disease. Jeffrey T.

Research Points to Effectiveness of Brachytherapy in Early Prostate

June 01, 1997

Studies presented at the annual meeting of the American Urological Association (AUA) in New Orleans show positive results for the treatment of early-stage prostate cancer using brachytherapy or "seeding." The studies, conducted by Nelson

Lung Cancer Surgical Practice Guidelines

June 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Pituitary Adenomas: Current Methods of Diagnosis and Treatment

June 01, 1997

Drs. Buatti and Marcus concisely review the clinical presentation, diagnosis, and current management of pituitary adenomas. It would be difficult, if not impossible, for a brief review article to cover in depth all of the areas of controversy for such a broad subject. Consequently, several supplementary comments are in order.

Management of Carcinoma of the Superior Pulmonary Sulcus

June 01, 1997

Johnson and Goldberg provide a comprehensive review of the management of the Pancoast tumor, a bronchogenic carcinoma located in the superior pulmonary sulcus. Due to this specific location, Pancoast tumors can invade nerves, blood vessels, and musculoskeletal structures located at the level of the thoracic inlet. Such invasion can produce a wide range of clinical signs and symptoms, recognized as the Pancoast syndrome.

SSO Practice Guidelines: Introductory Remarks

June 01, 1997

The Agency for Health Care Policy and Research established a forum for quality and effectiveness in health care under which practice guidelines were to be evaluated. The groups involved in this forum turned to the Institute of Medicine to evaluate the

Ovarian Cancer Surgical Practice Guidelines

June 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Prostate Cancer Surgical Practice Guidelines

June 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Radiotherapeutic Management of Medulloblastoma

June 01, 1997

Dr. Paulino provides a concise yet complete review of the radiotherapeutic management of patients with medulloblastoma. Radiotherapy treatment planning for medulloblastoma is complex, requires considerable attention to detail, and remains the subject of debate and clinical research. Clearly, this is an area of neuro-oncology in which multidisciplinary research has played a significant role in improving survival for children and young adults with this disease.

Radiotherapeutic Management of Medulloblastoma

June 01, 1997

The prognosis for patients with newly diagnosed medulloblastoma has improved dramatically over the past several decades. In contrast to the dismal results of treatment during the first half of the 20th century, current 5-year survival rates of better than 50% are now being reported, and certain subsets of patients have more than a 70% chance of long-term disease-free survival.[1,2] Although neurosurgeons and radiation oncologists have proposed that this improvement is due to advances in their respective specialties, probably multiple factors are involved.

Breast Cancer Surgical Practice Guidelines

June 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Docetaxel/Doxorubicin/Cyclophosphamide in the Treatment of Metastic Breast Cancer

June 01, 1997

A pilot phase II study examined the feasibility of 75 mg/m² of docetaxel (Taxotere) in combination with 50 mg/m²of doxorubicin and 500 mg/m² of cyclophosphamide (Cytoxan, Neosar) in the first-line treatment of metastatic breast cancer. This study was designed to evaluate the efficacy and toxicity of the docetaxel/doxorubicin/cyclophosphamide combination both alone and as induction before high-dose chemotherapy, supplemented by autologous peripheral blood stem-cell transplantation.

Preoperative Doxorubicin Plus Cyclophosphamide Followed by Preoperative or Postoperative Docetaxel

June 01, 1997

Protocol B-27, conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP), is a phase III, randomized trial designed to evaluate whether sequencing docetaxel (Taxotere) to neoadjuvant doxorubicin/cyclophosphamide (Cytoxan, Neosar) prolongs disease-free and overall survival in patients with operable breast cancer.

Radiotherapeutic Management of Medulloblastoma

June 01, 1997

Although craniospinal irradiation has been employed in children with medulloblastoma for the past 40 years, many issues concerning its use have been raised and examined, and some continue to be debated. Careful radiation technique includes adequate irradiation of the neuraxis with special attention to the cribriform plate region and termination of the thecal sac. Conventional-dose craniospinal radiation therapy, in combination with chemotherapy, is currently recommended for patients with high-risk medulloblastoma. The appropriate dose of radiation to the craniospinal axis when this modality is combined with chemotherapy for low-risk medulloblastoma remains to be defined. Long-term results of hyperfractionated radiation therapy are likewise awaited. In an effort to decrease late toxicity to the immature central nervous system, radiation therapy can be delayed in a proportion of infants by administering chemotherapy after maximal tumor debulking. [ONCOLOGY 11(6):813-823, 1997]

Docetaxel Combined With Vinorelbine: Phase I Results and New Study Designs

June 01, 1997

This was a phase I dose-finding and pharmacokinetic study of vinorelbine (Navelbine) and docetaxel (Taxotere) as first-line chemotherapy for metastatic breast cancer. Vinorelbine dose, 20 or 22.5 mg/m², on days 1 and 5, was followed on day 1 by docetaxel every 21 days, in doses increasing from 60 to 100 mg/m².

Pituitary Adenomas: Current Methods of Diagnosis and Treatment

June 01, 1997

Pituitary adenomas are benign neoplasms that can be effectively managed by a variety of therapeutic options. The clinician's goal in managing patients with these tumors should be to minimize the morbidity of each intervention used in diagnosis and treatment. Standard diagnostic interventions include MRI, hormonal assessment, and tissue diagnosis. Therapies include transsphenoidal surgery, external-beam radiotherapy, newer stereotactic irradiation techniques, and medical management. Appropriate treatment selection requires detailed knowledge of the expected outcomes and side effects of each option. Newer and perhaps less toxic treatment techniques are evolving and require further evaluation. [ONCOLOGY 11(6):791-796, 1997]

Docetaxel in Combination With Flourouracil: Study Design and Preliminary Results

June 01, 1997

The relatively recent introduction of a new class of chemotherapeutic agents--the taxoids--has raised hope of improved survival for patients with advanced or metastatic cancer. Following encouraging preclinical results of taxoid combinations, this phase I, nonrandomized trial was designed to evaluate a 1-hour intravenous infusion of docetaxel (Taxotere) on day 1 combined with fluorouracil (5-FU) as a daily intravenous bolus for 5 consecutive days.

Docetaxel in Breast Cancer and a Rationale for Combination Therapy

June 01, 1997

Development of the taxoids has progressedrapidly in the 1990s. In vitro studies have demonstrated that docetaxel(Taxotere) has a longer residence time and higher accumulation within tumorcells than paclitaxel (Taxol), possibly accounting for its greater cytotoxicity.

Current Challenges of Gene Therapy for Prostate Cancer

June 01, 1997

Gene therapy for prostate cancer faces hurdles similar to those being encountered for other cancers and nonmalignant processes. The greatest obstacle is the identification of efficient delivery systems, since numerous animal models and cell culture systems have shown potential efficacy when most cells express the introduced genetic material. Early prostate cancers are easily accessible to gene vector introduction, and the predictable metastatic patterns of this cancer may offer additional advantages for gene therapy. This article reviews gene vectors and gene products, as well as ongoing trials of gene therapy that have recently begun in prostate cancer. [ONCOLOGY 11(6):845-856, 1997]

Docetaxel and Cyclophosphamide in Patients With Advanced Solid Tumors

June 01, 1997

This trial was designed to determine the recommended maximum tolerated dose (MTD), toxicity, pharmacokinetics, and efficacy of docetaxel (Taxotere) and cyclophosphamide (Cytoxan, Neosar) for phase II studies. Both drugs were administered to 39 patients with advanced solid tumors, 26 of whom had breast cancer.

Docetaxel in Combination With Doxorubicin: A Phase I Dose-Finding Study

June 01, 1997

This phase I dose-finding study examined the effects of the combination of doxorubicin and docetaxel (Taxotere) in 42 women with metastatic breast cancer. The combination was studied at six different dosing levels. The maximum tolerated doses were defined as doxorubicin, 50 mg/m², and docetaxel, 85 mg/m², with sepsis as the dose-limiting toxicity.

Current Challenges of Gene Therapy for Prostate Cancer

June 01, 1997

The explosive increase in the apparent incidence of prostate cancer in the United States (which is due, in large measure, to wider efforts at early detection) has been accompanied by a dramatic stage migration, which can also be attributed to the increased use of prostate-specific antigen (PSA).

Management of Carcinoma of the Superior Pulmonary Sulcus

June 01, 1997

Tumors of the superior pulmonary sulcus (Pancoast tumors) are bronchogenic carcinomas that occur at the thoracic inlet and typically involve, by direct extension, the lower trunks of the brachial plexus, the intercostal nerves, the stellate ganglion, and adjacent ribs and vertebrae. These tumors are rare, comprising 5% of all lung cancers. Treatment of Pancoast tumors has traditionally consisted of preoperative radiation to a dose of 3,000 to 4,500 cGy followed by surgical resection. Overall 5-year survival rates range from 30% to 50%. Even if treatment achieves local disease control, distant failure (brain or bone) is common. Recent treatment efforts have focused on the use of induction chemoradiation followed by surgery and further chemotherapy. This combined-modality approach may become the new treatment paradigm for Pancoast tumors. [ONCOLOGY 11(6):781-785, 1997]

MSU to Study At-Home vs Inpatient Care After Breast Cancer Surgery

June 01, 1997

With the proper nursing care, do women recovering from breast cancer surgery do better at home than in the hospital? To answer this question, researchers at Michigan State University's colleges of Nursing and Human Medicine are undertaking