ONCOLOGY Vol 13 No 10

Prospects for the multimodality treatment of non–small-cell lung cancer have improved substantially with the demonstration of fairly dramatic results, in terms of 5-year survival, in several phase III trials that employed

Combination chemoradiation, alone or as an adjuvant to surgery, has been shown to improve treatment outcomes in a number of human malignancies, but may be limited by normal tissue toxicities. A primary challenge in

After nearly 4 decades of use in treating small-cell lung cancer (SCLC), thoracic radiation has become integral to the management of limited-stage disease. Many prospective randomized trials have demonstrated that adding

Obliteration of the tumor vasculature is an effective means of achieving tumor regression. Antiangiogenic agents have begun to enter cancer clinical trials. Ionizing radiation activates the inflammatory cascade and increases the

Three-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

Because treatment for most brain tumors remains inadequate, there has been a sustained interest in using concurrent chemotherapy and radiotherapy to improve local control, prolong overall survival, and reduce

The taxanes, paclitaxel and docetaxel, are novel antimitotic agents that are under extensive investigation in clinical trials in patients with various solid tumors. The taxanes have demonstrated significant activity against

Dr. Minsky provides an excellent review of the current status of primary and adjuvant therapy in patients with carcinoma of the esophagus. Although the treatment of esophageal cancer remains a hotly debated issue, recent results clearly show the superiority of combined-modality therapy, especially when surgical resection is not planned.

The major political question for the cancer community this fall is whether the House follows the Senate’s lead and includes a “clinical trials” amendment in its managed care bill. One of the competing House bills (H.R. 2723), sponsored by Reps. John

Many advances in the treatment and care of cancer patients have been closely linked to the availability of more effective pharmaceutical agents. As research continues to develop new and improved chemotherapeutic agents, it is heartening that the FDA maintains a flexible approach to the drug approval process and will consider an array of indicators of drug efficacy, including patient self-reports of health-related quality of life.

Depression is the most common postoperative complication seen in patients who have undergone surgery for brain tumors, but it is seldom recognized or treated, according to preliminary findings of a study presented at the annual meeting of the

Tumors of the head and neck continue to pose challenges for afflicted patients and their treating physicians. Because the complex and vital anatomy often involved affects the ability to communicate and interact socially, head and neck tumors can have a devastating effect on the patient’s quality of life. Due to the inherently complex nature of such tumors and their rarity, a comprehensive textbook devloted to their management is certain to be useful.

Both gastric and pancreatic cancer remain leading causes of cancer death in the United States and worldwide. While surgical resection continues to be required for long-term cure of both these neoplasms, 5-year survival

Lung cancer is the leading cause of cancer death in the United States. Surgery is the treatment of choice for early stage patients. Despite radical surgery, patients with early stage lung cancer remain at risk for recurrence. The

The two general treatment approaches for esophagel cancer are primary treatment (surgical or nonsurgical) or adjuvant treatment (preoperative or postoperative). Due to differences in the patient populations selected for surgical or nonsurgical therapies, which may bias the results against nonsurgical therapy, it is difficult to determine the best treatment approach for this disease. The standard of care is either surgery alone or primary combined-modality therapy. Based on a nonrandomized comparison of the data from recent intergroup trials, the results of these two approaches are similar. For patients treated without surgery, the intergroup INT 0123 trial will determine whether higher doses of radiation are of benefit. No clear survival advantage has been seen with preoperative or postoperative adjuvant radiation therapy alone or chemotherapy alone. The randomized trials comparing preoperative combined-modality therapy vs surgery alone reveal encouraging results for the combination approach but need further confirmation. For patients treated with combined-modality therapy, the ideal regimen remains to be determined. Part 1 of this two-part review, which appeared in last month’s issue, centered on primary therapy for esophageal carcinoma. This part explores the rationale for and results of adjuvant therapy. [ONCOLOGY 13(10):1415-1427,1999]

Chemoprevention is defined as the use of specific natural or pharmacologic agents to reverse, suppress, or prevent the carcinogenic process to the development of invasive cancer. The basic idea behind lung cancer