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In May 2008, ONI reviewed an article by Herman Suit, MD, and colleagues in which they argued that randomized trials of proton beam therapy vs standard radiotherapy are not needed prior to a wider use of proton beam therapy. In an ONI reader poll, 81% disagreed with Dr. Suit, as does Dr. Robert Parker, of SUNY Stony Brook, in his letter below.

The authors of this article accomplished their goal to provide an overview of physical long-term / late effects. Similar to most available literature published since the Institute of Medicine report in November 2005, it provided a descriptive summary of the epidemiologic data. While vital to increasing the knowledge base of nurses on the frontlines, it provides little guidance as to how to change or improve practice.

In cancer treatment these days, the immediate-what needs to be done for the patient right now toward achieving long-term survival-is coupled with planning post-treatment surveillance, care, and support for patients who will likely survive their disease.

Drug is indicated for rescue of normal cells following high dose methotrexate administration for osteosarcoma. It is also indicated to diminish and counteract methotrexate toxicity if the drug is not effectively eliminated, or for inadvertent overdose of folic acid antagonists.

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Matthew Ringel, MD, and colleagues have received an $11.9 million NCI grant for their research in thyroid cancer. The 5-year grant will fund the group’s work on genetics and signaling pathways in epithelial thyroid cancer. Dr. Ringel is co-director of the thyroid cancer unit at Ohio State University in Columbus.

The article by Khatcheressian and colleagues addresses the important topic of futility in chemotherapy use. While extensive previous literature has addressed the use of futile treatment by oncologists, Khatcheressian and coauthors pose interesting perspectives on patient persistence in seeking futile treatment.

CHICAGO-For breast cancer patients whose tumors have become resistant to available agents, restoring the sensitivity to treatment is an important goal. Preclinical studies have suggested that drugs that inhibit the mTOR protein kinase-which acts as a central regulator of tumor cell division, cell metabolism, and blood vessel growth-may be able to do so.

Over the past 2 decades, advances in cancer treatment have greatly improved survivorship statistics in the United States. As the oncology community works to ensure that this upward survival trend continues, it’s important for us to recognize the serious challenges that lie ahead.

CHICAGO-Newly diagnosed patients with metastatic colorectal cancer are most likely to benefit from cetuximab (Erbitux) when their tumors contain the normal version of the KRAS gene, compared to patients with KRAS mutations, according to a conclusive analysis from the phase III CRYSTAL trial presented at the ASCO 2008 plenary session (abstract 2).

Colon cancer patients who had abundant levels of vitamin D were less likely to die during a follow-up period than those who were deficient in the vitamin, according to a study by scientists at Dana-Farber Cancer Institute and the Harvard School of Public Health (J Clin Oncol 26:2984-2991, 2008).

CHICAGO-Sorafenib (Nexavar) is safe and prolongs overall survival and time to progression in Asian patients with advanced hepatocellular carcinoma (HCC), finds the randomized phase III Asia-Pacific liver cancer study. Moreover, efficacy was similar to that in the Western population even though the Asian patients had more adverse prognostic factors.

Today there are nearly 12 million individuals living in the United States who have ever received a diagnosis of cancer.[1] This number is growing, having just been recently updated to approximately 11.9 million from a previous estimate of about 10.8 million cancer survivors.[2] One half of all men and one in three women will be diagnosed with cancer in their lifetime, with the largest burden being during later life; one in seven Americans 65 years of age and older has a past or present cancer diagnosis.[3]

he field of geriatric assessment is crowded by a variety of assessment domains, a plethora of assessment tools, and research spanning diverse care settings. In their article published in this issue of the journal ONCOLOGY, Schubert, Gross, and Hurria have synthesized the evidence and propose a subset of commonly used functional assessment tools for assessing older adults with cancer.[1]

These are trying times at FDA. The agency has its hands full regulating pharmaceuticals produced in the United States: Now come the perils of globalization, which were dramatized by the recent heparin scandal. FDA contends that the adverse events and deaths associated with Baxter’s heparin products were caused by a contaminant deliberately introduced somewhere in China’s raw material supply. Chinese regulators quickly rebuffed FDA’s claim, asserting the problem was more likely caused by impurities introduced in the final US drug production process.

ORLANDO-In a phase III study, the investigational GnRH blocker degarelix (Ferring Pharmaceuticals) significantly reduced testosterone levels within 3 days in more than 96% of study patients, Laurence Klotz, MD, of the University of Toronto, reported at AUA 2008. The fast effect on testosterone levels was close to the immediate effect achieved with surgery, he said.

The authors have provided a concise review of stereotactic body radiosurgery (SBRS) in the treatment of mainly spinal/paraspinal metastases. This technique was primarily developed to treat spinal metastases in the reirradiation scenario given that treatment alternatives are limited for these patients and that-in the setting of advanced metastatic disease-surgical decompression is often not a suitable option.

The goal of palliative radiotherapy is to treat symptoms as rapidly and efficiently as possible, with the fewest side effects.[1] For many years, pain medication, radiotherapy, and surgery were the only tools available for the treatment of bone metastases. This has changed significantly over the past 15 years. New systemic agents, including bisphosphonates such as zoledronic acid (Reclast, Zometa), are available to prevent the development of new lesions, strengthen the bone, and improve symptoms. In addition, targeted treatments directed at achieving tumor ablation now include radiofrequency ablation and stereotactic body radiation therapy (SBRT).