Jeffrey S. Abrams, MD

The article by Dr. Echarri Gonzalez and her colleagues regarding intraperitoneal (IP) chemotherapy for women with epithelial ovarian cancer provides a comprehensive yet practical review of the critical questions surrounding the use of IP chemotherapy.

The Cancer Trials Support Unit (CTSU) is a pilot program sponsored by the National Cancer Institute (NCI). The CTSU has two primary functions. It centralizes regulatory support for all adult Cooperative Group trials (phases I- III), thereby reducing duplication among Group members regarding credentialing, compliance with federal regulations, and institutional review board (IRB) activities. It also provides all Group members and select non-Group members with access to phase III treatment trials.

The 4th National Institutes of Health (NIH) Consensus Conference on Adjuvant Therapy of Breast Cancer, held November 1-3, 2000, concluded that decreasing breast cancer mortality rates in the United States were due, at least in part, to advances made in adjuvant treatment. This fact lends credence to the importance of incremental improvements that have resulted from randomized, controlled clinical trials of adjuvant therapy, and underscores the value of this approach. With 185,000 new diagnoses of breast cancer expected in the United States in 2000, over 100,000 women may be candidates for some form of adjuvant therapy each year.[1]

To irradiate or not to irradiate, that is the question posed by Marks and Prosnitz for women with early invasive breast cancer or ductal carcinoma in situ (DCIS) undergoing breast conservation therapy (BCT). Due in large part to mammography, there has been in the 1990s a significant increase in the percentage of women presenting with stage 0 (DCIS) and stage I breast cancer, as recorded by the Surveillance, Epidemiology and End-Results Program of the National Cancer Institute (NCI). The generally excellent outcome of these tumors with current therapy has focused research efforts on studies directed at improving quality of life and minimizing the side-effects and expense of local therapy. In this regard, Marks/Prosnitz present a concise and balanced summary of results from randomized and non-randomized clinical trials, and develop a rationale for current treatment recommendations and future studies regarding the role of breast irradiation (RT).