The Prostate Cancer Intervention Versus Observation Trial (PIVOT)
August 1st 1997As described by Wilt et al in their review, the Prostate Cancer Intervention Versus Observation Trial (PIVOT) is asking very important questions about the effect of surgical treatment vs observation, with delayed androgen deprivation available to both groups, in patients with localized prostate cancer. Clinicians who have suffered with the old Uro-Oncology Trial comparison of prostatectomy vs radiation hope that PIVOT provides answers rather than confusion.
Oligodendroglial Component in Anaplastic Astrocytomas: A Prognostic Factor for Survival
August 1st 1997Perhaps contrary to expectations, the presence of an oligodendroglial component in patients with anaplastic astrocytomas was associated with a significantly longer survival than were pure anaplastic tumors. This finding emerged from a randomized
External Beam Radiation and Brachytherapy for Prostate Cancer: Worthwhile Long-Term Outcomes
August 1st 1997Long recognized as standard treatment of gynecologic cancer and some other malignancies, brachytherapy may also play a role in the treatment of prostate cancer, said Dr. John C. Blasko of the University of Washington in Seattle.
Practical Tips for Caring for HIV/AIDS Patients
August 1st 1997A nurse practitioner who has been caring for HIV/AIDS patients for over 15 years has some practical tips for dealing with the common symptoms associated with the disease. Dr. Gayle Newshan, PhD, NP, offered her advice during a recent
Research Helps Shed Light on Role of Apoptosis in Tumor Development and Growth
August 1st 1997Many types of cells undergo apoptosis as part of the normal physiological process. An interruption in apoptosis is thought to be a primary cause of tumor growth. Two presentations concerning this subject were made at the 88th Annual Meeting of the
The Role of Exercise in the Prevention and Treatment of Cancer
August 1st 1997Recent studies delineate the effect of exercise on specific cancers but much more research on the role exercise plays in the prevention and treatment of cancer is needed, according to Susan Oliveria, ScD, MPH, director of epidemiology at the
Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?
August 1st 1997Outlined in the article by Thompson and Seay are a series of questions relevant to the spectrum of stages of prostate cancer ranging from prevention to the treatment of advanced disease. Given the prevalence of prostate cancer, the morbidity of the disease, and the death rate from prostate cancer of more than 40,000 men in the United States each year, these questions warrant answers as soon as possible.
Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?
August 1st 1997Thompson and Seay have attempted to provide a concise overview of the treatment of both localized and metastatic prostate cancer. Also, they have listed most of the current clinical trials focusing on these issues, along with two current trials addressing the prevention of the disease. There is certainly no getting away from the fact that, even with the plethora of publications dealing with prostate cancer (1,643 in 1994 alone, as the authors point out), there are major gaps in our fund of knowledge about this disease entity.
Oropharyngeal and Oral Cavity Cancer Surgical Practice Guidelines
August 1st 1997The 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
Laryngeal Cancer Surgical Practice Guidelines
August 1st 1997The 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 Clinical Trials of the Southwest Oncology Group
August 1st 1997The Genitourinary (GU) Cancer Committee of the Southwestern Oncology Group (SWOG) has achieved repeated successes in conducting prospective studies of prostate cancer. This article is a summary of recently completed and current trials in prostate cancer and, as such, represents an intriguing snapshot of priorities in prostate cancer clinical trials in 1997.
Parotid Gland Cancer Surgical Practice Guidelines
August 1st 1997The 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 Clinical Trials of the Southwest Oncology Group
August 1st 1997In 1941, Charles Huggins, Clarence Hodges, and R. E. Stevens reported on the beneficial effects of orchiectomy in 21 men with advanced prostate cancer.[1] Fifty-five years later, Southwest Oncology Group (SWOG) investigators were able to confirm, in a 1,387-patient intergroup comparative trial of bilateral orchiectomy with or without flutamide (Eulexin), that we still have nothing better to offer these men. This fact alone should underscore the critical need for well-planned, well-executed clinical trials in prostate cancer. The incidence and death rates continue to rise, and even today too few men are being enrolled in studies designed to alter these statistics.
The Prostate Cancer Intervention Versus Observation Trial (PIVOT)
August 1st 1997The Prostate Cancer Intervention Versus Observation Trial (PIVOT) should prove interesting in that the study design will permit observation of the natural history of a potentially lethal malignant disease, influenced only by palliative treatments. My comments will focus on the concerns raised by this study design. I will not address possible biases of the trial introduced by: (1) enrollment of less than 20% of the eligible population; (2) an enrollment rate per participating center of less than 3 patients per year; (3) a 7-year enrollment period; and (4) a 12-year follow-up (for a total trial duration of 19 years).
Imagery and Hypnosis in the Treatment of Cancer Patients
August 1st 1997Spiegel and Moore draw an important distinction between the use of psychological techniques to promote quality of life and their use to promote quantity of life. On the one hand, a considerable body of research documents that hypnosis and other psychological techniques improve the quality of life of cancer patients. On the other hand, only limited empiric evidence supports the view that imagery and other psychological techniques increase the quantity of life of cancer patients.
Thyroid Cancer Surgical Practice Guidelines
August 1st 1997The 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
Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?
August 1st 1997Despite a heightened focus of the medical and research community on prostate cancer, many important questions about this disease remain unanswered. These include questions about the possible prevention of prostate cancer, as well as the optimal treatment approaches for localized, locally advanced, metastatic, and hormone-refractory disease. A whole host of prospective, well-designed clinical trials are currently in progress that should answer many of these questions. This review briefly explores some of these unresolved issues and describes ongoing trials designed to address them. [ONCOLOGY 11(8):1-11, 1997]
Docetaxel in Combination With Platinums in Patients With Advanced Non- Small-Cell Lung Cancer
August 1st 1997Docetaxel (Taxotere) is a semisynthetic taxoid that possesses significant activity as a single agent in the treatment of patients with non-small-cell lung cancer. In previously untreated patients with non-small-cell lung
The Prostate Cancer Intervention Versus Observation Trial (PIVOT)
The Prostate Cancer Intervention Versus Observation Trial (PIVOT) is a randomized trial designed to determine whether radical prostatectomy or expectant management provides superior length and quality of life for men with clinically localized prostate cancer. Conducted at Department of Veterans Affairs and National Cancer Institute medical centers, PIVOT will enroll over 1,000 individuals less than 75 years of age. The primary study end point is all-cause mortality. Secondary outcomes include prostate cancer- and treatment-specific morbidity and mortality, health status, predictors of disease-specific outcomes, and cost-effectiveness. Within the first 3 years of enrollment, over 400 men have been randomized. Early analysis of participants' baseline characteristics indicate that enrollees are representative of men diagnosed with clinically localized prostate cancer throughout the United States. Therefore, results of PIVOT will be generalizable. These results are necessary in order to determine the preferred therapy for clinically localized prostate cancer. [ONCOLOGY 11(8):1133-1143, 1997]
Review of Docetaxel/Doxorubicin Combination in Metastatic Breast Cancer
August 1st 1997Docetaxel (Taxotere) and doxorubicin (Adriamycin) have each demonstrated significant activity in metastatic breast cancer. Thus, the combination of docetaxel and doxorubicin has been evaluated in phase I trials to
Docetaxel/Doxorubicin/Cyclophosphamide in the Treatment of Metastatic Breast Cancer
Preliminary results from phase I trials suggest that the use of docetaxel (Taxotere) and doxorubicin (Adriamycin) is a well tolerated and highly active combination regimen for
Docetaxel as Neoadjuvant Chemotherapy in Patients With Stage III Breast Cancer
August 1st 1997Optimal management of locally advanced breast cancer (stage III) generally includes a combination of primary chemotherapy followed by surgery (if feasible), and local radiotherapy and adjuvant chemotherapy with or
Docetaxel vs Mitomycin Plus Vinblastine in Anthracycline-Resistant Metastatic Breast Cancer
This nonblinded, multicenter, randomized phase III study compares the median time to progression (primary endpoint), response rate, and quality of life, safety, and survival of