Current Surgical Management of Metastatic Spinal Disease
July 1st 2000At the outset of their article, Drs. Gerszten and Welch state that their primary goal is to review factors that affect surgical intervention in patients with metastatic spinal disease. On their way to achieving this goal, the authors touch on some of the
Cutaneous T-Cell Lymphoma: Pathogenesis and Treatment
July 1st 2000Drs. Girardi and Edelson provide a concise discussion of current issues surrounding the management of patients with cutaneous T-cell lymphomas. They discuss a number of current theories regarding etiology and pathogenesis and provide a
Permanent Prostate Brachytherapy: Lessons Learned, Lessons to Learn
July 1st 2000Dr. Potters has provided an excellent and timely overview of transperineal interstitial permanent prostate brachytherapy (TIPPB). The historical context, as the title suggests, nicely illustrates the lessons already learned and those still to be learned. There are a few points I would like to discuss in further detail.
Current Surgical Management of Metastatic Spinal Disease
July 1st 2000The article by Drs. Gerszten and Welch is a broad, general, and philosophic review of the surgical options that are currently available for the care of our unfortunate patients with metastatic spinal disease. The authors document the poor outcomes of
Advances in the Management of Lung Cancer
July 1st 2000In October 1999, 40 leading experts from Europe, the United States, and the Far East met in St. Julians, Malta, to discuss recent progress in the management of lung cancer. Emphasis was placed on novel treatment strategies for non–small-cell
Management of Hepatocellular Carcinoma
July 1st 2000The article, “Management of Hepatocellular Carcinoma,” by Drs. Nakakura and Choti, is an excellent, comprehensive overview of the treatment modalities used for one of the most challenging cancers. The thoroughness of this review underscores the current frustration of the clinician in the management of this disease and the inadequacies of available therapies. The authors list more than 17 treatments for the various stages of this disease. However, if any one of the therapies mentioned offered cure to a majority of patients, there would be little need for more review articles or randomized controlled trials. There are few cancers that command such a vast array of differing therapies from so many different specialties.
Combination Chemoradiotherapy With Gemcitabine: Potential Applications
July 1st 2000Gemcitabine (Gemzar) is a novel deoxycitidine drug that has demonstrated promising single-agent activity in non–small-cell lung cancer and has been proven to be a potent radiosensitizer. Although the exact mechanism of the
Advances in Treatment of Inoperable NSCLC: Gemcitabine Doublets-A Promising Alternative
July 1st 2000Gemcitabine (Gemzar) was originally approved for use in combination with cisplatin (Platinol) for the treatment of advanced non–small-cell lung cancer (NSCLC). Research began to focus on combining gemcitabine with newer
Gemcitabine/Cisplatin as Induction Therapy for Stage IIIA N2 Non–Small-Cell Lung Cancer
July 1st 2000Because the majority of patients with stage IIIA N2 non–small-cell lung cancer (NSCLC) ultimately die of distant metastases, recent efforts to improve their intermediate- and long-term survival have focused on neoadjuvant
Gemcitabine/Alimta in Locally Advanced or Metastatic Non–Small-Cell Lung Cancer
July 1st 2000The search for new combination chemotherapeutic regimens for the treatment of non–small-cell lung cancer is motivated not only by the desire to increase the objective tumor response and survival rates, but also by the desire
Paclitaxel/Carboplatin vs Paclitaxel/Gemcitabine in Advanced Non–Small-Cell Lung Cancer
July 1st 2000The Hellenic Cooperative Oncology Group conducted a randomized phase III trial to compare paclitaxel (Taxol) 200 mg/m² IV 3-hour infusion on day 1 plus carboplatin (Paraplatin) at an area under the curve (AUC) of 6 (group
Triple- vs Double-Agent Chemotherapy for Advanced Non–Small-Cell Lung Cancer
July 1st 2000In our previous phase I/II studies, both the cisplatin (Platinol), gemcitabine (Gemzar), and vinorelbine (Navelbine) (PGV), and cisplatin, gemcitabine, and paclitaxel (Taxol) (PGT) regimens produced a median survival of
Gemcitabine/Carboplatin Combination Regimens: Importance of Dose Schedule
July 1st 2000Platinum compounds, either cisplatin (Platinol) or carboplatin (Paraplatin), in combination with a number of new chemotherapeutic agents, have demonstrated improved response or survival compared to cisplatin alone or older
Gemcitabine, Paclitaxel, and Carboplatin for Advanced Non–Small-Cell Lung Cancer
July 1st 2000The purpose of this study was to evaluate the combination of gemcitabine (Gemzar), paclitaxel (Taxol), and carboplatin (Paraplatin) in patients with advanced non–small-cell lung cancer (NSCLC). Previously untreated
Current Surgical Management of Metastatic Spinal Disease
July 1st 2000Despite advances in the treatment of many malignancies, a large number of cancer patients will require evaluation and possible surgical intervention for lesions that have metastasized or directly invaded the spinal column. The need for heightened awareness of and aggressive early intervention for spinal metastases is underscored by many studies that have reported a relationship between pretreatment and posttreatment neurologic function in these patients. Recommendations for operative intervention should be made following an evaluation of the patient by multiple specialties, both medical and surgical. In the last decade, advances in surgical techniques for tumor decompression and spine stabilization, neurophysiologic monitoring, and anesthetic expertise have allowed surgeons to perform more extensive procedures with improved outcomes and reduced morbidity. This article will review the factors favoring an operative recommendation in patients with metastatic spinal disease, preoperative evaluation, and available surgical options. Patients with symptomatic spinal metastases should receive early surgical consultation as part of a multidisciplinary approach to their disease process. [ONCOLOGY 14(7):1013-1024, 2000]
Permanent Prostate Brachytherapy: Lessons Learned, Lessons to Learn
July 1st 2000Current techniques for permanent prostate brachytherapy are associated with excellent biochemical control in patients with localized prostate cancer. Data now available confirm 5- to 10-year results with this treatment
Commentary (Staley): Management of Hepatocellular Carcinoma
July 1st 2000As Drs. Nakakura and Choti point out, the incidence of hepatocellular carcinoma (HCC) is rising in many countries including the United States, mainly as the result of a steady increase in hepatitis C infections. Unfortunately, it now seems that the hepatitis C virus is more carcinogenic than the hepatitis B virus, judging from the frequency with which HCC develops among patients with hepatitis C- vs hepatitis B-induced cirrhosis.[1] Numerous studies have demonstrated changes in various oncogenes and tumor suppressor genes, but no consistent sequence of genetic changes has emerged similar to the adenoma-carcinoma sequence in colon cancer.
Commentary (Fong): Management of Hepatocellular Carcinoma
July 1st 2000Hepatocellular carcinoma (HCC) is the most common solid organ tumor worldwide. In recent decades, diagnosis and treatment of this cancer has evolved significantly. The article by Drs. Nakakura and Choti summarizes many of the advances in this field, delineates the current evidence-based treatment options, and defines promising areas for future study.
Current Surgical Management of Metastatic Spinal Disease
July 1st 2000The authors have provided an excellent review of contemporary approaches to the treatment of spinal metastatic disease. With improved diagnostics, advances in spinal fixation techniques, and a more rational approach to achieving decompression