Journal of the National Comprehensive Cancer Network : JNCCN
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J Natl Compr Canc Netw · Sep 2004
ReviewPrevention, diagnosis, and treatment of invasive fungal infections in patients with cancer and neutropenia.
Invasive fungal infections are a major cause of morbidity and mortality in patients with prolonged neutropenia and in allogeneic hematopoietic stem cell transplant recipients. The degree and duration of neutropenia influence the risk of opportunistic fungal infections. ⋯ Three strategies in preventing and treating patients at high risk for fungal infection will be considered: (1) prophylaxis; (2) empirical therapy; and (3) treatment for probable or proven fungal infection. In addition to more effective antifungal agents, growing interest has been noted in novel non-culture detection methods to facilitate early diagnosis of invasive fungal infections.
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J Natl Compr Canc Netw · Sep 2004
ReviewAdvanced ovarian cancer: a clinical update on first-line treatment, recurrent disease, and new agents.
Platinum-based therapy plays an integral role in the first-line treatment of advanced ovarian cancer as well as in the recurrent disease setting. In advanced disease, the standard of care in the United States is maximal surgical cytoreduction followed by paclitaxel/carboplatin chemotherapy. Results from the Gynecologic Oncology Group COG 158 trial show that paclitaxel/carboplatin is at least as effective as paclitaxel/cisplatin and is better tolerated and easier to administer. ⋯ Recent results from the International Collaborative Ovarian Neoplasm ICON 4 trial indicate that paclitaxel/carboplatin may offer superior efficacy to single-agent carboplatin. Additional randomized comparisons of carboplatin versus other carboplatin combinations are in progress. Finally, a variety of new cytotoxic and biologic agents are being evaluated in recurrent disease, either as single agents or in combination with standard chemotherapy.
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J Natl Compr Canc Netw · Sep 2004
ReviewEarly-stage NSCLC: the role of radiotherapy and systemic therapy.
Although surgical resection offers the best opportunity for cure in early-stage non-small cell lung cancer, long-term survival remains less than 50% for all but clinical stage IA disease. Nearly 80% of relapses occur in distant sites. Thus, investigators have turned to chemotherapy or radiotherapy to prevent relapse and extend survival. ⋯ Retrospective series, as well as randomized trials, show consistent benefit, but these trials suffer from small numbers of patients. More recently, phase II trials have confirmed the feasibility of this strategy in patients with stage IB-IIIA disease, with nearly all patients completing induction chemotherapy and no apparent increase in operative mortality. Ongoing trials continue to assess the role of preoperative and postoperative chemotherapy or radiotherapy in early stage non-small cell lung cancer.