American journal of clinical oncology
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Am. J. Clin. Oncol. · Apr 1998
ReviewAnastrozole: a new addition to the armamentarium against advanced breast cancer.
Estrogen manipulation represents an effective treatment for advanced breast cancer in postmenopausal women with estrogen-receptor positive disease. The antiestrogen agent, tamoxifen, is the first choice for advanced breast cancer in postmenopausal women due to its efficacy and lack of significant side effects. As with all cancer treatments, however, cancer may recur after initial treatment with tamoxifen, and the limitations of currently available alternative hormonal therapies in terms of tolerability and convenience of administration underscore the need for new agents. ⋯ In two multicenter clinical trials, anastrozole was as effective as megestrol acetate for the treatment of advanced breast cancer in postmenopausal women who progressed after tamoxifen therapy, based on objective response rates and time to objective progression of disease. In addition, the drug did not produce the weight gain observed with megestrol acetate therapy. Anastrozole is an effective endocrine agent in the treatment of advanced breast cancer in postmenopausal women.
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Am. J. Clin. Oncol. · Apr 1998
The management of metastatic squamous cell carcinoma in cervical lymph nodes from an unknown primary.
A patient is diagnosed with an unknown primary of the head and neck when metastatic disease is present in the cervical lymph node or nodes and no primary lesion is detected by thorough physical examination, directed biopsies of suspicious or most likely primary sites, and imaging studies. The optimal management of patients who have this syndrome is still unclear and controversial. We report our results and analysis of the management of 24 patients with this syndrome. ⋯ The high incidence of distant metastases shortly after treatment suggests a hematogenous spread before treatment in patients who had extensive nodal and extranodal disease. Our long-term disease-free survival beyond ten years seems to indicate combined treatment modalities, including radical neck dissection with postoperative radiotherapy of the neck, and the potential primary site in patients with N2 and N3 disease (our N1 group is too small for analysis). Further improvement of cure rate can be expected in the future with early detection and treatment.