Current opinion in oncology
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This review highlights how progress has been made in treating limited small cell lung cancer and outlines current challenges to overcome for improved cure rates. ⋯ Concurrent chemoradiotherapy is associated with a one in four chance of cure. Two ongoing phase III trials have been designed to address the optimal radiotherapy regimen to combine with cisplatin and etoposide. Close collaboration between radiation and medical oncologists is needed to make further progress and to improve patient access to curative intent concurrent chemoradiotherapy regimens.
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The majority of women diagnosed with epithelial ovarian cancer (EOC) will be diagnosed with advanced stage disease, a stage that is fundamentally incurable. Survival rates for this deadly disease have improved over the last 25 years secondarily to the advances in surgery and chemotherapeutics. Effective screening protocols are not currently available, and risk assessment protocols for the presence of EOC in women with an ovarian cyst need improvement. Earlier diagnosis may result in stage migration and decreased morbidity for women diagnosed with EOC. Better risk assessment will allow the triage of women to centers of excellence in the treatment and management of ovarian cancer with improved outcomes and survival rates. This review will focus on new biomarkers and algorithms for screening and risk assessment for ovarian cancer. ⋯ For more than 25 years CA125 has been the main biomarker for the management of women with EOC. Recently, novel biomarkers have become available clinically that improve upon the use of CA125 for the risk assessment and management of women with ovarian cancer.
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To present recent developments in the treatment of breakthrough pain (BTP) in cancer, we reviewed the literature with a special focus on last publications using Medline. ⋯ Data from epidemiological and clinical studies show that breakthrough pain remains a challenge especially among cancer patients. An accurate diagnosis followed by a specific treatment is the key for an effective pain relief.
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Brain metastases are frequent in lung cancer. They are responsible for life-threatening symptoms and serious impairment in patients' quality of life, resulting in a shortened survival. Prophylactic cranial irradiation (PCI) has been proposed in both small-cell lung cancers (SCLCs) and non-SCLCs to reduce the incidence of brain metastases and increase survival. ⋯ In limited disease SCLCs, PCI should be administered at the dose of 25 Gy in 10 fractions to first-line treatment responders. In extensive disease SCLC, PCI is recommended in patients who respond to first-line chemotherapy. Clinical trials are ongoing to investigate the role of PCI in non-SCLC patients.