Cancer
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The objective of this report was to present an outcomes validation for the Fox Chase Cancer Center (FCCC) management policy for patients who demonstrate prostate specific antigen (PSA) failure after receiving three-dimensional conformal radiation therapy (3DCRT). ⋯ The current results validate the use of PSADT as an indicator of patients who may be observed expectantly or treated with AD therapy for PSA failure after 3DCRT. Prospective trials are needed to define further the optimal treatment for these patients.
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The current study identified determinants of systemic recurrence and disease-specific survival (DSS) in patients with early-stage breast carcinoma treated with breast-conserving surgery and radiation therapy (breast-conserving therapy, or BCT). ⋯ Positive surgical margins and IBTR are predictors of systemic recurrence and disease-specific survival after BCT. Aggressive local therapy is necessary to ensure adequate surgical margins and to minimize IBTR.
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Bisphosphonates have become well established in the treatment of patients with metastatic bone disease, although the optimal use of these agents has not been defined clearly. Randomized, controlled trials have demonstrated that treatment with intravenous pamidronate can significantly reduce the rate of skeletal-related events in patients with bone metastases from myeloma or advanced breast carcinoma. To date, there are few data from controlled, randomized studies to support the use of bisphosphonates in patients with bone metastases from malignancies other than breast carcinoma and myeloma. ⋯ There are conflicting data on the use of bisphosphonates as an adjuvant therapy. Currently, such treatment should occur only as part of a clinical trial. Bisphosphonates can be used to prevent bone loss as a result of therapy for malignant disease, e.g., premature menopause in patients with early breast carcinoma.
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The authors conducted a series of four Phase I-II trials of high-dose and intermediate-dose docetaxel, cisplatin, and 5-fluorouracil (TPF)-based induction chemotherapy for patients with advanced squamous cell carcinoma of the head and neck (SCCHN). The chemotherapy regimens and response rates for each trial were published previously. In the current analysis, the authors report the data on long-term survival, patterns of failure, and morbidity among the patients who were treated at their institution. ⋯ These data suggest that docetaxel adds incrementally to the efficacy of cisplatin and fluorouracil. Local-regional failures continue to be the major impediment to cure in these patients. Given the increase in local-regional dose intensity with chemoradiation, sequential treatment plans that integrate induction chemotherapy and chemoradiotherapy seem to be the logical next step.
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Randomized Controlled Trial Comparative Study Clinical Trial
Liposomal amphotericin B versus the combination of fluconazole and itraconazole as prophylaxis for invasive fungal infections during induction chemotherapy for patients with acute myelogenous leukemia and myelodysplastic syndrome.
Fungal infections are a major cause of morbidity and mortality in patients undergoing induction chemotherapy for acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The authors evaluated the efficacy and toxicity of liposomal amphotericin B (L-AmB) compared with a combination of fluconazole plus itraconazole (F+I) as prophylaxis in this setting. ⋯ L-AmB and F+I appear similar in their efficacy as antifungal prophylaxis during induction chemotherapy for patients with AML and MDS. L-AmB was associated with higher rates of increased serum bilirubin and creatinine levels.