J Buon
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Peripheral neuropathy ranks among the most common non-haematological adverse effects of a number of effective chemotherapeutic agents, including platinum compounds, taxanes and vinca alkaloids. Newer agents, such as bortezomib, thalidomide and lenalidomide, frequently exert similar neurotoxic effects on peripheral nerves. Chemotherapy-induced peripheral neuropathy (CIPN) may result from a variety of mechanisms and may be related to causal factors, such as single dose per course, cumulative dose and risk factors including treatment schedule, prior or concomitant administration of other neurotoxic agents, age and pre-existing peripheral neuropathy of other causes. ⋯ Although several of these agents hold promise as possible neuroprotective factors, clinical data are still controversial and none have as yet robustly been proven effective against CIPN. This review critically looks at the pathogenesis, incidence, risk factors, diagnosis, characteristics and management of peripheral neuropathy associated with commonly used chemotherapeutic agents. We also highlight areas of future research to pursue.
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Adoption of screening programmes for early diagnosis of prostate cancer has led to an increased number of sonographically guided prostate biopsies. Core needle biopsies are now among the most common specimens received from pathology laboratories. As a result, urologists and pathologists may encounter small volume prostate tumors with obvious clinical and diagnostic implications. ⋯ The diagnosis of small cancer foci is a challenge for pathologists as it carries the risk of false positive or negative diagnosis. Additionally, it represents a difficult clinical dilemma for urologists whether they should proceed or withhold treatment for local disease. This report highlights current concepts regarding pathologic diagnosis and clinical management of these cases.
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Comparative Study
Contribution of (99m)Tc-depreotide (Neospect) scintigraphy in lung cancer staging.
The aim of this study was to evaluate the usefulness of scintigraphy with (99m)Tc-depreotide in the staging of lung cancer, especially in cases where CT findings are doubtful. ⋯ It seems that scintigraphy with (99m)Tc-depreotide in patients with SCLC does not change the tumor stage, whereas in NSCLC the contribution of Neospect in lung cancer staging may be a helpful tool, especially in cases where CT alone is unable to distinguish between IIIA and IIIB stages (operable from non operable status).
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Screening is a significant method for cancer control, nevertheless the implementation of non cost-effective screening tests at national level may constitute a major burden to health economics. The purpose of this study was to determine the cancer screening activities of a large sample of the Hellenic population, in a country with opportunistic screening practice. ⋯ Opportunistic cancer screening in a primary health care system where national guidelines are missing may cause ambiguous results. Reconsideration of health policy in such cases is mandatory.
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Comparative Study
A comparative study of prophylactic antiemetic treatment in cancer patients receiving radiotherapy.
Gastrointestinal side effects can often complicate radiotherapy (RT) in cancer patients. This work presents results of a retrospective open label study aiming to evaluate the optimum prophylactic treatment for nausea and vomiting in patients receiving fractionated radical or palliative RT. ⋯ Patients receiving prophylactic antiemetic treatment with tropisetron+dexamethasone completed RT with lower intensity of nausea and vomiting and lower ECOG PS scores compared to groups that received other antiemetic treatments.