J Buon
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The incidence of locoregional recurrence in rectal cancer has declined since total mesorectal excision (TME) has been widely adopted. The purpose of this study was to investigate the long-term survival and the incidence of locoregional recurrences in patients with middle and low rectal carcinomas undergoing TME. ⋯ TME appears to improve long-term survival in patients with middle and low rectal carcinomas. The incidence of locoregional recurrence is also reduced by TME.
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To identify the prognostic factors for biochemical outcome in patients with localized prostatic adenocarcinoma treated with external beam radiotherapy (EBRT) with or without androgen deprivation (AD) and to investigate the impact of percent positive prostate core biopsies (PCB%). ⋯ Our results suggest that high PCB% could be a predictor of biochemical relapse, especially in the intermediate risk group. The role of PCB% in prostate cancer should be investigated in further trials.
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Metastatic cancer remains difficult to treat effectively and treatments are in most cases not curative despite significant side effects. Novel, targeted approaches such as gene therapy hold promise for the treatment of various tumor types. Among the most promising cancer gene therapy approaches are oncolytic adenoviruses, which are able to infect, replicate in and lyse tumor cells. ⋯ This review focuses on targeting strategies to improve tumor cell transduction and cancer cell selective replication. Strategies to improve antitumor efficacy by arming the virus with therapeutic transgenes are also discussed. Furthermore, an overview of the most important clinical approaches with oncolytic adenoviruses is given.
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Throughout the past two decades the efforts to improve the efficacy of treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) have led to increased use of multimodality approaches combining surgery, radiotherapy (RT), and chemotherapy (CT). Conventional RT, a standard approach for locoregionally advanced disease, was associated with unsatisfactory results, thereby, a greater understanding of radiobiology led to the development of two classes of altered radiation fractionation schedules incorporating hyperfractionation (HF) and acceleration in the management of advanced HNSCC. Randomized controlled trials and meta-analyses demonstrated that for patients with locally advanced HNSCC major improvements in locoregional control (LRC) at high level of evidence can be achieved by accelerated fractionation (AF) and HF. ⋯ CCRT is now a standard treatment approach for patients with locally advanced HNSCC. CCRT has been also shown to allow organ preservation in almost two thirds of patients without affecting survival. Recently, strong evidence for an improved outcome for high-risk resected patients has been shown by the use of adjuvant CCRT.
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Talc remains a commonly used agent for pleurodesis malignant pleural effusion. Nevertheless, it is associated with a 3-9% incidence of pulmonary reactions ranging from simple pneumonitis to acute respiratory distress syndrome (ARDS). The underlying lung pathology and the size and rate of talc particle dissemination have been implicated as the cause of these complications. There seems to be an acknowledged lack of evidence regarding detailed very early intrathoracic talc particle migration. ⋯ Large-sized talc particles are deposited on both lungs very early after pleurodesis. At the same time inflammatory pulmonary changes appear bilaterally. Despite contradicting data in the literature, these findings should always be kept in mind when performing this procedure in high risk patients.