Oncology Ny
-
Adjuvant chemotherapy is an integral component of the multidisciplinary curative treatment of primary breast cancers. The experience of the last 3 decades indicates that anthracycline-containing regimens provide the most effective cytotoxic treatment for this purpose. The development of the taxanes over the past 10 years represents substantial progress, and taxane-containing regimens are widely used for the treatment of metastatic breast cancer. ⋯ The docetaxel (Taxotere)-containing regimens were developedfollowing one of three important strategies: (1) the sequential administration of docetaxel to existing, commonly used combinations; (2) the simultaneous addition of docetaxel to an existing regimen; and (3) the substitution of docetaxelfor one of the drugs included in standard combinations. These three approaches are under intense investigation by large multicenter, multinational clinical trials. The results of these phase III, prospective, randomized trials will establish the contribution of docetaxel to the curative treatment of breast cancer and will determine the optimal method of incorporating this drug into standard adjuvant therapy.
-
As active participants in the care of patients with acquired immunodeficiency syndrome (AIDS), oncologists need to be aware of the many facets of pain management in this population. This two-part article, which will conclude in the July 2002 issue, describes the prevalence and types of pain syndromes encountered in patients with AIDS, and reviews the psychological and functional impact of pain as well as the barriers to adequate pain treatment in this group and others with human immunodeficiency virus (HIV)-related disease. Finally, principles of pain management, with particular emphasis on controlling pain in HIV-infected patients with a history of substance abuse, are outlined.
-
Dyspnea is defined as a sensation of difficult or uncomfortable breathing. The symptom is highly prevalent among cancer patients with and without direct lung involvement. The gold standard of assessment is based on patient self-report. ⋯ Opioids are the first-line therapy for relief of dyspnea symptoms. When prescribed appropriately, respiratory depression is not a significant concern. In the rare cases in which opioids are unable to control dyspnea, sedation is an effective, ethical, and legal option.
-
Recent combinations of chemotherapy have significantly improved the response rate and survival time for patients with metastatic colorectal cancer. This improvement has been initially demonstrated with the combination of fluorouracil (5-FU)/leucovorin and irinotecan (CPT-11, Camptosar), which now is considered and recommended as first-line treatment. ⋯ This article will review the inclusion criteria and goal of these European trials. An update on accrual and on tolerance will also be provided.
-
Capecitabine (Xeloda) and irinotecan (CPT-11, Camptosar) both have demonstrated single-agent activity in patients with colorectal cancer. In an analysis of pooled results of two phase III studies, capecitabine provided advantages over intravenous fluorouracil (5-FU) plus leucovorin in patients with metastatic colorectal cancer. ⋯ Combinations of these agents therefore are being explored in patients with colorectal cancer. This report briefly reviews current and ongoing trials evaluating capecitabine/irinotecan combination regimens in treating this disease.