The cancer journal
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
I-125 versus Pd-103 for low-risk prostate cancer: morbidity outcomes from a prospective randomized multicenter trial.
The purpose of this study was to test the hypothesis that the shorter half-life of Pd-103 versus I-125 results in a shorter duration of radiation-related symptoms after prostate brachytherapy. ⋯ Patients treated with Pd-103 recovered from their radiation-induced prostatitis sooner than I-125 patients. It appears that patients with minimal pretreatment urinary obstructive symptoms are the most likely to experience implant-related exacerbations of their symptoms and are the most likely to benefit from the more rapid half-life of Pd-103 rather than I-125.
-
Metastases to the spine are a challenging problem. Percutaneous, image-guided tumor ablation with a thermal energy source, such as radiofrequency, has received increasing attention as a promising technique for the treatment of focal malignant disease. We used radiofrequency ablation for patients with unresectable, osteolytic spine metastases under computed tomographic and fluoroscopic guidance. The purpose of this study was to determine the feasibility, effectiveness, and safety of radiofrequency ablation as a palliative procedure to reduce pain and back pain-related disability in patients with vertebral and paravertebral spine tumors who were not able to benefit from radiotherapy, chemotherapy, or surgery. ⋯ Radiofrequency ablation was successfully performed in all 10 patients. Needles were placed accurately under image guidance, and a controlled lesion was created. Pain- and back pain-related disability was clearly reduced, and neurologic function was preserved or stabilized. When confirmed by further investigation, this therapy may be a new option for patients with unresectable spine tumors that do not respond to radiotherapy and chemotherapy.
-
Factors predictive of outcome in patients with breast cancer refractory to neoadjuvant chemotherapy.
The purpose of this study was to determine the clinical, pathological, and treatment factors that are predictive of local-regional recurrence and overall survival for patients with breast cancer that is refractory to neoadjuvant chemotherapy. ⋯ For patients with a poor response to neoadjuvant chemotherapy, conventional treatments achieve reasonable outcomes in those with lymph node-negative disease or estrogen receptor-positive disease. However, more active systemic and local therapies are needed for patients with estrogen receptor-negative disease and positive lymph nodes and for those with clinical evidence of progressive disease during neoadjuvant chemotherapy.
-
The purpose of this study was to compare the toxicity, particularly rectal, between short-course, intensity-modulated radiotherapy (SCIM-RT) delivering 70 Gy in 28 fractions and three-dimensional conformal radiotherapy (3D-CRT) delivering 78 Gy in 39 fractions. ⋯ SCIM-RT, delivering 70.0 Gy at 2.5 Gy per fraction, had an acute and late toxicity profile up to 18 months after therapy that was similarto that of 3D-CRT delivering 78.0 Gy at 2.0 Gy per fraction. The grade 2 actuarial combined rectal toxicity rate is low (10%) at 18 months, although it increased when rectal volumes > 15 mL received 70 Gy with SCIM-RT. Only 7% of SCIM-RT cases received 70 Gy to > 15 ml of the rectum. If longer follow-up confirms the low late toxicity rates, SCIM-RT will be an alternative and more convenient method of dose-escalation in the treatment of localized prostate cancer.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial.
Zoledronic acid, a new and more potent bisphosphonate, was compared with pamidronate, the current standard treatment for patients with osteolytic or mixed bone metastases/lesions. ⋯ Zoledronic acid (4 mg) via 15-minute intravenous infusion was as effective and well tolerated as 90 mg of pamidronate in the treatment of osteolytic and mixed bone metastases/lesions in patients with advanced breast cancer or multiple myeloma. (Can-