The lancet oncology
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The lancet oncology · Mar 2007
Meta Analysis Comparative StudySurvival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis.
Resectable oesophageal cancer is often treated with surgery alone or with preoperative (neoadjuvant) chemoradiotherapy or chemotherapy. We aimed to clarify the benefits of neoadjuvant chemoradiotherapy or chemotherapy versus surgery alone by a meta-analysis of randomised trial data. ⋯ A significant survival benefit was evident for preoperative chemoradiotherapy and, to a lesser extent, for chemotherapy in patients with adenocarcinoma of the oesophagus. The findings provide an evidence-based framework for the use of neoadjuvant treatment in management decisions.
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The lancet oncology · Mar 2007
Biography Historical ArticleWilliam Stewart Halsted: his life and contributions to surgery.
William Stewart Halsted was a pioneer of surgery in the USA and made many wide-ranging contributions, including the surgical treatment of breast cancer. He changed the training of surgeons from a disorganised apprenticeship to the residency training programmes used today. ⋯ Over a 40-year career, beginning in New York and continuing at Johns Hopkins University Hospital in Baltimore, he endured a terrible struggle resulting from an accidental addiction, acquired in the course of his research. Despite this, his legacy to medicine and human health is one of the greatest left by any individual surgeon in history and remains an inspiration today.
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The lancet oncology · Mar 2007
Randomized Controlled Trial Multicenter Study Comparative StudyGemcitabine plus vinorelbine versus vinorelbine monotherapy in patients with metastatic breast cancer previously treated with anthracyclines and taxanes: final results of the phase III Spanish Breast Cancer Research Group (GEICAM) trial.
We aimed to compare the additional benefit of gemcitabine when combined with vinorelbine above that of standard vinorelbine treatment in patients with metastatic breast cancer. ⋯ Patients with metastatic breast cancer assigned gemcitabine and vinorelbine had better progression-free survival compared with those assigned vinorelbine alone. However, this finding did not translate into a difference in overall survival. Although toxicity was manageable, patients in the combined group had more haematological toxic effects. These factors should be taken into account when deciding which chemotherapy patients should receive.
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The lancet oncology · Feb 2007
Randomized Controlled Trial Multicenter StudySkeletal effects of exemestane on bone-mineral density, bone biomarkers, and fracture incidence in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES): a randomised controlled study.
Tamoxifen preserves bone in postmenopausal women, but non-steroidal aromatase inhibitors accelerate bone loss and increase fracture risk. We aimed to study the effect on bone health in a subgroup of women included in the Intergroup Exemestane Study (IES), a large randomised trial that compared the switch to the steroidal aromatase inhibitor exemestane with continuation of tamoxifen in the adjuvant treatment of postmenopausal breast cancer. ⋯ These results indicate that the increase in survival shown previously with the IES switch strategy is achieved at the expense of some detriment to skeletal health, so the risk-benefit ratio to women needs to be individually assessed.