Managing hematologic toxicities.

This overview of the hematologic toxicities of cancer chemotherapy addresses the frequency and clinical significance of neutropenia, anemia, and thrombocytopenia and attempts to provide evidence-based guidelines, based on clinical trials, for the use of cytokine growth factors and transfusion support. The current emphasis on high-dose and dose-dense chemotherapy increases the need for close attention to the amelioration ofhematologic toxicities. The latter is highly dependent upon the appropriate and judicious use of cytokine support.

Clinical overview: adjuvant therapy of gastrointestinal cancer.

Adjuvant therapy has been tested widely in the treatment of cancers of the stomach, pancreas, and large bowel. In the USA, the use of postoperative chemoradiation in stomach cancer is considered a standard of care after the publication of the Intergroup Study 0116 in September 2001. This study demonstrated significant benefit in overall and disease-free survival for patients receiving postoperative treatment with fluorouracil (5-FU)/leucovorin chemotherapy and radiation after gastric resection.

Acute toxicity of high-dose-rate intracavitary brachytherapy with the MammoSite applicator in patients with early-stage breast cancer.

Background: Intracavitary brachytherapy with the MammoSite applicator as the sole radiation treatment in breast-conserving therapy is an option for women with early-stage breast cancer; we evaluated the acute toxicities associated with this treatment method.

Methods: Thirty-one patients with 32 stage I or II breast carcinomas underwent breast-conserving therapy, which included lumpectomy with negative margins, sentinel node biopsy, or axillary dissection, followed by brachytherapy with the MammoSite applicator. Acute radiation skin complications were graded on the day of radiotherapy completion and at weeks 2, 4, 6, and 12 after radiation treatment.

Adjuvant therapy for gastric cancer.

The curative management of gastric adenocarcinoma depends on complete resection of the primary tumor. In patients with lymph node metastases in the resected specimen, the relapse and death rates from recurrent cancer are 70% to 80%. There is continued debate over whether more extensive lymph node dissection (D2) improves survival when compared with less extensive operations.

Palladium-103 plaque radiotherapy for choroidal melanoma: an 11-year study.

Purpose: To describe 11 years of experience with 103Pd ophthalmic plaque brachytherapy for intraocular melanoma.

Methods And Materials: Since 1990, 152 patients have been diagnosed with uveal melanoma, found to be negative for metastatic disease, and treated with 103Pd radioactive plaque radiotherapy. This study presents the first 100 patients treated with 103Pd and followed for > or = 2 years.

Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction.

Background: Surgical resection of adenocarcinoma of the stomach is curative in less than 40 percent of cases. We investigated the effect of surgery plus postoperative (adjuvant) chemoradiotherapy on the survival of patients with resectable adenocarcinoma of the stomach or gastroesophageal junction.

Methods: A total of 556 patients with resected adenocarcinoma of the stomach or gastroesophageal junction were randomly assigned to surgery plus postoperative chemoradiotherapy or surgery alone.