The use of prophylactic anticonvulsants in patients with brain tumours-a systematic review.

Questions: Should patients with newly diagnosed brain tumours receive prophylactic anticonvulsants to reduce seizure risk? What is the best practice for patients with brain tumours who are taking anticonvulsant medications but who have never had a seizure?

Perspectives: Patients with primary or metastatic brain tumours who have never had a seizure still have a 20% risk of experiencing a seizure over the course of their disease. Because considerable practice variation exists in regard to the management of patients with brain tumours who have never had a seizure, and because conflicting evidence has been reported, the Neuro-oncology Disease Site Group (dsg) of Cancer Care Ontario's Program in Evidence-based Care felt that a systematic review of the evidence was warranted.

Outcomes: Outcomes of interest were incidence of seizures and adverse effects of prophylactic anticonvulsant therapy.

Comparative study of dosimetry between high-dose-rate and permanent prostate implant brachytherapies in patients with prostate adenocarcinoma.

Purpose: To compare the dose coverage, conformity, and homogeneity between high-dose-rate (HDR) brachytherapy and permanent prostate implant (PPI) in the treatment of prostate adenocarcinoma.

Methods And Materials: From January 2003 to August 2004, 54 patients (108 implants) underwent HDR brachytherapy of prostate cancer with iridium-192 stepping source. Of patients who underwent PPI brachytherapy with iodine-125, 72 patients were randomly selected for the purpose of dosimetric comparison.

Caring for the caregivers: Innovative program for oncology nurses.

An innovative program, Care for the Professional Caregiver, was designed to provide staff nurses in a cancer program with the opportunity to learn about coping with stress in their practice. The program was evaluated using quantitative and qualitative methods. The findings clearly describe the benefits of the program on both a short- and long-term basis.

Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer.

Background: Lymph node (LN) status is a major determinant of prognosis and treatment of gastric adenocarcinoma. The 1997 American Joint Commission on Cancer/Union Internationale Contre le Cancer guidelines were revised, requiring examination of > or =15 LN for staging.

Methods: We investigated compliance with these guidelines and the correlation with overall survival (OS) by analyzing 10,807 resected gastric cancers in the Surveillance, Epidemiology and End Results (SEER) database, 1988-2002.

Cardiovascular health and aromatase inhibitors.

Cardiovascular disease is the most frequent cause of death in North American women, and so death resulting from cardiovascular disease, rather than from malignancy, is not uncommon in breast cancer patients. This may be a consequence of the shared risk factors for developing breast cancer and cardiovascular disease, as well as the difficulty of managing cancer patients at higher risk for developing cardiovascular disease. Recently, much attention has focused on understanding the cardiovascular risk factors associated with breast cancer therapies.

The use of bisphosphonates in men with hormone-refractory prostate cancer: a systematic review of randomized trials.

Purpose: A systematic review of randomized controlled trials (RCTs) was performed to assess the benefits of bisphosphonate therapy in men with hormone-refractory prostate cancer (HRPC).

Methods: The literature was searched to identify RCTs or meta-analyses comparing treatment with bisphosphonates to placebo or no treatment.

Results: Ten trials that studied clodronate (five trials, 404 patients), pamidronate (two trials, 350 patients), alendronate (one trial, 49 patients), etidronate (one trial, 51 patients), and zoledronic acid (one trial, 643 patients) in men with HRPC and bone metastases met the eligibility criteria.

High-Dose celecoxib and metronomic "low-dose" cyclophosphamide is an effective and safe therapy in patients with relapsed and refractory aggressive histology non-Hodgkin's lymphoma.

Purpose: Angiogenesis is increased in aggressive histology non-Hodgkin's lymphoma and may be a target with selective cyclooxygenase-2 inhibition and metronomic chemotherapy.

Experimental Design: We assessed response, toxicity, and biomarkers of angiogenesis to low-dose cyclophosphamide (50 mg p.o.

Mild, moderate, or severe pain categorized by patients with cancer with bone metastases.

Purpose: To examine how patients categorize their pain with the two commonly employed scales.

Methods And Materials: Patients with bone metastases referred to an outpatient palliative radiotherapy clinic were asked to rate their current pain on a numerical scale of 0-10 (0 = no pain, 10 = worst pain possible) and a categorized scale: none, mild, moderate and severe.

Results: Two hundred and seventeen patients were enrolled in the study.

The role of high-dose-rate brachytherapy in the palliation of symptoms in patients with non-small-cell lung cancer: a systematic review.

Purpose: This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non-small-cell lung cancer.

Methods And Materials: Relevant trials were identified through a systematic search of the literature.

Results: Twenty-nine trials were eligible.

Whole brain radiotherapy for the treatment of multiple brain metastases.

Background: Brain radiotherapy is used to treat cancer patients who have brain metastases resulting from various primary malignancies.

Objectives: To assess the effectiveness and adverse effects of whole brain radiotherapy (WBRT) in adult patients with multiple metastases to the brain.

Search Strategy: CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CANCERLIT, and CINAHL were searched.

The role of radiation therapy in malignant pleural mesothelioma: a systematic review.

Introduction: Radiation therapy may offer patients presenting with malignant pleural mesothelioma (MPM) symptom palliation and improvements in quality of life. This systematic review will address the role of radiation therapy in the management of MPM.

Methods: A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts.

Cyclooxygenase-2 (COX-2) immunostaining does not correlate with the degree of vulvar neoplasia.

Objective: The cyclooxygenase-2 (COX-2) enzyme is up-regulated in inflammatory and neoplastic conditions. In the last decade, its biological role has been investigated in various pre-invasive and invasive cancers with the hope that it can serve as a target for cancer prevention and treatment.

Methods: We evaluated the expression of COX-2 in vulvar biopsies to determine its relationship to the degree of dysplasia.

Pre-menopausal breast cancer and aromatase inhibitors: Treating a new generation of women.

Aromatase inhibitors have revolutionized the treatment of post-menopausal women with hormone receptor positive breast cancer. However, approximately 22% of all cases of breast cancer in North America are diagnosed in women below the age of 50 and a substantial proportion of these women are pre-menopausal. In the pre-menopausal population with hormone receptor positive disease, research on the use of aromatase inhibitors is only beginning to emerge.

Principles of maintenance therapy.

Although follicular non-Hodgkin's lymphoma may respond well to induction therapy, almost all patients will eventually relapse. To reduce the frequency of relapses and prolong disease-free intervals, maintenance treatment may be given to patients who respond or have stable disease after induction therapy. Maintenance treatment is given at regular intervals over prolonged periods in patients who may be asymptomatic, and so it is important that administration is simple, toxicity is minimal and that there is clear evidence of efficacy.

Successful validation of a survival prediction model in patients with metastases in the spinal column.

Purpose: The Dutch Bone Metastases Study Group developed a survival prediction model in patients with symptomatic spinal bone metastases to guide the treating physician. The objective of this study was to validate the Dutch model and compare with our previously developed survival model at the Rapid Response Radiotherapy Program (RRRP model).

Methods And Materials: The following prognostic factors were extracted from a prospective database in an outpatient palliative radiotherapy clinic: Karnofsky Performance Scores (KPS), primary cancer site, and visceral involvement for the Dutch model; primary cancer site, site of metastases, KPS, fatigue, appetite, and shortness of breath scores in the Edmonton Symptom Assessment Scale for the RRRP model.

Radiosurgical retreatment for brain arteriovenous malformation.

Objective: To analyze our experience with a second radiosurgical treatment for brain arteriovenous malformations (BAVMs) after an unsuccessful first radiosurgical treatment.

Methods: Between 1993 and 2000, 242 patients were treated by the Toronto Sunnybrook Regional Cancer Center using a LINAC system. Fifteen of these patients required a second radiosurgical intervention due to the failure of the first procedure.

Percutaneous vertebroplasty in patients with intractable pain from osteoporotic or metastatic fractures: A prospective study using quality-of-life assessment.

Purpose: Percutaneous vertebroplasty (PVP) is a minimally invasive outpatient procedure whereby vertebral compression fractures are stabilized by the injection of bone cement, or polymethyl methacrylate (PMMA). Rapid partial or complete pain relief can usually be achieved through this procedure. We prospectively evaluate the efficacy of PVP in the relief of pain and improvement in quality of life of patients with intractable pain from osteoporotic and metastatic fractures.

HER2 and responsiveness of breast cancer to adjuvant chemotherapy.

Background: Amplification of the human epidermal growth factor receptor type 2 (HER2, also called HER2/neu) gene and overexpression of its product in breast-cancer cells may be associated with responsiveness to anthracycline-containing chemotherapy regimens.

Methods: In the randomized, controlled Mammary.5 trial, we studied 639 formalin-fixed paraffin-embedded specimens obtained from 710 premenopausal women with node-positive breast cancer who had received either cyclophosphamide, epirubicin, and fluorouracil (CEF) or cyclophosphamide, methotrexate, and fluorouracil (CMF) as adjuvant chemotherapy.

Differential lineage-specific regulation of murine CD45 transcription by Oct-1 and PU.1.

Although it has been established that CD45 expression is regulated at the transcriptional level, neither the regulatory elements that are responsible for its unique expression pattern nor the relevance of its three distinct transcriptional start sites (P1a, P1b, and P2) has been fully characterized. We studied the contribution of the three start sites to CD45 mRNA production in haematopoietic cell lines and primary haematopoietic cells. In myeloid and lymphoid cells and cell lines most CD45 transcripts originate from P1b with the exception of the thymoma-derived T cell line EL4, in which approximately 90% of CD45 transcripts originate from P1a.

Temozolomide in metastatic breast cancer (MBC): a phase II trial of the National Cancer Institute of Canada - Clinical Trials Group (NCIC-CTG).

Background: Temozolomide is an oral alkylating agent that crosses the blood-brain barrier, and has preclinical activity in breast cancer. This phase II trial sought to determine the activity and toxicity of temozolomide in metastatic breast cancer (MBC). Temozolomide was administered in a dose dense schedule of 150 mg/m(2) on days 1-7 and 15-21 in a 28-day cycle.

The use of complementary and alternative medicines among patients with locally advanced breast cancer--a descriptive study.

Background: Complementary and alternative medicine (CAM) use is common among cancer patients. This paper reviews the use of CAM in a series of patients with locally advanced breast cancer (LABC).

Methods: Women with LABC attending a specialist clinic at a single Canadian cancer centre were identified and approached.

Ovarian cancer.

Ovarian cancer is the leading cause of death from gynecologic cancers. Although approximately 2,400 women are diagnosed each year in Canada, most women know little about the disease. While it is not common, ovarian cancer is a devastating diagnosis.

Low-dose metronomic daily cyclophosphamide and weekly tirapazamine: a well-tolerated combination regimen with enhanced efficacy that exploits tumor hypoxia.

The recent clinical successes of antiangiogenic drug-based therapies have also served to highlight the problem of acquired resistance because, similar to other types of cancer therapy, tumors that initially respond eventually stop doing so. Consequently, strategies designed to delay resistance or treat resistant subpopulations when they arise have assumed considerable importance. This requires a better understanding of the various possible mechanisms for resistance.

Association of clinical status of follicular lymphoma patients after autologous stem cell transplant and quantitative assessment of lymphoma in blood and bone marrow as measured by SYBR Green I polymerase chain reaction.

Molecular remission in the autograft and bone marrow after transplant are predictive of durable clinical remission in relapsed follicular lymphoma. Thus, a simple reliable method to quantify minimal residual disease (MRD) would improve prognostication in these patients. Fluorescent hybridization probes have been used in real-time quantitative polymerase chain reaction (RQ-PCR) to monitor MRD with a reproducible sensitivity of 0.