Critical reviews in oncology/hematology
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Crit. Rev. Oncol. Hematol. · Jun 2008
ReviewPeripheral nerve damage associated with administration of taxanes in patients with cancer.
Peripheral neuropathy is a well recognized toxicity of taxanes, usually resulting to dose modification and changes in the treatment plan. Taxanes produce a symmetric, axonal predominantly sensory distal neuropathy with less prominent motor involvement. A "dying back" process starting from distal nerve endings followed by effects on Schwann cells, neuronal body or axonal transport changes and a disturbed cytoplasmatic flow in the affected neurons is the most widely accepted mechanism of taxanes neurotoxicity. ⋯ However, further confirmatory trials are warranted on this important clinical topic. This review critically looks at the pathogenesis, incidence, risk factors, diagnosis, characteristics and management of taxanes-induced peripheral neuropathy. We also highlight areas of future research.
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Crit. Rev. Oncol. Hematol. · Feb 2008
ReviewDepression and cancer: an unexplored and unresolved emergent issue in elderly patients.
Despite the high prevalence of depressive disorders in cancer patients and elderly people, the topic of depression in elderly cancer patients still remains unexplored. This emerges from a systematic review of the literature conducted to investigate issues of depression, diagnosis, pathogenesis, treatment and their complex neuroimmunobiological interactions. Indeed, it becomes apparent that depression in elderly patients with cancer may have a peculiar phenomenology. ⋯ Immune dysfunction may represent a common pathogenic ground of depression, cancer and aging. This may have important implications for treatment. In the near future, we need to develop validated mood disorder diagnoses and verify antidepressant treatment efficacy for elderly cancer patients with depression in order to improve their clinical outcome and quality of life.
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The incidence of most types of cancers is age-dependent and progressive ageing is rapidly increasing the number of elderly people who need treatment for cancer. It is an ethical dilemma how aggressive one should be when it comes to treating cancer in the older population. Presumed fear of increased postoperative morbidity and mortality often results in delivery of sub-optimal cancer surgery. ⋯ In this review article we take into consideration physiology of the aged and tools available to assess surgical risks in elderly patients, in the aim of increasing awareness on optimising surgical management of elderly patients with cancer. MEDLINE and EMBASE.com (search terms: "elderly", "preoperative", "surgery"), bibliographies of articles retrieved and the authors' reference files have been used as data sources. Independent extraction has been performed by the authors using predefined criteria, including study quality indicators.
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Crit. Rev. Oncol. Hematol. · Jun 2007
ReviewQuality of life research in head and neck cancer: a review of the current state of the science.
Quality of life (QOL) has become an increasingly important outcome measure for patient's undergoing treatment for a wide array of illnesses. QOL is a global construct that reflects a patient's general sense of well being. It is by definition multi-dimensional and reflective of the patient's point of view. ⋯ This may be attributed to methodological issues in study design or the patient's ability to adapt to functional and symptom control problems. Whether routine use of QOL measures in the clinical setting is beneficial to patients has yet to be determined. Further studies are warranted as currently available instruments may not be valid for repeated clinical use.
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Crit. Rev. Oncol. Hematol. · Apr 2007
ReviewEGFR targeting therapies: monoclonal antibodies versus tyrosine kinase inhibitors. Similarities and differences.
Current development of targeted therapy in oncology is particularly active and concerns principally two types of agents which are monoclonal antibodies (Mabs) and tyrosine kinase inhibitors (TKIs). Epidermal growth factor receptor (EGFR) signaling pathways play a key role in the regulation of cell proliferation, survival and differentiation. ⋯ Cetuximab (Erbitux), belonging to the Mabs family, gefitinib (Iressa) and erlotinib (Tarceva), belonging to the TKIs family, are among the most advanced anti-EGFR drugs at the clinical level. The aim of this review article is to compare at both experimental and clinical levels the key points which govern the activity of these two types of targeting agents.