Current opinion in oncology
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To present recent developments in the treatment of breakthrough pain (BTP) in cancer, we reviewed the literature with a special focus on last publications using Medline. ⋯ Data from epidemiological and clinical studies show that breakthrough pain remains a challenge especially among cancer patients. An accurate diagnosis followed by a specific treatment is the key for an effective pain relief.
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Brain metastases are frequent in lung cancer. They are responsible for life-threatening symptoms and serious impairment in patients' quality of life, resulting in a shortened survival. Prophylactic cranial irradiation (PCI) has been proposed in both small-cell lung cancers (SCLCs) and non-SCLCs to reduce the incidence of brain metastases and increase survival. ⋯ In limited disease SCLCs, PCI should be administered at the dose of 25 Gy in 10 fractions to first-line treatment responders. In extensive disease SCLC, PCI is recommended in patients who respond to first-line chemotherapy. Clinical trials are ongoing to investigate the role of PCI in non-SCLC patients.
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This article reviews the recent developments in neck ultrasound for thyroid cancer published in the last 18 months, with emphasis on the emerging role of surgeon-performed ultrasound in clinical endocrine practice. ⋯ Ultrasound is an essential modality in the evaluation of thyroid malignancy. Surgeon-performed ultrasound has proved invaluable in the preoperative, intraoperative and postoperative setting. Future developments in ultrasound may lead to further improvement in the diagnostic accuracy of this modality.
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In the 1990s, cancer patients were described as poor candidates for ICU admission on the basis of high mortality rates and management costs. Over the last decade, however, advances in the management of malignancies and organ failures have led to substantial increases in survival. This review discusses current outcomes of critically ill cancer patients and recent insights into prognostic factors. Persistent areas of uncertainty are emphasized. ⋯ ICU admission of selected cancer patients leads to meaningful survival. The optimal time of ICU admission needs to be determined, and patient selection criteria by both hemato-oncologists and intensivists should be improved. Long-term studies of overall survival, disease-free survival, and quality of life are needed.
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Editorial Review
Should the indications for the use of myeloid growth factors for the prevention of febrile neutropenia in cancer patients be extended?
Prevention of infectious complications of chemotherapy-induced granulocytopenia is a major issue in preventive medicine, as febrile neutropenia is still associated with an overall 10% mortality and extensive morbidity and cost. ⋯ It is likely that the consideration of these newly recognized risk factors and the availability of more affordable granulocyte colony-stimulating factors will lead, in the near future, to an extension of the presently recognized indications for the prescription of granulocyte colony-stimulating factors.