Current oncology reports
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Current oncology reports · Apr 2013
ReviewTransoral microsurgery for treatment of laryngeal and pharyngeal cancers.
Minimally invasive surgery has evolved over the last two decades to encompass all fields of surgery, including curative intent cancer surgery of the head and neck. Much evidence is in favor of routine use of transoral laser resection, which can be considered the method of choice for treatment of early laryngeal carcinomas (T1-T2) of the glottis and the supraglottis on the basis of oncologic, functional, and cost considerations. The results of transoral laser microsurgery in patients with moderately advanced (T3) supraglottic cancer are comparable to those of open supraglottic laryngectomy with regard to local control and survival rates, and they are superior to those of primary radiotherapy with respect to organ preservation. Transoral laser microsurgery as a unique treatment should also be considered as an alternative to other organ preservation protocols in the early stages (I-II) of hypopharyngeal and oropharyngeal carcinomas.
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Current oncology reports · Jun 2012
ReviewPancreatic neuroendocrine and carcinoid tumors: what's new, what's old, and what's different?
Well-differentiated neuroendocrine tumors (NETs) can be subdivided into carcinoid and pancreatic NETs (panNETs). Recently, two therapies have been FDA approved for progressive well-differentiated pancreatic NETs but have not been submitted for use in carcinoid tumors (Yao, Shah, Ito, et al. N Engl J Med 364:514-23, 2011••; Raymond, Dahan, Raoul, et al. ⋯ This review will discuss "new" NET therapies and provides an overview of liver directed and "older" cytotoxic treatment options. We also briefly outline "what's different" by describing a recent genetics report identifying genetic mutations in panNETs. Such a discovery could potentially be used to stratify treatment and such studies are currently being investigated.
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Current oncology reports · Aug 2011
ReviewThe value of data collection within a palliative care program.
Collecting reliable and valid data is an increasing expectation within palliative care. Data remain the crux for demonstrating value and quality of care, which are the critical steps to program sustainability. Parallel goals of conducting research and performing quality assessment and improvement can also ensure program growth, financial health, and viability in an increasingly competitive environment. ⋯ We present types of data to collect, published guides for data collection, and how data can inform quality, value, and research within a palliative care organization. Our experiences with the Quality Data Collection Tool (QDACT) in the Carolinas Palliative Care Consortium to collect data on quality have led to valuable lessons learned in creating a data collection system. Suggested steps in forming data-sharing collaborations and building data collection procedures are shared.
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Current oncology reports · Aug 2011
ReviewThe challenges of providing palliative care for older people with dementia.
Palliative care seems the right approach to dementia, except that it suggests a dichotomy between cure and care. As in cancer care, supportive care provides a broader framework, viewing dementia from the time of diagnosis until death and bereavement. The challenge is to find the right approach to the individual. ⋯ The challenging features of palliative care for older people with dementia are found in connection with the use of antibiotics, antipsychotics, and other medications, as well as in decisions about whether the person is in pain or in distress, or whether artificial feeding should be contemplated or not, as well as about the use of advance care plans. In short, the challenges are essentially ethical as well as clinical. The right approach will be the one that recognizes this facet of clinical care.
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Current oncology reports · Apr 2011
ReviewAbiraterone acetate, a novel adrenal inhibitor in metastatic castration-resistant prostate cancer.
The androgen receptor remains the key player in patients with castration-resistant prostate cancer (CRPC). Available agents capable of blocking early adrenal androgen production have limited activity and can lead to significant toxicities. Abiraterone acetate, a pregnenolone analog, is a small molecule that irreversibly inhibits CYP17, a rate-limiting enzyme in androgen biosynthesis. ⋯ Recently, a randomized phase 3 trial evaluating abiraterone acetate in docetaxel-refractory CRPC patients demonstrated a survival improvement over placebo-treated patients (14.8 vs 10.9 months; HR 0.646; P < 0.0001). A similar trial in the pre-chemotherapy setting has completed accrual and is undergoing analysis. Here we review the rationale and clinical development of abiraterone acetate in men with CRPC.