Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: "High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina...
Some people believe that if cancer has spread
to other parts of the body (called metastatic
cancer), it is the same as advanced cancer. This
is not necessarily true. You can have widespread
cancer, but it can still be treatable and sometimes
curable. Examples of this are testicular cancer and
certain types of leukemia and lymphoma.
Head and Neck Cancer: Treatment Patients with head and neck cancer can be categorized into three clinical groups: those with localized disease, those with locally or regionally advanced disease, and those with recurrent and/or metastatic disease. Comorbidities associated with tobacco and alcohol abuse can affect treatment outcome and define long-term risks for patients who are cured of their disease.
Nearly one-third of patients have localized disease; that is, T1 or T2 (stage I or stage II) lesions without detectable lymph node involvement or distant metastases.
Squamous Cell Carcinoma
The natural history of SCC depends on both tumor and host characteristics. Tumors arising on actinically damaged skin have a lower metastatic potential than those on protected surfaces. The metastatic frequency of cutaneous SCC, reported at 0.3–5.2%, occurs most frequently in regional draining lymph nodes. Tumors occurring on the lower lip and ear have metastatic potentials approaching 13 and 11%, respectively. The metastatic potential of SCC arising in scars, chronic ulcerations, and genital or mucosal surfaces is higher.
Estrogen receptors (ERs) and androgen receptors, members of the steroid hormone family of nuclear receptors, are targets of inhibition by drugs used to treat breast and prostate cancers, respectively. Tamoxifen, a partial agonist and antagonist of ER function, can mediate tumor regression in metastatic breast cancer and can prevent disease recurrence in the adjuvant setting, saving thousands of lives each year. Tamoxifen binds to the ER and modulates its transcriptional activity, inhibiting activity in the breast but promoting activity in bone and uterine epithelium.
Palliation Surgery is employed in a number of ways for supportive care: insertion of central venous catheters, control of pleural and pericardial effusions and ascites, caval interruption for recurrent pulmonary emboli, stabilization of cancerweakened weight-bearing bones, and control of hemorrhage, among others. Surgical bypass of gastrointestinal, urinary tract, or biliary tree obstruction can alleviate symptoms and prolong survival. Surgical procedures may provide relief of otherwise intractable pain or reverse neurologic dysfunction (cord decompression).
Breast Cancer: Treatment
Primary Breast Cancer
Breast-conserving treatments, consisting of the removal of the primary tumor by some form of lumpectomy with or without irradiating the breast, result in a survival that is as good as (or slightly superior to) that after extensive surgical procedures, such as mastectomy or modified radical mastectomy, with or without further irradiation. Postlumpectomy breast irradiation greatly reduces the risk of recurrence in the breast.
Most recurrences after a surgical resection of a large-bowel cancer occur within the first 4 years, making 5-year survival a fairly reliable indicator of cure. The likelihood for 5-year survival in patients with colorectal cancer is stagerelated (Fig. 87-3). That likelihood has improved during the past several decades when similar surgical stages have been compared. The most plausible explanation for this improvement is more thorough intraoperative and pathologic staging.
Radiation therapy to the pelvis is recommended for patients with rectal cancer because it reduces the 20–25% probability of regional recurrences following complete surgical resection of stage II or III tumors, especially if they have penetrated through the serosa.
Stages I and II Seminoma Inguinal orchiectomy followed by retroperitoneal radiation therapy cures ~98% of patients with stage I seminoma. The dose of radiation therapy (2500– 3000 cGy) is low and well tolerated, and the in-field recurrence rate is negligible. About 2% of patients relapse with supradiaphragmatic or systemic disease. Surveillance has been proposed as an option, and studies have shown that about 15% of patients relapse. The median time to relapse is 12–15 months, and late relapses (5 years) may be more frequent than with nonseminoma.
Follow-Up of Breast Cancer Patients Despite the availability of sophisticated and expensive imaging techniques and a wide range of serum tumor marker tests, survival is not influenced by early diagnosis of relapse. Surveillance guidelines are given in Table 86-5.
The second requirement is a clear and well defined starting point. For popu-
lation-based cancer registries, the starting date (from which the survival is
calculated) is the incidence date (see Section 17.3.1).
The third requirement is a clear and well defined outcome. Death is gener-
ally the outcome of interest, but some registries collect enough data to allow
them to conduct analyses using recurrence of tumour, or first recurrence of
a particular complication, as the outcome of interest.
Johnson (1982), randomized 52 patients with newly diagnosed or recurrent cancer to
either a psycho-educational group intervention “I Can Cope” or a control group. The
intervention group demonstrated decreased anxiety and increased perceived purpose and
meaning in life compared to the control group.
Berglund et al. (1994) performed a prospective randomized study with 98 cancer
patients who participated in a rehabilitation program focused on “starting again,” and
101 patients who served as controls.
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Combination therapy with docetaxel and S-1 as a first-line treatment in patients with advanced or recurrent gastric cancer: a retrospective analysis
Neither randomized clinical trials nor meta-
analysis are available and evidence is based on a number of retrospective studies with
multivariate for mortality risk factors or data from national cancer registries (Gilliland et al.,
1997; Hundahl et al., 1998). Unfortunately, very remarkable differences in patient’s selection,
staging systems, and clinical management affect the available studies. In particular,
radioiodine treatment is not routinely carried out in a standard manner and outcome results
of different studies are thus not comparable (Sciuto et al., 2009).
While there has been an increase in development assistance for health in
general, this aid is volatile — often driven by proﬁts and politics. Donor
governments are susceptible to the political agendas of their parliaments, plac-
ing a focus on short term results. Sustained health development does not ﬁt
Part of the solution lies in the harmonization or pooling of funds, focused
around a single country plan, that is ﬂexible and includes funding for both
recurrent and capital expenditures.
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: The effect of external beam radiotherapy volume on locoregional control in patients with locoregionally advanced or recurrent nonanaplastic thyroid cancer...
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Renal cancer associated with recurrent spontaneous pneumothorax in Birt-Hogg-Dubé syndrome: a case report and review of the literature