Locally Advanced Non Small Cell Lung Cancer: The Case for Radiation Dose De-escalation in the Management of the Mediastinum
Locally Advanced Non Small Cell Lung Cancer: The Case for Radiation Dose De-escalation in the Management of the Mediastinum Viacheslav Soyfer1* and Benjamin W. Corn2 1Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel 2Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel Outcomes for patients with locally-advanced Non Small Cell Lung Cancer (NSCLC) remain poor. In the context of definitive (as opposed to neoadjuvant) treatment, radiation oncologists have traditionally embraced dose escalation as a means to improve control of the primary tumor as well as draining nodal regions for this clinical problem. Yet we wonder: is it optimal—or even rational—to treat the primary and the mediastinal nodes to the same dose in these patients? Enthusiasm for dose escalation was fueled by RTOG 73-01, a randomized trial that systematically explored incremental increases of dose which were correlated with improved intra-thoracic disease control in nearly linear fashion (1). Although the trial has acquired landmark status, it may not be germane for today's patients since radiation alone was used. It is conceivable that in the absence of chemotherapy, higher doses of radiation were needed. However, even when 60 Gy was delivered, a survival advantage did not emerge. At this juncture, standard management is predicated on a multi-modality approach. The same cooperative group endeavored to push the dose envelope even further w...
ConclusionsMore than half (51%) of women who underwent genetic counseling and received an uninformative negative genetic test result had a significantly elevated risk for the development of breast cancer. It is, therefore, imperative that women do not conclude that a negative genetic test result represents a lack of risk.
Publication date: Available online 11 October 2019Source: The American Journal of SurgeryAuthor(s): Dhruv J. Patel, Waseem Lutfi, Patrick Sweigert, Emanuel Eguia, Gerard Abood, Lawrence Knab, Paul C. Kuo, Marshall S. BakerAbstractBackgroundPrior studies of adjuvant systemic therapy in pancreatic acinar cell carcinoma have been underpowered.MethodsWe queried the National Cancer Data Base to identify patients presenting with resectable (clinical stage I and II) acinar cell carcinoma between 2004 and 2015. Multivariable Cox Regression was used to evaluate the association between overall survival and systemic therapy.Results29...
ConclusionsAdjuvant therapy is associated with improved OS for patients with gastric GISTs>10cm but provides no benefit in OS for those with GISTs 2-10cm.
Publication date: Available online 12 October 2019Source: Journal of Visceral SurgeryAuthor(s): M. Pocard
ConclusionCutaneous metastases secondary to urothelial bladder carcinoma are exceptional especially in its inflammatory presentation. Diagnosis is based on immunohistochemical study. Treatment is based on chemotherapy and the prognosis is poor.
https://marginalrevolution.com/marginalrevolution/2019/05/physician-and-nurse-incomes-have-increased-tremendously.html New Findings Confirm Predictions on Physician Shortage The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply, according to new www.aamc.org The Demand for Physicians is Increasing and That’s Not All G...
ConclusionsMen with BRCA-related cancer risks lack understanding about their risks and how to manage them. Increased attention should be paid to the development of interventions tailored specifically to men. Further, interventions focusing on strategically developing proactive family communication behaviors would also be beneficial to men and their families.
ConclusionLaparoscopic approach to isolated relapse of ovarian cancer is feasible and safe, with fast recovery
ConclusionsRobotic resection of the tumor nodule off the external iliac vessels was successfully performed with adequate range of motion provided by the arms and without any complications.Trocar placement should be tailored to the site of surgical interest. Robotic-assisted laparoscopy should be considered as a valid alternative to the traditional open approach, when managing solitary masses in recurrent ovarian cancer patients.
Publication date: Available online 11 October 2019Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Ding Feng, Baoping Ma, Ali Nazary-Vannani, Hamed Kord-Varkaneh, Somaye Fatahi, Maria Papageorgiou, Jamal Rahmani, Faezeh Poursoleiman, Israel Júnior Borges do Nascimento, Hui Li, Dongyang Ham, Dongmei WangAbstractBackground and aimThis systematic review and meta-analysis aimed to assess the effects of green coffee bean extract (GCBE) supplementation on lipid profile in adults.Methods and resultsThe PubMed/Medline, Scopus, Web of sciences, and Google Scholar were systematically searched for randomized...
More News: Academia | Breast Cancer | Breast Carcinoma | Cancer | Cancer & Oncology | Carcinoma | Cardiology | Chemotherapy | Clinical Trials | Colon Cancer | Colorectal Cancer | Denmark Health | Erbitux | Esophagus Cancer | Head and Neck Cancer | Heart | Heart Failure | Hodgkin's Disease | Hospitals | Immunotherapy | Intensity-Modulated Radiation Therapy | Israel Health | Learning | Lung Cancer | Lymphoma | Middle East Health | Molecular Biology | Neoadjuvant Chemotherapy Therapy | Neoadjuvant Radiation Therapy | Neoadjuvant Therapy | Non-Small Cell Lung Cancer | Oropharyngeal Cancer | Pediatrics | Portugal Health | Radiation Therapy | Reproduction Medicine | Smokers | Study | Toxicology | Universities & Medical Training | USA Health | Women