Abstract:
:Based on rigorous interpretation of current evidence, systemic therapy has two roles in the management of carcinoma of the uterine cervix. In patients with advanced or recurrent disease, single-agent chemotherapy constitutes the treatment of choice. The most extensively studied agents are the platinum compounds. Either cisplatin or carboplatin represents a reasonable choice for first-line treatment. There appears to be no significant influence of either dose or schedule on patient benefit. Other agents with clear-cut activity include ifosfamide, dibromodulcitol, and doxorubicin. At this time, there is no scientific basis for the use of combination chemotherapy in advanced or recurrent carcinoma of the cervix. In patients with locoregionally advanced disease (stages IIIB or IVA), radiation plus either hydroxyurea or a combination of cisplatin plus 5-fluorouracil offers an advantage over radiation alone in terms of progression-free interval and survival. In patients with more limited disease, there is no defined role for systemic therapy at the present time. Three goals constitute the focus for current investigational efforts: (1) continued efforts to identify additional highly active drugs are needed; (2) the development of effective combination chemotherapy depends on the use of logically designed combinations of active drugs in well-designed phase III trials with single-agent therapy as the control; and (3) phase III trials seeking more effective combinations of systemic therapy with surgery and/or radiotherapy should continue for not only locoregionally advanced disease but also for more limited carcinoma of the cervix.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Thigpen T,Vance RB,Khansur Tsubject
Has Abstractpub_date
1994-04-01 00:00:00pages
43-54; quiz 55, 58issue
2 Suppl 2eissn
0093-7754issn
1532-8708journal_volume
21pub_type
杂志文章,评审abstract::The side effects of cisplatin (75 mg/m2) in combination with paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (175 mg/m2 over 3 hours) are expected to be more severe and frequent than those of carboplatin (area under the concentration-time curve of 5) in combination with the same dose of paclitaxel, but...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-10-01 00:00:00
abstract::Malignant biliary obstruction, duodenal, and gastric outlet obstruction, and tumor-related pain are the complications of unresectable pancreatic adenocarcinoma that most frequently require palliative intervention. Surgery involving biliary bypass with or without gastrojejunostomy was once the mainstay of treatment in ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.12.014
更新日期:2015-02-01 00:00:00
abstract::The discovery that etoposide is one of the most active drugs in small-cell lung cancer (SCLC) led to its incorporation into a number of first-line combination chemotherapy regimens. The cyclophosphamide/doxorubicin/etoposide (CAE) regimen was shown to be as active or more active than other standard regimens in nonrand...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-09-01 00:00:00
abstract::Combinations of active antineoplastic agents have been the most effective treatment for metastatic breast cancer. Criteria for an effective combination include use of drugs with different mechanisms of action, nonoverlapping toxic effects, and synergistic, or at least additive, antitumor activity. Paclitaxel (Taxol; B...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract::Bendamustine has clinical potential in the treatment of low-grade non-Hodgkin's lymphoma (NHL). As a single agent, bendamustine has been used in two studies in patients with relapsed or refractory low-grade NHL. When bendamustine 120 mg/m(2) was given on days 1 and 2, the overall response rate was 73% with complete re...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.34877
更新日期:2002-08-01 00:00:00
abstract::Hepatic metastases are a major cause of morbidity and mortality for patients with colorectal cancer (CRC). The rationale for hepatic arterial chemotherapy has both an anatomical and pharmacological basis. Several randomized clinical studies of fluoropyrimidine showed higher response rates in all trials when the drug w...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00
abstract::Experimental and clinical observations of the proliferation of cancer cells and their responses to cytotoxic drugs already have had an impact on the design of anticancer therapies and it is possible that further understanding of the natural history of tumors will enable better treatments to be developed. This review a...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 00:00:00
abstract::The sequencing of targeted therapy is well established in metastatic renal cancer. Switching between different vascular endothelial growth factor (VEGF)-targeted therapies or VEGF-targeted therapies and mammalian target of rapamycin (mTOR) inhibitors are both of proven benefit. The optimal sequence remains unclear. Un...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2013.05.002
更新日期:2013-08-01 00:00:00
abstract::In April 1990, the Argentine Group for Treatment of Acute Leukemia began a multicenter trial for the treatment of previously untreated acute myeloblastic leukemia patients who were under 21 years of age. Initial treatment consisted of an 8-day induction phase with cytarabine together with idarubicin on days 3 to 5 and...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1993-12-01 00:00:00
abstract::There are several treatment options for patients with metastatic colorectal cancer (mCRC), including those with disease that has progressed after treatment with chemotherapy. Bevacizumab-containing regimens show good efficacy in patients with previously treated disease. Compared with infused 5-fluorouracil, leucovorin...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2006.08.003
更新日期:2006-10-01 00:00:00
abstract::The purpose of this pilot study was to determine the safety and feasibility of accelerated fractionation (via concomitant boost) radiotherapy (XRT) with concurrent carboplatin/paclitaxel chemotherapy for locally advanced stage III non-small cell lung carcinoma. Radiotherapy consisted of 3-dimensional conformal techniq...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:10.1053/j.seminoncol.2005.03.004
更新日期:2005-04-01 00:00:00
abstract::Hypercalcemia of malignancy (HCM) is a potentially life-threatening complication of cancer resulting from increased bone resorption by osteoclasts. Clinical management of HCM primarily consists of intravenous rehydration therapy combined with pharmaceutical agents that decrease osteoclast activity. Several generations...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.37417
更新日期:2002-12-01 00:00:00
abstract::Over the last 40 years the National Cancer Institute (NCI) has created a vibrant public-private partnership for the implementation of NCI-sponsored cooperative group (Network) clinical trials throughout the United States and Canada. Over these four decades, the cancer clinical trials process has become more complex mo...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2015.07.011
更新日期:2015-10-01 00:00:00
abstract::Adrenocortical cancer (ACC) is a rare, challenging disease with a broad range of clinical presentations. Often presenting in an advanced stage with a large, locally invasive primary tumor or with Cushing's syndrome, it requires a multidisciplinary approach to treatment. We discuss controversies in the evaluation and m...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2010.10.011
更新日期:2010-12-01 00:00:00
abstract::Although the benefit of adjuvant therapy for pancreas cancer is clear, the most effective therapy remains elusive. In the United States, combination therapy with chemotherapy and radiation remains the standard of care, while in other parts of the world the contribution of radiation is questioned. Clinical trials are r...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2007.05.006
更新日期:2007-08-01 00:00:00
abstract::Interest in retinoids as therapeutic agents has developed as a result of the observations of remission induction with all-trans retinoic acid (tRA) in patients with acute promyelocytic leukemia (APL), and of high objective response rates noted with the combination of cis-retinoic acid (cRA) with interferon-alpha in sq...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::It is a truism that a better understanding of the biology of breast cancer should lead to improvements in diagnosis and therapy. Despite this, our significantly improved grasp of breast cancer biology has had little direct therapeutic impact to date. The technologies used to treat breast cancer (surgery, radiation the...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-02-01 00:00:00
abstract::To evaluate the activity of thalidomide in Waldenstrom's macroglobulinemia (WM), 20 patients were treated on a dose schedule that escalated from 200 mg/d to 600 mg/d. On an intention-to-treat basis, five (25%) patients achieved a partial response, which was noted within 3 months of treatment. Adverse effects were comm...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2003.50079
更新日期:2003-04-01 00:00:00
abstract::Etoposide has proven to be an active agent in the treatment of a variety of neoplasms, particularly germ cell cancers and small cell lung cancer. Yet despite its widespread use, the optimal dose and schedule for etoposide remain unknown. The fact that its efficacy appears to be schedule dependent, along with the recen...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::Docetaxel (Taxotere, Rhône-Poulenc Rorer, Antony, France) is highly effective in the first-line treatment of metastatic breast cancer, achieving an objective response rate of 61% (95% confidence interval, 52% to 69%). This rate of response is seen in patients with poor prognostic factors such as liver metastases and m...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::Advanced-stage mantle cell lymphoma (MCL) is a disease for which no curative treatment strategy exists. Results with standard combination chemotherapy, with or without an anthracycline, are disappointing, and new and better therapies are needed. High-dose therapy and autologous stem-cell transplantation (ASCT) have be...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:2002-02-01 00:00:00
abstract::The potential benefits of docetaxel (Taxotere; Aventis, Antony, France) to patients with previously-treated non-small cell lung cancer have been evaluated in two prospective randomized phase III trials. In one study, patients with stage IIIB/IV non-small cell lung cancer who had failed previous cisplatin-based chemoth...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:2001-02-01 00:00:00
abstract::Over the past 5 years there has been a renewed interest in the use of monoclonal antibodies and immunoconjugates in the treatment of nonhematologic malignancies. This enthusiasm has stemmed from advances in recombinant technology allowing for the production of chimeric and humanized antibodies, from Food and Drug Admi...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Cyclooxygenase-2 (COX-2) is an enzyme involved in prostaglandin production in pathologic states such as inflammatory processes and cancer. The enzyme is often overexpressed in premalignant lesions and various cancers, including cancer of the lung. Inhibition of this enzyme with selective COX-2 inhibitors was found to ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2003.12.014
更新日期:2004-02-01 00:00:00
abstract::The epidemiologic studies relevant to the hypothesis that exposure to tamoxifen is associated with risk of cancer of the endometrium and perhaps other organs are described, summarized, and evaluated. One large body of data comes from the randomized trials of tamoxifen as a therapeutic agent against established breast ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract::Ifosfamide, an oxazaphosphorine analogue, is now commonly used in first-line anthracycline-containing regimens for advanced soft tissue sarcomas, based on its demonstrated single-agent activity in previously treated patients. At the Institut Gustave-Roussy, we performed a phase II study of high-dose ifosfamide without...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::Currently, the primary use of liver transplantation in the setting of malignancy is in patients with hepatocellular carcinoma, with generally accepted criteria for transplantation consisting of the presence of one nodule less than 5 cm or two of three nodules each less than 3 cm in the absence of detectable vascular i...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2005.07.023
更新日期:2005-12-01 00:00:00
abstract::To address the urgent need for novel therapies for multiple myeloma (MM), long-term research efforts have characterized the mechanisms whereby MM cells home to the bone marrow and adhere to bone marrow stromal cells and extracellular matrix proteins. Research also characterizes the functional sequelae of this binding ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.34072
更新日期:2002-12-01 00:00:00
abstract::Kaposi's sarcoma (KS) is the major neoplastic complication of the acquired immune deficiency syndrome (AIDS). Although most patients succumb to infectious complications of AIDS rather than as a direct consequence of the tumor, KS may, in some cases, pursue an aggressive clinical course resulting in considerable morbid...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1987-06-01 00:00:00
abstract::Postmenopausal patients with advanced measurable and/or evaluable breast cancer entered a phase II trial of multiple agent cytotoxic therapy combined with endocrine therapy. Cycles of PNMF (prednimustine, novantrone, methotrexate, and 5-fluorouracil) were repeated every 4 weeks as follows: P, 100 mg/m2 PO on days 1 to...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00