Abstract:
:From February 1985 to June 1993, 173 consecutive, previously untreated patients with small cell lung cancer received individualized treatment tailored to disease extent. Almost all patients (14 of 16) with stage I and II disease and 30 patients with operable stage III disease were submitted to surgery preceded or followed by chemotherapy. Chest irradiation and prophylactic brain radiotherapy (in complete responders) were administered at the end of treatment in 42 of 44 cases. Patients with inoperable limited disease received chemotherapy followed by radiotherapy in 67 of 71 cases, while chemotherapy alone or followed by radiotherapy in sites of either initially bulky or residual disease was administered to 58 patients with extensive disease. The overall response rate was 77% (complete response, 45%; partial response, 32%). Complete responses were documented more frequently in limited disease than in extensive disease (57% v 22%; P < .001). The 2- and 5-year freedom from progression rates (24% and 16%, respectively), as well as overall survival rates (31% and 16%, respectively) were significantly affected by disease extent. No patient with extensive disease was progression free and alive at 2 years, while more than half of stage I and II patients were disease free and alive at 5 years. This retrospective analysis performed on a large number of consecutive, nonrandomized patients suggests that, at least in patients with limited disease, it is possible to achieve favorable long-term results using treatment tailored to disease extent. Nonetheless, the disappointing results commonly achieved in the treatment of small cell lung cancer strongly support the need for either prospective, randomized studies to confirm recently reported improved results or new pilot studies with investigation of entirely innovative approaches.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Santoro A,Parra HS,Bidoli P,Angelidou M,Cataldo I,Salvini P,Valagussa P,Milani F,Ravasi G,Bonadonna Gsubject
Has Abstractpub_date
1995-02-01 00:00:00pages
9-14issue
1 Suppl 2eissn
0093-7754issn
1532-8708journal_volume
22pub_type
杂志文章abstract::Therapy for metastatic breast cancer can palliate disease and prolong life, but cannot cure. New drugs will be required if this is to change. Cisplatin and its analogue carboplatin offer new approaches to the treatment of metastatic breast cancer. Cisplatin has significant single-agent, front-line activity in metastat...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 00:00:00
abstract::Epigenetic alterations play a pivotal role in cancer development and progression. Pharmacologic reversion of such alterations is feasible, and second generation "epigenetic drugs" are in development and have been demonstrated to possess significant immunomodulatory properties. This knowledge, together with the availab...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2015.02.003
更新日期:2015-06-01 00:00:00
abstract::Current data indicate that most elderly patients with acute myelogenous leukemia should be treated with intensive chemotherapy. Most should receive remission induction chemotherapy using cytarabine 100 to 200 mg/m2/d by constant intravenous infusion for five to seven days plus daunorubicin greater than or equal to 30 ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1989-02-01 00:00:00
abstract::At Indiana University, we began clinical trials with ifosfamide in 1981. Although our initial efforts were in a variety of tumor types, including pancreatic cancer, we have most recently focused our attention on two tumors that have historically exhibited a higher degree of chemosensitivity--testicular cancer and smal...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1992-02-01 00:00:00
abstract::The efficacy and toxicity of cisplatin/etoposide and carboplatin/etoposide combinations along with thoracic irradiation were prospectively assessed in patients with small cell lung cancer. Both combinations were equally effective. However, the carboplatin/etoposide regimen caused significantly less nausea, vomiting, n...
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:1994-06-01 00:00:00
abstract::Gastrointestinal stromal tumor (GISTs) are the most common connective tissue malignancies of the gastrointestinal (GI) tract, with an incidence on the order of 10-13 per million people per year. Primary therapy is usually surgical, but the recurrence rate of large, so-called high-risk tumors, with a high mitotic rate,...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2009.06.002
更新日期:2009-08-01 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::Expanding knowledge about basic biology and a detailed understanding of the signaling pathways that participate in the growth and metastasis of breast cancer have identified opportunities for diagnostic and therapeutic intervention. Endocrine therapy represents the first and most successful example of targeted therapy...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.01.003
更新日期:2004-02-01 00:00:00
abstract::Tamoxifen has been demonstrated to be hepatocarcinogenic in some but not all strains of the laboratory rat and is not a carcinogen in the mouse. To resolve the question of whether tamoxifen is genotoxic in humans, many laboratories have studied its interspecies metabolism and its propensity to form DNA adducts. This r...
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::Approximately 60% of patients diagnosed with colorectal cancer (CRC) will go on to develop hepatic metastases. Although surgical resection is the only curative modality, a majority will not be able to undergo surgery. Alternative methods for treating this population have focused on the feasibility of hepatic arterial ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.31680
更新日期:2002-04-01 00:00:00
abstract::Oligodendroglial tumors are relatively rare, comprising approximately 5% of all glial neoplasms. Oligodendroglial tumor patients have a better prognosis than those with astrocytic neoplasms, and patients with tumors that contain 1p/19q co-deletions or IDH-1 mutations appear to be particularly sensitive to treatment. I...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.06.009
更新日期:2014-08-01 00:00:00
abstract::Hormonal therapy is very effective in the treatment of patients with metastatic breast cancer. Response to various therapies leads to improved quality of life and prolonged survival. This clinical trial compared two commonly utilized additive hormonal agents, tamoxifen citrate and megestrol acetate (Megace). Prelimina...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::High-dose interferon alfa (IFN alfa) therapy induces an overall response rate of 25% to 30% in unselected patients with acquired immunodeficiency syndrome (AIDS)-related Kaposi's sarcoma. Up to 50% of patients with relatively preserved immune reactivity respond to treatment. However, when dosages of 20 x 10(6) units o...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1990-02-01 00:00:00
abstract::Among the various deleterious effects of cancer chemotherapy, vascular toxicity is the least well recognized. This lack of recognition may be because the vasculotoxic phenomena are not unique to antineoplastic agents, can occur in patients without exposure to these agents, and the fact cancer itself may produce a hype...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2005.11.006
更新日期:2006-02-01 00:00:00
abstract::Anorexia and cachexia are common clinical problems of many patients with advanced cancer. Approximately 20 years ago, a controlled, clinical study demonstrated that dexamethasone could stimulate appetites of patients with advanced gastrointestinal cancer without causing any apparent effect on patient weight or surviva...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Autoimmune complications are common in chronic lymphocytic leukemia (CLL), occurring in up to a quarter of all patients during the course of the illness. By far the most common manifestation is autoimmune hemolytic anemia (AIHA), followed by immune thrombocytopenia (ITP). It is not true to say that autoimmunity is con...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2006.01.011
更新日期:2006-04-01 00:00:00
abstract::The efficacy and toxicity of combination intravenous carboplatin (300 mg/m2) and cyclophosphamide (600 mg/m2) were evaluated in 70 newly diagnosed patients with advanced-stage epithelial ovarian cancer. Cycles were administered at 4-week intervals for a total of six cycles, and treatment was provided on an outpatient ...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::Since its foundation in 1971, the RTOG has conducted a successful clinical research program in head and neck mucosal squamous cell carcinoma with 22 treatment protocols and one registry study which combined have accumulated data on over 5,500 patients. The RTOG was the first multicenter group to evaluate neoadjuvant c...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract::Recent advances in the biology of multiple myeloma cell growth and survival have suggested new avenues for treatment and potential cure of this disease. Adhesion molecules on the myeloma cell surface mediate their localization in the bone marrow via binding to extracellular matrix proteins and stromal cells. Stromal c...
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::COVID-19 has a clear sex disparity in clinical outcome. Globally, infection rates between men and women are similar; however, men are more likely to have more severe disease and are more likely to die. The causes for this disparity are currently under investigation and are most likely multifactorial. Sex hormones play...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2020.06.002
更新日期:2020-10-01 00:00:00
abstract::Although chemotherapy for advanced bladder cancer has historically been based on cisplatin-based combination regimens, the limitations of these regimens both in terms of efficacy and toxicity are now widely appreciated. In response to these limitations, other single agents have been studied, and a number have demonstr...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::32P orthophosphate administered in a wide range of activity reduces or relieves the pain from osteoblastic metastases in approximately 80% of patients treated. The efficacy of this agent is equal to that of newer agents and of wide field radiotherapy, as documented in a literature review of 28 series reporting the use...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Colorectal cancer is the third most common cause of cancer-related death in both men and women. Surgery is the primary form of treatment, with greater than 90% of patients surviving 5 years or more. The remaining patients have metastatic disease, for which treatment options are limited. The fluoropyrimidine, 5-fluorou...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-12-01 00:00:00
abstract::Over 50% of patients with small cell lung cancer (SCLC) will develop symptomatic brain metastases during the course of their disease. Results of whole brain radiotherapy, the standard treatment, are rather poor and relapses are frequent. Thus, new modes of therapy are urgently needed for these patients. In this study,...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::From this brief review is should be evident that the hereditary varieties of common cancers are characterized by a high degree of genetic heterogeneity. The specific types of hereditary cancers can be identified by focusing on the histologic types and sites of involvement, not only of the primary neoplasm, but also of...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1978-03-01 00:00:00
abstract::Alterations in chromatin structure resulting from aberrant DNA methylation and perturbations of the histone code profoundly influence gene expression during pulmonary carcinogenesis. Recent studies indicate that DNA demethylating agents and histone deacetylase (HDAC) inhibitors synergistically induce gene expression a...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2005.07.007
更新日期:2005-10-01 00:00:00
abstract::Lymphoproliferative disorders are characterized by the abnormal accumulation of aberrant lymphocytes, which frequently interfere with the processes associated with immunologic response and hematopoiesis. Chronic lymphocytic leukemia (CLL) has traditionally been considered indolent, with a prolonged clinical course. Ho...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2006.01.026
更新日期:2006-04-01 00:00:00
abstract::90Y ibritumomab tiuxetan (Zevalin; Biogen Idec Inc, Cambridge, MA), the first radioimmunotherapeutic agent approved by the US Food and Drug Administration, is a promising treatment option in patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma, including patients wit...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2003.10.003
更新日期:2003-12-01 00:00:00
abstract::It is well known that African American men are more likely to be diagnosed with metastatic prostate cancer than White men. Racial variation in the use of prostate cancer early detection modalities (ie, digital rectal examination [DRE] and prostate-specific antigen [PSA] testing) has been suggested as a major reason fo...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::A large meta-analysis showed that chemotherapy results in significant prolongation of survival for patients with non-small cell lung cancer (NSCLC). Pemetrexed is a new multitargeted antifolate chemotherapeutic agent that has shown activity in NSCLC and appears to be similar to the third-generation antitumor agents cu...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2002.37470
更新日期:2002-12-01 00:00:00