Abstract:
:Acute lymphoblastic leukemia (ALL) 5-year survival rates are approaching 90% in children and 50% in adults who are receiving contemporary risk-directed treatment protocols. Current efforts focus not only on further improving cure rate but also on patient quality of life. Hence, all protocols decrease or limit the use of cranial irradiation as central nervous system (CNS)-directed therapy, even in patients with high-risk presenting features, such as the presence of leukemia cells in the cerebrospinal fluid (even resulting from traumatic lumbar puncture), adverse genetic features, T-cell immunophenotype, and a large leukemia cell burden. Current strategies for CNS-directed therapy involve effective systemic chemotherapy (eg, dexamethasone, high-dose methotrexate, intensive asparaginase) and early intensification and optimization of intrathecal therapy. Options under investigation for the treatment of relapsed or refractory CNS leukemia in ALL patients include thiotepa and intrathecal liposomal cytarabine. CNS involvement in non-Hodgkin lymphoma (NHL) is associated with young age, advanced stage, number of extranodal sites, elevated lactate dehydrogenase, and International Prognostic Index score. Refractory CNS lymphoma in patients with NHL carries a poor prognosis, with a median survival of 2 to 6 months; the most promising treatment, autologous stem cell transplant, can extend median survival from 10 to 26 months. CNS prophylaxis is required during the initial treatment of NHL subtypes that carry a high risk of CNS relapse, such as B-cell ALL, Burkitt lymphoma, and lymphoblastic lymphoma. The use of CNS prophylaxis in the treatment of diffuse large B-cell lymphoma is controversial because of the low risk of CNS relapse ( approximately 5%) in this population. In this article, we review current and past practice of intrathecal therapy in ALL and NHL and the risk models that aim to identify predictors of CNS relapse in NHL.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Pui CH,Thiel Edoi
10.1053/j.seminoncol.2009.05.002subject
Has Abstractpub_date
2009-08-01 00:00:00pages
S2-S16issue
4 Suppl 2eissn
0093-7754issn
1532-8708pii
S0093-7754(09)00092-Xjournal_volume
36pub_type
杂志文章,评审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::Vinorelbine, a vinca alkaloid, was the first drug in over 20 years to be approved by the Food and Drug Administration for treatment of advanced non-small cell lung cancer (NSCLC). The drug's nonhematologic toxicities are usually mild; its dose-limiting toxicity is neutropenia. Vinorelbine has been studied in many phas...
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::First-line therapy for men with metastatic or recurrent prostate cancer following definitive local therapy is medical or surgical castration. Though effective initially in most patients, the majority of tumors develop castration resistance, necessitating the addition of further therapy. The historic treatment paradigm...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2013.04.015
更新日期:2013-06-01 00:00:00
abstract::Constitutive expression of interferons (IFNs) and activation of their signaling pathways have pivotal roles in host responses to malignant cells in the tumor microenvironment. IFNs are induced by the innate immune system and in tumors through stimulation of Toll-like receptors (TLRs) and through other signaling pathwa...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.02.002
更新日期:2014-04-01 00:00:00
abstract::In vitro uptake and retention of 3H-cytosine arabinoside (ara-C) was studied in 68 acute myelogenous leukemia (AML) patients (ten were studied twice) treated with a regimen containing conventional (54 patients) or high doses (24) of ara-C. Drug uptake and retention after four hours were measured following 30 minutes e...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract::The goal of this National Cancer Institute-sponsored phase I trial is to determine the feasibility, toxicity, and pharmacokinetics of continuous-infusion (24 hr/d, 7 d/wk, 7-week total) intravenous paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) combined with standard curative radiotherapy (RT) for pre...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::In two different controlled prospective randomized trials the Lung Cancer Study Group has shown that adjuvant CAP chemotherapy is effective in prolonging the disease-free survival. These studies indicate that the adjuvant chemotherapy has its effect by way of diminishing systemic recurrences and that the adjuvant ther...
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:1988-06-01 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::Non-small cell lung cancer (NSCLC) represents almost three quarters of all cases of lung cancer. Most NSCLC patients present with either locally advanced inoperable disease, stage IV metastatic disease, or comorbid medical conditions that make them unsuitable for curative resection. Among NSCLC patients in the United ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 00:00:00
abstract::As with many other aspects of health care delivery in the United States, the entrenchment of managed care practices has significantly affected the management of patients with advanced ovarian cancer. Nurses continue to play a vital role in the delivery of health care in this venue, serving as the primary conduit betwe...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-02-01 00:00:00
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::Carboplatin is one of the most active agents in untreated small cell lung cancer (SCLC) (11% complete response [CR], 59% CR plus partial response [PR]). Combination carboplatin/etoposide/vincristine (CEV) (phase II trial) led to an overall remission rate of 84% in patients with limited disease (LD), with 52% CRs. The ...
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:1992-02-01 00:00:00
abstract::We report an open, three-armed, multicenter study being carried out to assess the optimum treatment for acute and delayed emesis and nausea in patients undergoing highly emetogenic chemotherapy. Eighty-seven patients were randomized to receive tropisetron (Navoban; Sandoz Pharma Ltd, Basel, Switzerland), tropisetron p...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1994-10-01 00:00:00
abstract::The mainstay of screening for breast cancer is the mammogram. There are several randomized control trials that demonstrate a significant decrease in breast cancer mortality when compared to women without screening mammography included in their care. Digital mammography has improved detection in the dense breast. With ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2010.11.004
更新日期:2011-02-01 00:00:00
abstract::The evaluation of the activity of new drugs against small cell lung cancer (SCLC) is discussed and the results with gemcitabine are presented. Gemcitabine has activity against untreated SCLC. Preliminary results from an ongoing study also indicate activity in so-called resistant SCLC. ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract::In recent years, the most frequent indication for high-dose autologous stem-cell-supported chemotherapy in the United States has been breast cancer. This approach is applied in "high-risk," early-stage disease as adjuvant treatment, and with either curative or palliative intent in metastatic disease. Among both lay pe...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-02-01 00:00:00
abstract::Organ function preservation in patients with head and neck cancer can be achieved by intensity-modulated radiation therapy (IMRT). Much of the work on the physics of IMRT has been done for currently available IMRT systems. However, clinical data remain scarce. Before IMRT is accepted as a standard of care, more compre...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章,评审
doi:10.1053/j.seminoncol.2003.11.009
更新日期:2003-12-01 00:00:00
abstract::In spite of the chemosensitivity seen with the initial treatment of malignant lymphoid disorders, relapse is common and death most often occurs as a result of disease progression. This is related to a multitude of resistance mechanisms associated with the various lymphoproliferative disorders. As a result, therapies t...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::In studies conducted by the Eastern Cooperative Oncology Group, treatment with either paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) or carboplatin was associated with an improvement in 1-year survival in patients with stage IV non-small cell lung cancer (NSCLC). Based on these findings, a phase II tr...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-12-01 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::Anemia is a multi-symptom syndrome involving both physical and emotional problems that can be evaluated for their impact on quality of life. Fatigue is the cardinal symptom of anemia, reported by three of four cancer patients using the general version of the Functional Assessment of Cancer Therapy (FACT-G) questionnai...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract::Ten years of interferon (IFN) therapy have followed the approval of this agent by the US Food and Drug Administration on June 5, 1986. As the first biotherapeutic approved, IFN-alpha paved the way for the many new biotherapeutics. Regardless of this long history, however, we have just touched the surface of understand...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-06-01 00:00:00
abstract::Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) displays nonlinear pharmacokinetics in humans. Both peak plasma paclitaxel concentrations and areas under the curve (AUCs) of the concentration versus time profiles will change disproportionately to changes in dose. Models that accurately describe the pla...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1995-06-01 00:00:00
abstract::CEP (CCNU, etoposide, and prednimustine) was tested as third-line chemotherapy in 40 patients resistant to both MOPP and ABVD. The observed response rate (complete remission, 35%, and partial remission, 25%) is encouraging. Treatment was generally well tolerated and all acute side effects were reversible. ...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Many novel antifolate compounds with unique pharmacologic properties are currently in clinical development. These newer antifolates differ from methotrexate, the most widely used and studied drug in this class, in terms of their lipid solubility and cellular transport affinity, their level of polyglutamation, and thei...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1997-10-01 00:00:00
abstract::Locoregionally advanced unresectable non-small cell lung cancer is defined by bulky primary site disease and/or regionally advanced lymphadenopathy involving the contralateral mediastinum and/or supraclavicular lymph nodes. These tumors are not amenable to curative-intent surgical resection but can be approached with ...
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::Lonidamine belongs to a new class of antineoplastics agents, since it does interfere with cell energy processes. When administered as single agent in metastatic breast cancer, it produces moderate therapeutic effects. The pattern of toxicity includes myalgias, asthenia, testicular pain, and gastrointestinal discomfort...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::The approval, in 2015, of the first poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi; olaparib, Lynparza) for platinum-sensitive relapsed high-grade ovarian cancer with either germline or somatic BRCA1/2 deleterious mutations is changing the way that BRCA1/2 testing services are offered to patients with...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2017.08.004
更新日期:2017-06-01 00:00:00
abstract::Multitargeted antifolate (MTA, LY231514) is a novel antifolate antimetabolite, with antitumor activity via inhibition of thymidylate synthase, glycinamide formyl transferase, and dihydrofolate reductase. Three dosing schedules have been investigated in the phase I setting: daily x5 every 21 days, weekly x4 every 42 da...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-04-01 00:00:00
abstract::In recent years, several new cytotoxic agents have been investigated for the management of non-small cell lung cancer (NSCLC), including the antimetabolic gemcitabine (Gemzar; Eli Lilly and Company, Indianapolis, IN) and the new multitargeted antifolate pemetrexed (Alimta, Eli Lilly and Company), which are both among ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1016/s0093-7754(03)00284-7
更新日期:2003-08-01 00:00:00