Abstract:
:Long-term survival is occasionally observed in patients with neoplastic meningitis (NM) accompanying breast cancer (13% one-year and 6% 2-year survival), melanoma, and lymphoma, but in general the survival of most patients is short and averages only 3 to 4 months. The incidence of NM appears to be increasing, in part due to earlier detection by magnetic resonance imaging (MRI), and in part due to development of more effective therapies for systemic cancer, which has resulted in a larger subset at risk for late-stage development of this complication. Survival of NM patients is negatively affected by concomitant progression of systemic disease despite multiple prior therapies. However, there are certain prognostic factors that have been identified as "favorable" in retrospective series, including age less than 60 years, long symptom duration, controlled systemic disease, Karnofsky performance status (KPS) > or =70, lack of encephalopathy or cranial nerve deficits, low initial cerebrospinal fluid (CSF) protein level, history of breast primary tumor, and lack of evidence of CSF compartmentalization or bulky meningeal disease as determined by CSF flow studies. Standard treatment has traditionally involved radiotherapy (RT) to sites of symptomatic or bulky disease, as detected by neuroimaging, and in selected patients, the administration of intrathecal, intraventricular, or systemic chemotherapy. However, treatment remains palliative and many patients and physicians choose supportive care only. Future hope is provided by studies that have improved our understanding of the disease pathogenesis, have identified prognostic variables associated with outcome, and have provided new therapeutic approaches, such as administration of high-dose systemic chemotherapy and investigations of novel therapeutic agents.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Jaeckle KAdoi
10.1053/j.seminoncol.2006.04.016subject
Has Abstractpub_date
2006-06-01 00:00:00pages
312-23issue
3eissn
0093-7754issn
1532-8708pii
S0093-7754(06)00190-4journal_volume
33pub_type
杂志文章,评审abstract::The results of adjuvant chemotherapy in high-grade gliomas are disappointing. Carmustine (BCNU) wafers placed in the resection cavity provide a modest increase in median survival. However, the overall benefit of this approach is small, it offers no potential for cure, and the results are not statistically significant ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2003.11.035
更新日期:2003-12-01 00:00:00
abstract::A substantial proportion of patients with squamous cell carcinoma of the head and neck have extensive locoregional disease at presentation. While extensive surgical procedures may completely eradicate local disease with acceptable morbidity for smaller tumors, in patients with stage III and IV disease, high local rela...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Many patients with Hodgkin's and non-Hodgkin's lymphoma (NHL) can be cured today with combination chemotherapy and/or radiotherapy. However, for patients with suboptimal responses to initial therapy or for patients with refractory or relapsed disease, salvage therapy alone is usually inadequate to achieve long-term su...
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::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::Chemotherapy for prostate cancer currently has an established role in the treatment of hormone-refractory prostate cancer. There is strong evidence that combined modality treatment with androgen ablation in addition to radiotherapy provides a benefit above and beyond radiotherapy alone in patients with a poor prognosi...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1016/s0093-7754(03)00274-4
更新日期:2003-08-01 00:00:00
abstract::Recent changes to the staging of melanoma, coupled with advances in surgical and medical treatment, have resulted in new methods for diagnostic evaluation and reporting of melanocytic lesions by pathologists. This review provides an update on recent changes in evaluation and reporting of primary melanoma, evaluation o...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2012.01.005
更新日期:2012-04-01 00:00:00
abstract::ZD1839 (Iressa; AstraZeneca Pharmaceuticals LP, Wilmington, DE) is an orally active, selective inhibitor of epidermal growth factor receptor-tyrosine kinase (EGFR-TK) that blocks signaling pathways responsible for driving proliferation, invasion, and survival of cancer cells. In preclinical studies of cell lines and h...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/sonc.2003.50028
更新日期:2003-02-01 00:00:00
abstract::In vitro data suggest a synergistic antiproliferative effect of different cytokines. In four clinical studies chronic myelogenous leukemia (CML) patients were treated with interferon (IFN)-alpha alone or IFN-alpha combined with either low-dose IFN-gamma or tumor necrosis factor (TNF)-alpha. The best response was achie...
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:1992-04-01 00:00:00
abstract::Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has been shown to be an effective agent in the treatment of metastatic breast carcinoma. This multicenter randomized study compared paclitaxel 175 mg/m2 given as a 3-hour infusion every 3 weeks with mitomycin 12 mg/m2 given as an intravenous infusion ever...
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:1995-08-01 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 recommended weekly dose and the maximum tolerated weekly dose of docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) have yet to be determined. We report that a weekly dose of up to 40 mg/m2 docetaxel for 6 weeks is active in pretreated patients with metastatic breast cancer. From a preliminary study, this d...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::Session V of the Colloquium was chaired by Professors Teresa López-Fernández of Spain and Grzegorz Opolski of Poland. The 3 speakers addressed cardio-oncology issues as they relate to both clinical studies and real life situations. Professor Susan Dent discussed cardio-oncology networks for patients, emphasizing the i...
journal_title:Seminars in oncology
pub_type:
doi:10.1053/j.seminoncol.2019.01.004
更新日期:2019-12-01 00:00:00
abstract::Elderly patients with malignant gliomas present unique treatment challenges. Data are limited on the efficacy of various treatment modalities for high-grade gliomas in the elderly patient population, particularly for patients over 70 years of age, and the most appropriate treatment strategies remain a matter of debate...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2003.11.027
更新日期:2003-12-01 00:00:00
abstract::Cisplatin has been employed in the treatment of non-small-cell lung cancer (NSCLC) since the late 1970s. Current evidence suggests that it may be the most effective single drug for the treatment of NSCLC patients. The overall response rate as a single agent is 21%, though responses are higher in previously untreated p...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1989-08-01 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::Gemcitabine is a novel nucleoside analogue that has demonstrated activity against several solid tumors. A large phase II study has been performed in Europe and Canada with a total enrollment of 161 non-small cell lung cancer patients, 26 of whom were from the Institut Gustave-Roussy. Patient characteristics were the s...
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:1997-04-01 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::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::The targeting of molecular abnormalities in neoplasms may provide an opportunity to improve the selectivity of cancer therapy. Ras mutations are a common genetic event in human cancers. Other genetic changes in tumors can signal through ras-dependent pathways as well. The targeting of ras through the inhibition of Ras...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1016/s0093-7754(01)90286-6
更新日期:2001-10-01 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
abstract::Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually di...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2018.07.002
更新日期:2018-08-01 00:00:00
abstract::Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it a...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1053/j.seminoncol.2004.11.017
更新日期:2005-04-01 00:00:00
abstract::The application of molecular and genetic techniques to the study of body weight regulation have produced exciting new insights into the physiological systems governing energy expenditure, appetite, and metabolic signaling. A number of new peptides have been identified that play important roles in these regulatory syst...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1998-04-01 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::Pancreatic cancer is one of the most lethal neoplasms. Incidence in the United States has remained fairly stable over the past 25 years, with about 25,000 cases annually. Almost 100% of cases are fatal. Incidence in the developed world parallels that in the United States. Incidence in undeveloped nations is lower but ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-04-01 00:00:00
abstract::In the last decade our understanding of chronic lymphocytic leukemia (CLL) biology and pathogenesis has increased substantially. These insights have led to the development of several new agents with novel mechanisms of action prompting a change in therapeutic approaches from chemotherapy-based treatments to targeted t...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2016.02.007
更新日期:2016-04-01 00:00:00
abstract::This article summarizes the likely attenuation properties of RRx-001 in COVID-19 based on its mechanism of action and the putative pathogenesis of the disease, which appears to activate inflammatory, oxidative, and immune cascades with the potential to culminate in acute respiratory distress syndrome, cytokine storm a...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1053/j.seminoncol.2020.07.002
更新日期:2020-10-01 00:00:00
abstract::Skin findings can serve as a clue to internal disease. In this article, cutaneous manifestations of underlying lung malignancy are reviewed. Paraneoplastic dermatoses are rare, but when recognized early, can lead to early diagnosis of an underlying neoplasm. Malignancy-associated dermatoses comprise a broad group of h...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2016.02.025
更新日期:2016-06-01 00:00:00
abstract::Over the past three decades conceptual approaches to breast cancer have led to improvements in locoregional therapy and early diagnosis. Systematic screening programs with mammography reduce disease-specific mortality by 25% to 30%, while many patients with early breast cancer receive optimal breast-conserving treatme...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Patients with advanced colorectal cancer were randomized to receive either fluorouracil (5-FU) 370 mg/m2 IV days 1 to 5 followed by weekly applications of 5-FU 600 mg/m2 or the same doses of 5-FU preceded by folinic acid 200 mg/m2. Because of toxicity, the weekly 5-FU dose in the combination treatment schedule was red...
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:1992-04-01 00:00:00