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. These patients generally have a poor clinical course and lower tolerance to therapy compared with younger patients. Standard radiotherapy (RT) may provide a survival benefit for patients with a good Karnofsky performance status (>/=70); however, RT is associated with significant neurologic toxicity in elderly patients. Some argue that the apparent modest clinical benefits of RT do not outweigh the risks and inconvenience of the standard schedule. Clearly, more effective and better-tolerated treatments are needed. Chemotherapy agents with good safety profiles, such as oral temozolomide (Temodar [US], Temodal [international]; Schering-Plough Corporation, Kenilworth, NJ), are being considered as alternatives to RT. When used as single-agent therapy, temozolomide induced objective responses and improved neurologic status in elderly patients with newly diagnosed, unresected glioblastoma. For patients with good performance status, treatment options should be discussed and the risks and potential benefits of RT carefully considered. Furthermore, prospective randomized studies should be performed to define the best therapeutic option for efficacy, toxicity, convenience, and quality of life.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Chinot OLdoi
10.1053/j.seminoncol.2003.11.027subject
Has Abstractpub_date
2003-12-01 00:00:00pages
68-71issue
6 Suppl 19eissn
0093-7754issn
1532-8708pii
S0093775403005955journal_volume
30pub_type
杂志文章,评审abstract::Although originally developed as an antitumor agent in the 1970s, dexrazoxane (DEX) is currently used as a cardioprotective agent in combination with doxorubicin (DOX). Due to concerns about anthracycline-induced cardiotoxicity at higher cumulative doses, many investigators have chosen to administer DOX by prolonged i...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-08-01 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::Glioblastoma multiforme (GBM) is the most common form of primary malignant brain cancer. Median overall survival (OS) for newly diagnosed patients is only about 12 to 18 months. GBM tumors invariably recur, and there is no widely recognized and effective standard treatment for recurrent GBM. NovoTTF Therapy is a novel...
journal_title:Seminars in oncology
pub_type: 杂志文章
doi:10.1053/j.seminoncol.2014.09.009
更新日期:2014-10-01 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::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 weeks total) intravenous paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) when combined with standard, curative-intent radiation t...
journal_title:Seminars in oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract::This article reviews the associations of cancer with rheumatic diseases. Recent epidemiologic data linking the autoimmune connective tissue diseases with malignancy will be emphasized. Reports linking the occurrence of malignancy with rheumatoid arthritis, systemic lupus erythematosus, idiopathic inflammatory myopathy...
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::An overview of the causes, the clinical pictures and the management of obstruction in three major organ systems due to primary and secondary malignant neoplasms has been presented. Such obstruction often produces dramatic clinical pictures that require careful, appropriate, and often aggressive therapy if patients are...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1978-06-01 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::Choices of treatment for patients with estrogen receptor (ER) positive metastatic breast cancer refractory to first-line endocrine therapies include progestins, antiadrenal drugs, and androgens. These treatments should be administered sequentially to achieve maximum palliation of the disease. For ER positive patients ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1988-06-01 00:00:00
abstract::The medical treatment of squamous cell cervical carcinoma is receiving increasing attention. Cisplatin and ifosfamide are known effective drugs. Paclitaxel has been tested with interesting results in cervical cancer. We evaluated the toxic effects and the antitumor activity of a multiagent regimen that included paclit...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract::Knowledge of the pharmacokinetics of a drug is essential to the optimal design of the dose and schedule of chemotherapy protocols. As an extension, an understanding of the mechanism of drug action is necessary to construct the optimal strategy for combination chemotherapy. Nucleoside antimetabolites such as fludarabin...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract::Etoposide phosphate (Etopophos; Bristol-Myers Squibb Company, Princeton, NJ) is a water-soluble prodrug of etoposide that is converted in vivo by endogenous phosphatases to the active drug etoposide. This conversion process is efficient and not saturable in humans at doses between 50 and 1,600 mg/m2. The resultant eto...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::Cardiovascular toxicity is one of the most feared complications of cancer treatment. Recent advances in oncologic therapies have resulted in improved cancer outcomes but also a new set of cardiovascular adverse effects. Common toxicities include left ventricular dysfunction/heart failure, hypertension, and myocardial ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2013.01.003
更新日期:2013-04-01 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::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::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::Ifosfamide was developed by investigators at Asta-Werke in Germany. Its chemical structure differs from that of cyclophosphamide by the transposition of one of the side chain chloroethyl groups to the ring nitrogen. In several preclinical models, ifosfamide had greater activity than cyclophosphamide. It produced less ...
journal_title:Seminars in oncology
pub_type: 历史文章,杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::For four decades, 5-fluorouracil was the only option available for patients with metastatic colorectal cancer. It provided a response rate of 15% to 20%, with a median survival of approximately 1 year. In the past 5 years, remarkable progress has been made in colorectal cancer research with the approval of irinotecan ...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2005.04.022
更新日期:2005-12-01 00:00:00
abstract::Gene therapy has now become a standard experimental approach for treating cancers that have failed conventional therapies. As the understanding of the molecular nature of carcinogenesis develops, new approaches are being taken to directly target tumor cells, thus bypassing the difficulties of killing cells that are re...
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::Phase I trials of the intraperitoneal (IP) administration of cisplatin have demonstrated that the drug can be safely delivered by this route with a major increase in exposure (approximately tenfold to 15-fold) of the cavity to the cytotoxic agent compared with that of the systemic circulation. Phase I trials of IP cis...
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::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::Pancreatic neoplasms are morphologically and genetically heterogeneous and include a wide variety of tumors ranging from benign to malignant with an extremely poor clinical outcome. Our understanding of these pancreatic neoplasms has improved significantly with recent advances in cancer sequencing. Awareness of molecu...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2014.12.004
更新日期:2015-02-01 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::Most important is the physician's attitude, energy, and skill focused toward helping the patient through the difficulties in the last weeks of life. Many causes of nausea, dyspnea, and other troublesome symptoms can be effectively treated, and pharmacologic palliation is nearly always possible. A multidisciplinary tea...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::Despite marked improvements in the treatment options available for patients with lung cancers, more than 85% of patients ultimately relapse and die of their disease. Among the most auspicious of new agents available to treat lung cancers, paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) also has been th...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 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::The liver is the most common site of metastatic colorectal cancer (CRC) and the status of this organ is an important determinant of overall survival in patients with advanced disease. Complete resection of hepatic CRC metastases can provide a long-term cure for some patients, but the majority of liver metastases are n...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:10.1053/j.seminoncol.2004.09.025
更新日期:2005-02-01 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::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::Intravesical therapy has been used in the management of superficial transitional cell carcinoma (TCC) of the urinary bladder (Ie, Ta, Tl, and carcinoma in situ [CIS]) with specific objectives that include treating existing/residual tumor, preventing recurrence of tumor, preventing disease progression, and prolonging s...
journal_title:Seminars in oncology
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00