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Speciality Spotlight
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Ballow MT, Zagars GK, Pollack A, et al [Univ of Texas, Houston]
Desmoid Tumor: Prognostic factors and Outcome After Surgery, Radiation Therapy, or Combined Surgery and Radiation Therapy
J Clin Oncol 17: 158-167, 1999
The study of 189 patients with desmoid tumor treated with surgical resection, and radiation therapy or radiation therapy alone. Analysis revealed an overall recurrence rate of 30% with margin status as the single most important predictor of recurrence. The data from this study supports adjuvant radiotherapy in patients with either gross disease or microscopic disease remaining after surgical removal.
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Coucke PA, Zouhair A, Ozsahin M, et al [ Centre Hospitalier Universitaire Vaudois, Lousanne, Switzerland]
Focalized Extenal Radiotherapy for Resected Solitary Brain Metastasis : Does the Dogma Stand?
Radiother Oncol 47: 99-101, 1998
This study of 12 patients received conformal postoperative external irradiation of of 50.4 Gy after surgical resection for solitary metastasis. The treatment was focused on the tumor bed plus a 2-cm safety margin. The median survival was 7.2 months and 11 patients died of their disease. This study was stopped due to high rate of CNS failures.
Focalized radiotherapy for brain metastasis is neither a safe nor an effective procedure.
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Paszat LF, Mackillop WJ, Groome PA, et al [ Kingston Regional Cancer Ctr, Canada; Queen’s Univ, Kingston, Canada; Ontario Cancer Registy, Toronto; et al]
Mortality From Myocardial Infarction After Adjuvant Radiotherapy for Breast Cancer in the Surveillance, Epidemiology, and End-Results Cancer Registries
J Clin Oncol 16: 2625-2631, 1998
The use of adjuvant radiotherapy [RT] for breast cancer has been associated with an increased risk of death from either cardiac disease or causes unrelated to breast cancer.
In this study the data obtained from cancer registry were compared with adjuvant radiotherapy when given to right side versus the left side. The data revealed that adjuvant RT for left sided breast cancer in women younger than 60 years carries a higher risk for fatal myocardial infarction 10-15 years later than the right side RT.
The editor comments that the problem with this data as there was no control for radiation dosage, fields, concomittant chemotherapeutic agents, and other cardiac risk factors such as smoking.
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Siemann DW, Hinchman CA [Univ of Florida, Gaineville]
Potentiation of Cisplatin Activity by the Bioreductive Agent Tirpazamine
Radiother Oncol 47: 215-220, 1998
Benzotriazine-di-N-oxides are a class of bioreductive agents that demonstrate preferential cytotoxicity to hypoxic cells. This in vitro study revealed adding tirapazamine to cisplatin in mice bearing IM transplanted 16C mammary carcinomas was therapeutically beneficial.
The editor comments that due to this agents ability to confer cytotoxicity in hypoxic cells, it would be necessary to explore this agent with radiation therapy.
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Sneed PK, Stauffer PR, McDermott MW, et al [Univ of California, San Francisco]
Survival Benefit of Hyperthermia in a Prospective Randomized Trial of Brachytherapy Boost + Hyperthermia for Glioblastoma Multiforme
Int J Radiat Oncol Biol Phys 40: 287-295, 1998
This study of patient with supratentorial glioblastoma were assigned to radiotherapy bracytherapy and then with or without hyperthemia.
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Nieto Y, Cagnoni PJ, et al (Univ of Colorado, Denver)
Acute Encephalopathy: A New Toxicity Associated With High-Dose Paclitaxel
Clin Cancer Res 5: 501-506, 1999
Paclitaxel at doses of 600 mg/m2 is used for before stem cell support, 6/114 patients had acute encephalopathy.
Two of these had earlier received local RT. Three out of six patients recovered. As one uses high doses of a particular drug unrecognised toxicities surface out.
