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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..

Curr. Oncol., Volume 13, Issue 3 (June 2006) – 5 articles

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85 KiB  
Article
Impact of Geometric Uncertainties on Dose Distribution During Intensity Modulated Radiotherapy of Head-and-neck Cancer: The Need for a Planning Target Volume and A Planning Organ-at-Risk Volume
by O. Ballivy, W. Parker, T. Vuong, G. Shenouda and H. Patrocinio
Curr. Oncol. 2006, 13(3), 108-115; https://doi.org/10.3390/curroncol13030010 - 1 Jun 2006
Cited by 24 | Viewed by 752
Abstract
We assessed the effect of geometric uncertainties on target coverage and on dose to the organs at risk (OARS) during intensity-modulated radiotherapy (IMRT) for head-and-neck cancer, and we estimated the required margins for the planning target volume (PTV [...] Read more.
We assessed the effect of geometric uncertainties on target coverage and on dose to the organs at risk (OARS) during intensity-modulated radiotherapy (IMRT) for head-and-neck cancer, and we estimated the required margins for the planning target volume (PTV) and the planning organ-at-risk volume (PRV). For eight headand- neck cancer patients, we generated IMRT plans with localization uncertainty margins of 0 mm, 2.5 mm, and 5.0 mm. The beam intensities were then applied on repeat computed tomography (CT) scans obtained weekly during treatment, and dose distributions were recalculated. The dose–volume histogram analysis for the repeat CT scans showed that target coverage was adequate (V100 ≥ 95%) for only 12.5% of the gross tumour volumes, 54.3% of the upper-neck clinical target volumes (CTVS), and 27.4% of the lower-neck CTVS when no margins were added for PTV. The use of 2.5-mm and 5.0-mm margins significantly improved target coverage, but the mean dose to the contralateral parotid increased from 25.9 Gy to 29.2 Gy. Maximum dose to the spinal cord was above limit in 57.7%, 34.6%, and 15.4% of cases when 0-mm, 2.5-mm, and 5.0-mm margins (respectively) were used for PRV. Significant deviations from the prescribed dose can occur during IMRT treatment delivery for headand- neck cancer. The use of 2.5-mm to 5.0-mm margins for PTV and PRV greatly reduces the risk of underdosing targets and of overdosing the spinal cord. Full article
84 KiB  
Review
Natural Health Products That Inhibit Angiogenesis: A Potential Source for Investigational New Agents to Treat Cancer—Part 2
by S.M. Sagar, D. Yance and R.K. Wong
Curr. Oncol. 2006, 13(3), 99-107; https://doi.org/10.3747/co.v13i3.88 - 1 Jun 2006
Cited by 44 | Viewed by 790
Abstract
The herbalist has access to hundreds of years of observational data on the anticancer activity of many herbs. Laboratory studies are expanding the clinical knowledge that is already documented in traditional texts. The herbs that are traditionally used for anti-cancer treatment and that [...] Read more.
The herbalist has access to hundreds of years of observational data on the anticancer activity of many herbs. Laboratory studies are expanding the clinical knowledge that is already documented in traditional texts. The herbs that are traditionally used for anti-cancer treatment and that are anti-angiogenic through multiple interdependent processes (including effects on gene expression, signal processing, and enzyme activities) include Artemisia annua (Chinese wormwood), Viscum album (European mistletoe), Curcuma longa (curcumin), Scutellaria baicalensis (Chinese skullcap), resveratrol and proanthocyanidin (grape seed extract), Magnolia officinalis (Chinese magnolia tree), Camellia sinensis (green tea), Ginkgo biloba, quercetin, Poria cocos, Zingiber officinalis (ginger), Panax ginseng, Rabdosia rubescens hora (Rabdosia), and Chinese destagnation herbs. Natural health products target molecular pathways other than angiogenesis, including epidermal growth factor receptor, the HER2/neu gene, the cyclo-oxygenase-2 enzyme, the nuclear factor kappa-B transcription factor, the protein kinases, the Bcl-2 protein, and coagulation pathways. Quality assurance of appropriate extracts is essential prior to embarking upon clinical trials. More data are required on dose–response, appropriate combinations, and potential toxicities. Given the multiple effects of these agents, their future use for cancer therapy probably lies in synergistic combinations. During active cancer therapy they should generally be evaluated in combination with chemotherapy and radiation. In this role, they act as modifiers of biologic response or as adaptogens, potentially enhancing the efficacy of the conventional therapies or reducing toxicity. Their effectiveness may be increased when multiple agents are used in optimal combinations. New designs for trials to demonstrate activity in human subjects are required. Although controlled trials may be preferable, smaller studies with appropriate endpoints and surrogate markers for anti-angiogenic response could help to prioritize agents for larger, resource-intensive phase iii trials. Full article
45 KiB  
Article
Promoting Best Gynecologic Oncology Practice: A Role For The Society of Gynecologic Oncologists of Canada
by L. M. Elit, M. Johnston, M. Brouwers, M. Fung- Kee-Fung, G. Browman and I. D. Graham
Curr. Oncol. 2006, 13(3), 94-98; https://doi.org/10.3390/curroncol13030009 - 1 Jun 2006
Viewed by 533
Abstract
During March 30–April 1, 2005, the Society of Gynecologic Oncologists of Canada (GOC) and the Canadian Strategy for Cancer Control (CSCC) Clinical Practice Guidelines Action Group (CPG-AG) met to • determine how GOC would like to influence [...] Read more.
During March 30–April 1, 2005, the Society of Gynecologic Oncologists of Canada (GOC) and the Canadian Strategy for Cancer Control (CSCC) Clinical Practice Guidelines Action Group (CPG-AG) met to • determine how GOC would like to influence practice in the care of women with gynecologic cancer. • explore a collaborative model for developing and implementing evidence-based practice guidelines. • investigate the utility of the CPG evaluation and adaptation cycle as a tool for selecting, adapting, and adopting guidelines. At the workshop meeting, 21 members of the GOC and the CPG-AG heard presentations from various Canadian guideline initiatives. As an example of adaptation and adoption processes, the AGREE (Appraisal of Guidelines for Research and Evaluation) tool was applied to guidelines in recurrent ovarian cancer, and the group explored their opportunity to use knowledge translation to influence the care of women with gynecologic cancer. The themes influencing practice are consistent with GOC’s mandate. The future is expected to involve partnering with other groups to maximize scarce resources. Resources should be directed to facilitating implementation of existing guidelines rather than to developing new documents. The full spectrum of cancer care includes prevention, screening, diagnosis, primary treatment, follow-up, treatment of recurrent disease, and palliation. High-quality evidence is available in some areas, but gaps exist where guideline panels could provide guidance. Development of a pan-Canadian gynecologic oncology process could provide an opportunity to influence access to care at the political and policy levels. The GOC will develop linkages such that the toolbox available through CSCC-CPG-AG can be incorporated into future collaboration. Full article
116 KiB  
Review
Maximal Androgen Blockade for the Treatment of Metastatic Prostate Cancer—A Systematic Review
by H. Lukka, T. Waldron, L. Klotz, E. Winquist, J. Trachtenberg and on behalf of the Genitourinary Cancer Disease Site Group of the Cancer Care Ontario Program in Evidence-Based Care
Curr. Oncol. 2006, 13(3), 81-93; https://doi.org/10.3747/co.v13i3.85 - 1 Jun 2006
Cited by 22 | Viewed by 612
Abstract
Introduction: Maximal androgen blockade (mab) versus castration alone in patients with metastatic prostate cancer has been extensively evaluated in randomized trials. The inconsistent results have led to the publication of multiple meta-analyses. The present review examines the evidence from meta-analytic [...] Read more.
Introduction: Maximal androgen blockade (mab) versus castration alone in patients with metastatic prostate cancer has been extensively evaluated in randomized trials. The inconsistent results have led to the publication of multiple meta-analyses. The present review examines the evidence from meta-analytic reports to determine whether mab using agents such as flutamide, nilutamide, and cyproterone acetate (cpa) is associated with a survival advantage. Methods: We conducted a systematic review of the literature (medline, embase, and the Cochrane Library through July 2004; cancerlit through October 2002) for meta-analyses that compared mab with castration alone in previously untreated men with metastatic prostate cancer (D1 or D2, N+/M0 or M1). Two reviewers selected papers for eligibility; disagreement was resolved by all the authors through consensus. Results: The literature search identified six meta-analyses that met the eligibility criteria of the review. Two of those reports were based on individual patient data (ipd), and four were based on data from the published literature. All six meta-analyses pooled data on overall survival. The best evidence came from the largest meta-analysis, conducted by the Prostate Cancer Trialists Collaborative Group and based on ipd (8725 patients) from 27 trials. That analysis detected no difference in overall survival between mab and castration alone at 2 or 5 years. However, a subgroup analysis showed that mab with nonsteroidal anti-androgens (nsaas) was associated with a statistically significant improvement in 5-year survival over castration alone (27.6% vs. 24.7%; p = 0.005). The combination of mab with cpa, a steroidal anti-androgen, was associated with a statistically significant increased risk of death (15.4% vs. 18.1%; p = 0.04). Compared with castration alone, mab was associated with more side effects (that is, gastrointestinal, endocrine function) and reduced quality of life in domains related to treatment symptoms and emotional functioning. Conclusions: The small survival benefit conferred by mab with nsaa is of questionable clinical significance given the added toxicity and concomitant decline in quality of life observed in patients treated with mab. Therefore, combined treatment with flutamide or nilutamide should not be routinely offered to patients with meta-static prostate cancer beyond the purpose of blocking testosterone flare. Monotherapy, consisting of orchiectomy or the administration of a luteinizing hormone–releasing hormone agonist is recommended as standard treatment. Full article
17 KiB  
Editorial
In This Issue of Current Oncology
by M. Chasen
Curr. Oncol. 2006, 13(3), 80; https://doi.org/10.3390/curroncol13030008 - 1 Jun 2006
Viewed by 403
Abstract
Promoting best gynecologic oncology practice is the subject of a manuscript from the Society of Gynecologic Oncologists of Canada. [...] Full article
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