Current Drug Therapy - Volume 5, Issue 3, 2010

In recent years, a substantial proportion of patients with solid tumors has received concurrent treatment with radiation and systemic chemotherapy; the association of chemotherapy and radiation is becoming the best current standard therapy option for many patients with locoregionally advanced solid tumors. This issue of Current Drug Therapy reviews for several tumor types the clinical evidence and the s Read More

The combination of radiation and chemotherapy, based on a demonstrated preclinical rationale, has involved in the last decades the use of cytotoxic agents as radiosensitizers. Classic chemotherapeutic agents, such as 5-fluouracil and cisplatin, and more recently gemcitabine and taxanes, have been employed in different sequences with radiation therapy, even though the optimal combinations and scheduling are s Read More

Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults. Until recently, the standard of care consisted of maximal surgical resection followed by external beam radiotherapy (RT). Several randomized trials conducted over the past 30 years have failed to show a significant survival advantage for patients treated with BCNU or PCV chemotherapy. The randomized EORTC 26981/22981-NCIC trial has Read More

Recently new strategies such as the association of chemotherapy with radiotherapy have emerged for the improvement of therapeutic outcome in the curative treatment of HNSCC: for patients with locally advanced HN-SCC, where outcome with radiotherapy alone is poor. More than one-hundred Phase III trials collected in large meta-analyses have showed that loco regional control and overall survival may be improved at Read More

Over the past 30 years, significant advances have been made in the integration of radiation therapy and chemotherapy in the treatment of patients with esophageal malignancies. The therapeutic goal of chemoradiotherapy is to enhance local control resulting in improved loco-regional control and survival of these patients. To define the optimal sequence, the need of combination with surgery, and the efficacy of these modalitie Read More

Radiochemotherapy represents the cornerstone of the treatment for patients affected by locally advanced non small cell lung cancer. Nevertheless, to date there is no agreement concerning how the standard therapy is and many questions are still open. Two timing modalities have been proposed to combine chemotherapy and radiotherapy: after many phase II/III have tested concurrent or sequential approach, con Read More

Postoperative treatment of early-stage breast cancer often includes radio- and chemo- therapy and, more recently, trastuzumab. Optimal timing, i.e. sequential or concomitant, of radiotherapy and systemic therapies to maximize efficacy and cosmetic outcome and minimize toxicity, is still controversial. This review analyzes the effects of different sequences after surgery as reported in phase III randomized studies and the Read More

Invasive transitional cell carcinoma of the urinary bladder is traditionally treated with radical cystectomy (RC), which remains the “gold standard” of therapy, providing a 5-year survival rate of about 75% in organ confined disease. However, approximatively half of the patients (pts) treated in this way experienced distant recurrence besides great morbidity and lifestyle changes. Although radiation has been the mainstay of nonsurg Read More

Significant advances have been made in the treatment of rectal cancer. Multidisciplinary management is the preferred approach and offers the best clinical outcome. In locally advanced disease, surgery with total mesorectal excision remains the leading option, but adjuvant treatments are necessary due to local and systemic failure. Even if the preoperative approach is the treatment of choice, chemoradiotherapy may be c Read More

Squamous cell carcinoma of anal canal (SCCA) and its precursor lesions are increasing in prevalence for the diffusion of human papillomavirus infection. The treatment of the cancer of the anal canal represents a model for the application of organ sparing, combined modality therapy for curative treatment. Squamous cell carcinoma of anal canal was originally a surgically treated disease that required Abdominoperineal R Read More