In this issue


    Radiotherapy and outcomes in males and females with breast cancer
 Top
 Radiotherapy and outcomes in...
 Epirubicin, cisplatin and...
 Prognostic indexes in follicular...
 Screening studies for fatigue
 Quote
 
Breast cancer in males has an annual incidence of <1 per 100,000 compared with >120 per 100,000 in females. Overall survival is reportedly worse for males, but after adjusting for age and stage, survival in men and women has been found to be similar. However, an analysis of 3627 pairs of men and women with breast cancer, matched for age and stage showed that males received significantly more aggressive local treatment (surgery and radiotherapy) than females but had similar locoregional control and survival. In this issue, Macdonald et al. report the results of a study that aimed to determine whether gender was a significant prognostic factor for post-mastectomy relapse, after accounting for known prognostic factors and delivery of radiotherapy. These authors suggest that gender is not a prognostic factor in patients undergoing mastectomy for early stage breast cancer and that men undergoing mastectomy for breast cancer should receive adjuvant radiotherapy following guidelines similar to those developed for females.


    Epirubicin, cisplatin and docetaxel combination for metastatic gastric cancer
 Top
 Radiotherapy and outcomes in...
 Epirubicin, cisplatin and...
 Prognostic indexes in follicular...
 Screening studies for fatigue
 Quote
 
Despite the declining incidence of gastric cancer in Western industrialized countries, this tumour remains the fourth most common cancer worldwide and the second leading cause of cancer-related death. Localized gastric cancer is potentially curable with surgery, but the majority of patients present with locally advanced or metastatic disease, which precludes resection. Systemic chemotherapy of these patients has been associated with a significantly superior median survival and a better quality of life in comparison with the best supportive care. Several phase II studies of the taxane docetaxel, in patients with advanced gastric cancer, have reported response rates of around 20%, and in combination with cisplatin (DC) an overall response rate of 37.2–56% and a median survival of 9–10.4 months were achieved. In this issue, Di Lauro et al. report the results of a phase II study that aimed to evaluate the activity and safety of an epirubicin, cisplatin and docetaxel combination in patients with metastatic gastric cancer. These authors report that the combination is active and well tolerated and they suggest that it deserves further evaluation in randomized studies.


    Prognostic indexes in follicular lymphoma
 Top
 Radiotherapy and outcomes in...
 Epirubicin, cisplatin and...
 Prognostic indexes in follicular...
 Screening studies for fatigue
 Quote
 
Follicular lymphoma (FL) is most commonly seen in middle-aged patients and accounts for about 30% of newly diagnosed non-Hodgkin lymphomas. The international prognostic index (IPI) has been successfully applied to patients with FL but seems to have a limited discriminating power. In recent years, two FL-specific prognostic scores have been proposed, the Italian Index (ILI), and the Follicular Lymphoma International Prognostic Index (FLIPI). In this issue, Perea et al. present the results of a study that aimed to compare all three prognostic indexes in a large group of patients with FL and tried to determine the value of each of them. These authors report that all three indexes, IPI, ILI and FLIPI, were useful for the classification of patients with FL into differentiated risk groups, but they note that the FLIPI identified a larger proportion of high-risk patients than the IPI and the ILI.


    Screening studies for fatigue
 Top
 Radiotherapy and outcomes in...
 Epirubicin, cisplatin and...
 Prognostic indexes in follicular...
 Screening studies for fatigue
 Quote
 
Many studies show fatigue affecting more than 75% of cancer patients, especially in the setting of chemotherapy and radiation treatments. However, the pathogenesis of fatigue is not well understood, and while it has been correlated with a variety of factors, including anemia, psychological distress, nausea, performance status and treatment modalities, studies of biological correlates are limited. In this issue Shafqat et al. present a study that aimed to evaluate the prevalence of fatigue in a diverse cancer patient population undergoing chemotherapy, and looked for potential markers by screening for anemia, depression, hypoalbuminemia, hypothyroidism, total testosterone, TNF-alpha levels and dehydroepiandrosterone-sulfate (DHEAS) levels. These authors suggest that low levels of DHEAS and testosterone in males have an association with fatigue and provide a rationale for testing hormone replacement therapy in this cancer patient population.


    Quote
 Top
 Radiotherapy and outcomes in...
 Epirubicin, cisplatin and...
 Prognostic indexes in follicular...
 Screening studies for fatigue
 Quote
 
‘INSPECTOR: Matron Boll. Kindly fetch the doctor-in-charge.

MATRON: Quite out of the question. The Fraulein Doktor is accompanying Einstein on the piano. Einstein can only calm down when the Fraulein Doktor plays his accompaniments.

INSPECTOR: And three months ago the Fraulein Doktor had to play chess with Sir Isaac Newton, to calm him down. We can't have any more of this, Matron. I simply must speak to the doctor-in-charge.

MATRON: Certainly.

INSPECTOR: Thank you.

MATRON: But you'll have to wait.'

An inspector calls, in Friedrich Durrenmatt's The Physicists.





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