ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

With the widespread diffusion of stereotactic radiosurgical procedures, GKR treatments have gained considerable momentum as a major therapeutic option for patients harboring primary or metastatic brain tumors. Present results in high grade gliomas indicate a potential palliative role of this technique. The overall low radiosensitivity of these oncotypes and their infiltrative nature—with the resulting problems in properly defining the tumor target—are still a major obstacle to further development of the approach. In this regard, useful contributions are expected from advances in molecular neurobiology and functional neuroimaging as shown by preliminary investigations with MR spectroscopy. Surgery maintains a dominant role in the therapeutic armamentarium for low grade gliomas. However, in unfavorable cases (unresectable tumors, recurrences), GKR seems to be an effective alternative to conventional radiochemotherapy. In grade 2 astrocytomas and specifically in grade 1 pilocytic forms, short-to-mid-term reported studies have documented encouraging 70 to 93% local tumor control rates, with minimal cerebral toxicity. Finally, during the last decade, GKR has become a primary treatment choice for patients harboring small-to-medium-size brain metastases, with reasonable life expectancy and no impending intracranial hypertension. Focal tumor responses are consistently elevated, even in the most radioresistant oncotypes (melanoma, renal carcinoma); median and actuarial survival rates are far better than with conventional radiation treatments and are comparable to those observed in accurately selected surgical–radiation series.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Primary brain tumors, particularly glioblastomas, remain a challenge for oncology. Uncontrolled cellular proliferation, lack of apoptosis, invasion, and angiogenesis are among the biologic processes that render these tumors both aggressive and difficult to treat. An understanding of the genetics and molecular events regulating these aggressive tumors is beginning to emerge, partly because of recent knowledge in genomics, gene expression analysis, and mouse tumor models. As a result, it is now generally accepted that brain tumors, particularly those arising from cells of glial lineage, result from stepwise accumulation of deleterious genetic alterations. Several genetic abnormalities have been described, and current research is aimed at elucidating their causal association with brain tumor formation and progression. The purpose of this review is to summarize some of the most important recently published findings on the molecular genetics of primary gliomas.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The relative ineffectiveness of current therapies for malignant gliomas has led to the need for novel therapeutics. Therapies based on biologic modifiers are among a variety of cancer treatments currently in use or under experimental evaluation and have shown great promise, especially since several potent stimulators of the immune system have been cloned and are now available for clinical use. Early attempts at glioma therapy based on biologic modifiers, however, have failed to demonstrate significant effectiveness. In this review, we select and summarize the results of preclinical and clinical studies published during the past two years that focus on immunotherapy and biologic modifiers for treating gliomas. Despite limited clinical success, we conclude that an increased understanding of molecular biology and immunology from recent studies may pave the way for more effective approaches.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The rich multidisciplinary environment in which skull base surgery has developed has allowed for significant progress in the field and has improved patient outcomes. More precise and detailed anatomic dissection in the laboratories has provided surgeons with the benefit of undertaking the serious technical challenges encountered in the skull base. Significant work has been done and continues to be developed in the field of adjuvant treatments including radiotherapy, chemotherapy, and hormonal therapy. Using biologic end points and specific genetic targets in the tumors may further expand our management options in the future.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Renal cell carcinoma (RCC) continues to present a diagnostic and therapeutic challenge. The increased use of abdominal imaging studies does not appear to completely account for the rising incidence of RCC. Alcohol consumption has been found to be a possible protective factor among women in a recent study, but among women with children, RCC risk may increase with each child born when compared with nulliparous women. An alternative staging system shows promise, and two randomized clinical trials clarify the role of removing the primary tumor in the setting of metastatic RCC. New agents have shown promise in early clinical trials such as CCI-779, pegylated interferon, thalidomide, and anti-VEGF antibody.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Research has yielded important insights into the impact of radical prostatectomy in patients with localized prostate cancer. Other recent research has focused on the role of nutrition in prostate cancer development and progression, improved prognostication for patients with both early and advanced prostate cancer, efficacy of adjuvant and neoadjuvant hormonal therapy, and development of novel agents. In addition, the role of bisphosphonates in patients with bone metastasis was established.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Advances continue to be made in the evaluation and treatment of genitourinary tumors in children. Continued research on the cellular, molecular, and genetic process in tumorigenesis is rapidly evolving. We review the 2002 literature on pediatric genitourinary tumors. Molecular and cellular biology research continues to identify markers that may predict a worse prognosis. This identification will allow a more tailored approach with intensified treatment of aggressive tumors.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Bladder cancer is a significant public health problem responsible for more than 130,000 deaths annually worldwide. Disease prevalence is also remarkable, with more than 500,000 patients carrying the diagnosis in the United States alone. Significant progress has been made in understanding the underlying molecular and genetic events in bladder cancer. However, there remains a great need for the development of reliable markers that can provide clinically useful information regarding diagnosis and prognosis and to facilitate the selection of appropriate therapy in the individual patient. Ongoing and future investigation is anticipated to refine treatment of patients with high-risk superficial disease, to determine the role of neoadjuvant and adjuvant chemotherapy for high-risk invasive disease, and to improve the efficacy of chemotherapy for patients with metastatic bladder cancer.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Testicular cancer remains a major success story in the realm of solid tumors. There are still many remaining challenges in diagnosis, treatment, and prevention of long-term toxicity. Surgery and platinum-based chemotherapy, however, still encompass the main treatment modalities. Attempts to limit toxicity from both surgery and chemotherapy remain at the forefront of research. New chemotherapeutic options are available for patients with platinum-resistant disease, and stem cell transplant remains an area of active study.

ISSN:1040-8746    

出版商:OVID    

年代:2003

数据来源: OVID