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Volume 4, Number 10 (October 2007) | |||||
Letter from the Editor |
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Zeroing in on focused beams Pennsylvania Hospital, Philadelphia, PA This month, we dedicate our issue of Community Oncology to radiation therapy and some of the rapidly developing applications, techniques, and subspecializations in the field. Dr. Jondavid Pollock, of Schiffler Cancer Center in Wheeling, West Virginia, has done an admirable job piloting this special edition of the journal as our Guest Editor.
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Community Dialogue |
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A radiation pioneer reflects He sold ladies’ shoes to put himself through college and entered medical school when he was 19. Coming of age in the wake of the Manhattan Project, Dr. Suit studied atomic and nuclear physics and decided he wanted to be a radiation oncologist—against the advice of his professors who thought cancer was a soon-to-be-cured disease. He has championed proton beam therapy for close to 40 years. Dr. Suit spoke with this month’s Guest Editor, Jondavid Pollock, MD, PhD, about how the field of radiation therapy has grown and where he expects it to go.
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Original Contributions |
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Spinal radiosurgery for metastatic disease Department of Radiation Oncology, Stanford University, Stanford, CA Management of metastatic spinal disease, which affects more than 100,000 patients yearly, is a continuing challenge. Treating symptomatic lesions often includes radiotherapy to control pain and neurologic symptoms. Advances in the delivery of radiation have allowed the implementation of radiosurgical principles to extracranial sites such as the spine. The authors examine the rationale behind the increasingly common use of spinal stereotactic radiosurgery, some of the initial data supporting it, and its potential advantages over conventional fractionated radiotherapy.
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Proton beam radiotherapy: a specialized treatment alternative Indiana University School of Medicine, Midwest Proton Radiotherapy Institute, and Indiana University Cyclotron Facility/Indiana University, Bloomington, IN Although not a new modality, proton beam therapy has long been regarded as a relatively exotic form of radiation therapy, consigned to one of two centers: Massachusetts General Hospital in Boston and Loma Linda University Medical Center near Los Angeles. The cost of the accelerator and beam-line systems, along with the personnel needed to maintain the equipment, has made this highly effective and proven therapy available in only a limited number of centers.
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Stereotactic body radiation therapy: 2007 update Department of Radiation Oncology, University of Virginia Medical School, Charlottesville, VA Stereotactic body radiation therapy has been made possible by the convergence of new body immobilization systems, improvements in radiation therapy planning algorithms, and the commercial availability of image-guided radiation units capable of delivering and verifying the spatial accuracy of such treatment. Several institutional phase I/II clinical trials designed to determine the maximal permissible doses and at least one cooperative group trial have been completed for tumors in the lungs, liver, and spine. Initial reports of efficacy in early-stage peripheral non-small cell lung cancer patients are encouraging.
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Challenging Cases/Rare Cancers |
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Merkel cell carcinoma: an uncommon and challenging disease entity Radiation Oncology, Schiffler Cancer Center, Wheeling, WV Merkel cell carcinoma is a rare cutaneous malignancy with an aggressive course and a propensity to involve regional lymph nodes. Adjuvant radiotherapy following surgery is effective in reducing the rate of locoregional recurrence but appears to have little impact on the rate of distant metastases—and therefore survival. The response of patients to systemic adjuvant chemotherapy is unpredictable, and no standard chemotherapeutic regimen is available.
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Managing Side Effects |
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Recognizing and treating a new entity on the quality-of-life front: small intestinal bacterial overgrowth Gadsden Regional Cancer Center, Gadsden, AL; Department of Radiation Oncology, University of Alabama–Birmingham, AL; and Department of Medical Affairs, Salix Pharmaceuticals, Inc., Morrisville, NC Emerging data suggest that small intestinal bacterial overgrowth (SIBO) contributes to numerous gastrointestinal disorders. Recognizing this, our institution evaluates patients undergoing abdominopelvic radiotherapy (RT) for SIBO if they develop diarrhea or related symptoms. A retrospective case review was conducted. To our knowledge, this is the first published report demonstrating an association between SIBO and RT.
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Adverse Events Alert |
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Pharmacovigilance and reporting of bisphosphonate use and osteonecrosis of the jaw Divisions of Geriatric Medicine and Hematology Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL; The Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; and VA Midwest Center for the Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago, IL Concerned groups need better coordination when it comes to reporting serious adverse drug reactions.
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Washington Update |
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Medicare cuts and ESA restrictions Community Oncology Alliance, Memphis, TN In issuing a national coverage decision limiting the use of erythropoiesis-stimulating agents (ESAs) in the treatment of cancer, the Centers for Medicare & Medicaid Services appears to have overstepped its authority in ignoring FDA-approved labeling, spawned confusion among physicians and payers, and raised concerns over whether it really protects patients.
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© 2007 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. |
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