Chemotherapy

Prophylactic myeloid growth factors before chemotherapy in the elderly – pro

Standard guidelines recommend prophylactic Neulasta or Neupogen for patients who are treated with chemotherapy regimens that produce a greater than 20% risk of febrile neutropenia. These guidelines do not apply to the elderly. Elderly patients are at a higher risk of febrile neutropenia following chemotherapy, with worse morbidity and mortality rates. However, good prospective trial data are lacking with respect to elderly cancer patients due to

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Acid reflux caused by chemotherapy – pro

Acid reflux is a known side effect of chemotherapy. Chemotherapy worsens symptoms in patients with pre-existing GERD, especially in esophageal cancer. Unfortunately, it had not been rigorously studied but a variety of medications are known to alleviate this side effect. Proton pump inhibitors(PPI) are useful in this condition and have been investigated to some extent. It stands to reason that therapy should be continued as long as chemotherapy continues

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Low Grade Follicular Lymphoma Treatment – pro

Lay Summary: I review options for follicular lymphoma treatment. Patients with low-grade non-Hodgkin's lymphoma (NHL) have a median survival of 4-8 years from diagnosis and a cause-specific survival of about 10 years. Radiotherapy can be curative in a small proportion of patients with very localized disease, but the majority of patients have advanced disease at diagnosis and it is not clear that any current therapy is curative in this situation.

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Ajuvant chemotherapy for lung cancer – pro

Lay Summary: Adjuvant chemotherapy is now standard for lung cancer. There is evidence to recommend platinum-based chemotherapy regimens as post-operative adjuvant therapy in the management of patients with completely resected stage II and IIIA NSCLC. Cisplatin-based treatment is preferred, although a carboplatin-based regimen can be used as an alternative if there is a contraindication to cisplatin. There is uncertainty about a benefit to patients

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DCF in gastric cancer – pro

Most cases of stage IV gastric cancer cannot be curatively treated with surgery alone, except for those with N3 or T4N2 cancers. Chemotherapy is therefore essentially palliative. There is no evidence of survival benefit for treatment modalities other than surgery for stage IV cancer, but some benefits are suggested for marginal life prolongation, tumor shrinkage, and relief of symptoms. Chemotherapy is indicated for patients with unresectable tumor

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PET for testicular cancer – pro

Lay Summary: PET is not recommended by NCCN for non-seminomatous testicular carcinoma. Most of the research on PET in testicular cancer focused on restaging, because functional assessment of residual masses after chemotherapy is of great clinical interest. Staging is less well studied. In a 2003, CMS reviewed 11 studies of FDG-PET in testicular cancer and concluded that the literature suggests a possible role for FDG PET in staging testicular cancer,

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Gemzar for renal cell carcinoma – pro

Lay Summary: Gemcitabine does not appear to be very active by itself in kidney cancer but may turn out to be effective in combinations. Gemcitabine has some dated phase II evidence in a phase II trial and the response rates were quite low. There are moore recent studies in combination with other drugs. Researchers from Italy recently conducted a small clinical trial evaluating the combination of Gemzar® , alfa interferon and Proleukin® in 16 patients

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Standard chemotherapy for endometrial cancer – pro

Lay Summary: Adjuvant chemo is standard for endometrial cancer and has a limited role for metastatic disease. However, chemotherapy may be useful for metastatic cases. There is currently little hope for cure in patients with metastatic endometrial carcinoma. Selected patients will respond to hormonal therapy, particularly progestins; however, for most women with advanced disease, chemotherapy is currently the standard antineoplastic treatment option.

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Gemcitabin Docetaxel for soft tissue sarcoma – pro

Lay Summary: There is limited role for chemotherapy in second line for soft tissue sarcoma, although in first line it has some effect. Fixed-dose-rate gemcitabine and docetaxel achieved high objective response rates in three prospective phase II studies as first-line or second-line therapy for advanced uterine leyomyosarcoma. In a randomized trial, the combination of gemcitabine and docetaxel was superior to gemcitabine alone in terms of objective

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Second line chemo for non small cell lung cancer – pro

Lay Summary: Treating with new chemo drugs after first attempt at chemo fails in non-small cell lung cancer is supported by credible evidence.   Two randomized clinical trials have been reported that addressed the issue of second-line treatment in patients with advanced NSCLC that progresses after they have received first-line platinum-based chemotherapy. Both trials used docetaxel because this agent had shown significant activity in this patient

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