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donderdag 27 april 2017

The Lancet: [Comment] A new standard of care or just another option for patients with relapsed ovarian cancer?

[Comment] A new standard of care or just another option for patients with relapsed ovarian cancer?
The standard of care in patients with late relapse of ovarian cancer is platinum-based re-induction chemotherapy. So far, multiple platinum-based options have shown activity within randomised phase 3 trials. Still open are the questions of further chemotherapy options in the combination of bevacizumab and the role of surgery. In The Lancet Oncology, Robert Coleman and colleagues report the results of the GOG-0213 study,1 which has investigated these two questions: the role of surgery and the effect of the addition of bevacizumab to chemotherapy in women with recurrent, platinum-sensitive ovarian cancer.
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[Series] Proton therapy for head and neck cancer: expanding the therapeutic window
Use of proton beam therapy has expanded, with the number of proton centres rapidly increasing not only in the USA but also worldwide. The physical characteristics of the proton beam offer important advantages versus widely used photon techniques in terms of radiation precision. In head and neck cancer in particular, proton beam therapy is uniquely suited for the complex anatomy of tumours and sensitive surrounding organs. De-intensification and personalisation of treatment to limit toxicity are of renewed importance in the context of human papilloma virus-associated disease, in which young patients will be cured but bear the consequences of adverse effects for decades.
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[Series] The future of personalised radiotherapy for head and neck cancer
Radiotherapy has long been the mainstay of treatment for patients with head and neck cancer and has traditionally involved a stage-dependent strategy whereby all patients with the same TNM stage receive the same therapy. We believe there is a substantial opportunity to improve radiotherapy delivery beyond just technological and anatomical precision. In this Series paper, we explore several new ideas that could improve understanding of the phenotypic and genotypic differences that exist between patients and their tumours.
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[Series] Potential for low-value palliative care of patients with recurrent head and neck cancer
Curative treatment for patients with advanced head and neck cancer can be associated with many side-effects, and many patients suffer from persistent treatment-related side-effects. Patients with recurrent cancer bear the burden of these effects along with additional symptoms attributed to the recurrent tumour. To better understand the benefits and burden of palliative treatments for patients with recurrent head and neck cancer, we reviewed the evidence on commonly used palliative treatments and their effect on quality of life.
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[Comment] Treating head and neck cancer: for better or for worse?
Head and neck cancer is a heterogenous group of diseases arising from a range of anatomical sites with distinct histopathologies and an unpredictable presentation. Over half a million new cases are diagnosed globally each year, with the majority being of squamous cell origin arising from the mucosal lining of the oral cavity, oropharynx, larynx, and hypopharynx, and often related to tobacco and alcohol misuse. Although surgery and chemoradiotherapy remain the mainstay of treatment, these treatments can substantially impede quality of life by having detrimental functional and cosmetic outcomes.
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