Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
Reviewer: Charles Wood, MD
Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 5 de junio del 2006
Presenter: Calais G
Presenter's Affiliation: Centre Henry S. Kaplan, Tours, France
Type of Session: Scientific
Materials and Methods
This laryngeal preservation trial is somewhat unique in that it includes a mix of larynx and hypopharynx patients. The goal of the trial was the achievement of a 50% functional laryngeal preservation rate. Though there were more T3-T4 tumors in the TPF arm, more patients in this group (80% vs. 67%) were able to move on to RT. To be sure, an 80% rate of potential larynx preservation in the TPF arm in such advanced tumor patients borders on astounding, and is certain to generate skepticism as to its validity. More patients in the TPF arm did achieve functional larynx preservation at the 3-year mark, and the authors should be commended for applying a definition of "functional" larynx preservation in lieu of any sort of larynx preservation, functional or not.
Though there were significantly more responses in the TPF arm, this did not translate into an OS or DFS as of yet; however, the curves appear to diverge at 18 months in favor of TPF, such that differences between the groups with respect to OS and DFS may become statistically significant with further follow-up. Fortunately, there were no chemotherapy-related deaths in either arm, and similar acute toxicity rates were observed between the 2 groups; late toxicity reporting remains pending.
It is somewhat problematic to compare this study with previous laryngeal preservation trials, as the patient inclusion and treatment criteria are different (hypopharynx patient inclusion and stipulation of functional larynx). Additionally, the protocol specified RT alone following induction treatment as opposed to concurrent chemoradiation which might affect patient outcome.
Ultimately, however, the literature has shown an improvement in response rates with TPF that has not as of yet translated into an increase in locoregional control. Nevertheless, TPF appears to be the standard of care as an induction regimen in head & neck cancer.
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