bluuebunny/crossref_metadata_2025_split huggingface dataset:
European trials and the management of prostate cancer
Authors: Newling D. W. W. 
Published: February 2007

AbstractEfforts continue to improve the outlook for patients with all stages of prostate cancer. The addition of adjuvant or neo‐adjuvant hormone therapy to radical prostatectomy may improve the curability of advanced localized disease. Various novel forms of maximal androgen blockade continue to be explored, including the reintroduction of safer forms of estrogen therapy. Chemotherapy remains largely experimental but its earlier introduction, when the patient's general condition remains good, may lead to improvement in the quantity and quality of life of patients with advanced disease. © 1995 Wiley‐Liss, Inc.
Pathobiology of cancer of the pancreas
Authors: Digiuseppe Joseph A. , Hruban Ralph H. 
Published: February 2007

AbstractThe diagnosis of infiltrating adenocarcinoma of the pancreas is associated with an overall 5‐year survival of less than 5%. Although surgical resection has improved the prognosis for patients with localized disease, in the absence of ancillary techniques, clinical and pathologic assessment of pancreas cancer fails to predict outcome in many patients. Recent work has focused on the genetic alterations in pancreas cancer, offering the promise of improving our ability not only to predict survival but also to select the most appropriate therapy. The study of genetic alterations in colon cancer, wherein mutations in the oncogene, K‐ras, and the loss of functional activity of several tumor suppressor genes is required for progression from small adenoma to invasive carcinoma, has served as a paradigm for the molecular analysis of pancreas cancer. A similar pattern is emerging for pancreas cancer, in that there is apparently progression from intraductal lesions to invasive cancer, and that K‐ras, and several tumor suppressor genes, including p53, deleted in colon cancer (DCC), and multiple tumor suppressor‐1 (MTS1), are frequent targets of mutation and/or deletion. Cytogenetic studies and molecular studies assessing allelic loss suggest that several additional oncogenes and tumor suppressor genes involved in the pathogenesis of pancreas cancer remain to be discovered. These recent findings enhance our understanding of the etiology of carcinoma of the pancreas, and serve as the basis for the early detection and, potentially, improved treatment of this typically fatal malignancy. © 1995 Wiley‐Liss, Inc.
Early diagnosis of pancreatic carcinoma—Reality or oxymoron?
Authors: Malik Amer 
Published: February 2007

AbstractThe greatest impact on survival in pancreatic carcinoma will most likely be from earlier diagnosis. Newer technologies have surfaced and dramatic improvements in existing diagnostic techniques have occurred in detecting smaller tumors. Fast spiral CT scans utilizing dynamic intravenous contrast have resulted in very high resolution of small masses while improving accuracy of vascular staging. Improved cytology brushes and biopsy forceps during ERCP should improve the preoperative diagnosis of malignancy. Endoscopic ultrasound similarly is proving very useful for detecting small lesions, depth of invasion, and vascular involvement. Specialized use, lengthy training, and cost may limit its dissemination though. Also remarkable has been vastly improved MR images with 3‐D reconstruction (Magnetic Resonance Cholangiopancreatography). Randomized controlled trials comparing these improved and new techniques are awaited. © 1995 Wiley‐Liss, Inc.
Pancreaticoduodenectomy: The Johns Hopkins experience
Authors: Cameron John L. 
Published: February 2007

AbstractSome 60 years after Whipple popularized pancreaticoduodenectomy for carcinoma of the head of the pancreas, we have finally learned how to do the operation safely. When it is done before lymph node spread, the operative procedure can substantially prolong survival. The task for the immediate future is to identify a solid tumor marker that will facilitate earlier diagnosis of this disease at a stage prior to lymph node spread. In addition, adjuvant therapy which has clearly been shown to be effective, needs to be improved. © 1995 Wiley‐Liss, Inc.
Pancreatic cancer: An overview
Authors: Wanebo Harold J. , Vezeridis Michael P. 
Published: February 2007

AbstractThere are about 27,000 new cases of carcinoma of the pancreas each year and most afflicted patients will die of the disease. Although smoking is a common denominator, chronic pancreatitis is considered to be an important precursor lesion, but to a much lesser degree. Pancreatic cancer is primarily a disease of the pancreatic ducts. The molecular events are under intense study, but c‐K‐ras mutation is involved in about 80% of the cases and p53 to a slightly lesser degree (60–80%). Early manifestations are usually occult with jaundice being a relatively early manifestation. Diagnostic imaging with thin slice computerized tomography and portography, along with endoscopic retrograde cho‐langiopancreatography (ERCP), are currently the most sensitive detection techniques. The developing use of endoscopic ultrasound and laparoscopy appear to enhance detection and are under evaluation. In advanced disease, endoscopic bypass may eliminate the need for unnecessary surgery in many patients, although gastrointestinal bypass is still required in some (10–15%). Curative resection is possible in selected patients (perhaps 10–15%) with expectation of extended survival ranging from 6 to 20% in some series. The survival differences may be related to stage, patient selection, and the expertise of the operative team. Pre‐operative chemoradiation is under study and may improve outcome. Clinical trial participation is essential for improvement in treatment outcomes. © 1995 Wiley‐Liss, inc.
Advances in osseointegrated implants for dental and facial rehabilitation following major head and neck surgery
Authors: Beumer John , Roumanas Eleni , Nishimura Russell 
Published: February 2007

AbstractOsseointegrated implants can be used to facilitate rentention stability and support for facial and intraoral prostheses used to restore head and neck defects. Preliminary studies indicate that in nonirradiated maxillectomy patients the success rates are about 75%. In the reconstructed mandible the results appear to be more favorable—over 90% for implants placed in free nonvascularized bone grafts and over 90% for free revascularized bone grafts. Similar high success rates have been observed for most sites used to support facial prostheses. Success rates for auricular sites exceed 95% and for floor of nose sites success rates exceed 90%. Success rates have been lower (77%) for implants placed in the frontal bone for retention of orbital prostheses. Success rates for irradiated bone sites have been lower and range from 60.4% in the maxilla to 68.6% in facial bone sites. Of greater concern is that most implants placed in irradiated sites are beginning to show signs of impending failure. © 1995 Wiley‐Liss, Inc.
Reconstruction of the pharynx and cervical esophagus
Authors: Coleman John Joseph 
Published: February 2007

AbstractThe recent twenty years have brought major advances in reconstruction of pharyngoesophageal defects. Early dependence on multiple staged procedures initially were replaced by colon interposition and gastric pull‐up. Subsequent elucidation of the musculocutaneous concept has added useful techniques such as the sternocleidomastoid and pectoralis major musculocutaneous flaps. Increasing experience with microsurgical reconstruction and a larger number of flaps available have made free tissue transfer a common and reliable method of reconstruction of significant defects.The choice of reconstruction depends to greatest degree on the oncologic needs of the situation. If the entire esophagus or significant part of the thoracic esophagus is involved by tumor then total esopha‐gectomy and gastric pull‐up or colon interposition is indicated. For most hypopharyngeal and laryngopharyngeal tumors, and a significant number of cervical esophageal tumors, segmental resection of the area with the appropriate node dissection and replacement with a jejunal free autograft or radial forearm free flap gives a high likelihood of success. Thoracic musculocutaneous flaps may be useful if proper precautions are observed in the reconstructive technique. This article presents the accumulated experience with these techniques and management of the subsequent problems. © 1995 Wiley‐Liss, Inc.
Changing trends in the management of salivary tumors
Authors: Spiro Ronald H. 
Published: February 2007

AbstractFine‐needle aspiration biopsy (FNAB) and computed tomography (CT) or magnetic resonance imaging (MRI) are useful in the evaluation of salivary gland tumors, but they are not essential for treatment planning in every patient. The mainstay of therapy is a well‐planned and carefully executed surgical procedure which adequately excises the tumor. Disease‐free survival is very likely in patients with early stage malignant tumors. When treatment is delayed until the tumor is extensive (Stage 3,4), local recurrence and distant metastases are common and survival rates are low. Adjunctive postoperative radiation therapy can enhance locoregional control in the latter patients, but does not invariably lead to better survival. No consistently effective chemotherapy agents or combinations are presently available. Early diagnosis and consistent, high quality treatment offer the best hope for improved survival. © 1995 Wiley‐Liss, Inc.
Advances in radiotherapy for head and neck cancer
Authors: Mendenhall William M. , Parsons James T. , Buatti John M. , Stringer Scott P. , Million Rodney R. , Cassisi Nicholas J. 
Published: February 2007

AbstractSelected advances in radiotherapy for treatment of head and neck cancer are reviewed. These include the role of postoperative radiotherapy, planned postirradiation neck dissection, altered fractiona‐tion, neoadjuvant chemotherapy and radiotherapy for laryngeal preservation, three‐dimensional conformal treatment planning, charged particle irradiation for skull base tumors, and stereotactic radiosur‐gery. © 1995 Wiley‐Liss, Inc.
Chemotherapy advances in head and neck oncology
Authors: Liggett William , Forastiere Arlene A. 
Published: February 2007

AbstractChemotherapy has an expanding role in the treatment of squamous cell carcinoma of the head and neck. Patients with recurrent or meta‐static disease that have a good performance status should receive combination therapy with cisplatin and 5‐fluorouracil or enter investi‐gational protocols. Neoadjuvant chemotherapy should be offered to patients with laryngeal carcinoma as an alternative to surgery. Adjuvant chemotherapy should be considered in patients with an increased risk for relapse. Combined chemoradiotherapy may improve locore‐gional control and impact on survival. Chemoradiotherapy warrents further investigation through clinical trials and should be considered for patients at high risk for relapse. As the biology of these tumors becomes better defined, so too will our ability to define subsets of patients who may benefit from combined modality treatment. © 1995 Wiley‐Liss, Inc.
Basic science advances in head and neck oncology: The past decade
Authors: Schantz Stimson P. 
Published: February 2007

AbstractResearch advances over the past decade have led to a changing perception of the natural history of head and neck cancer. For instance, we now have the capacity to quantify and characterize various environmental carcinogens bound to mucosal DNA. These DNA adducts provide a quantitative measure of a disease process which exists long before clinically defined cancer is recognized. Similarly, histopathologically normal mucosa within head and neck cancer patients is currently known to express multiple genetic abnormalities including increased cellular DNA content, mutations in cell regulatory genes, as well as alterations in growth factors and their associated receptors. These subclinical events may, likewise, be associated with aberrant cellular proliferation and differentiation which provide a target for subsequent therapy. Disease invasion and metastases is now seen as a heterogenous process involving a complex of factors intrinsic to both the host as well as the cancer. Most significantly, advanced disease is not simply defined by its size and location. Rather, the progression of head and neck cancer is a dynamic process characterized by increasing genetic instability leading to an accumulation of critical mutational events. A biologic basis for resistance to treatment is thus being defined. Treatment strategies based on these laboratory advances are emerging and involve monoclonal antibody targeting, cytokines produced through recombinant molecular technology, and gene therapy. © 1995 Wiley‐Liss, inc.
Laser photochemotherapy: A less invasive approach for treatment of cancer
Authors: Saxton R. E. , Paiva M. B. , Lufkin R. B. , Castro D. J. 
Published: February 2007

AbstractThe effectiveness of combining surgery with chemo‐ and radiation therapy in treatment of human cancer provides a useful model for further development of new multimodality approaches including laser photochemotherapy. Laser endoscopy often is a useful treatment for obstructive tumors in airways, but interstitial laser fiberoptics is becoming a more precise, minimally invasive alternative for ablation of unresectable or recurrent neoplasms. Combining intratumor chemotherapy with laser energy delivery via interstitial fiberoptics should be most effective using drugs activated by photothermal energy. A number of investigators have shown that anthracyclines and cis‐platinum are likely candidates for light or heat activation in cancer cells. An advantage of anthracyclines is their dual role as antitumor drugs and as photosensitizers. Because they are effective chemotherapy agents without photoactivation, two approaches are possible to increase tumor responses. Maximum tolerated dose followed by photoillumina‐tion via laser fiberoptics can be used to obtain better tumor palliation. Improved treatment response to lower intratumor drug levels after laser activation also should reduce systemic toxicity. Preclinical studies and recent case reports from several groups suggest photochemotherapy with currently approved drugs and lasers may soon become an attractive alternative for treatment of recurrent tumors in cancer patients. © 1995 Wiley‐Liss, Inc.
Nd:YAG laser procedures in tumor treatment
Authors: Philipp Carsten M. , Rohde Ewa , Berlien H.‐Peter 
Published: February 2007

AbstractDue to the wide variability of tissue interactions and the possibility of specific applications, the neodymium‐yttrium‐aluminum‐garnet (Nd:YAG) laser is the most important surgical laser. With the adequate choice of application mode and relationship between interaction time and power density, it can be used for precise cutting in the contact mode with the bare fiber, with either a wide or small coagulation seam. With a handpiece a precise focal coagulation for preparation and hemostatic purposes is possible, as well as cutting with the focussed noncontact beam where additionally a wide coagulation seam is necessary. Endoscopically guided coagulation, vaporization, and cutting are possible with bare fibers which can be introduced through nearly all endoscopes. With increasing importance, the possibility for wide and homogeneous volume coagulation is used to destroy diseased tissues either by noncontact irradiation or interstitial placement of the fiber. Thus, the field of laser application in tumor therapy ranges from the treatment of superficial tumors to endoscopie tumor ablation, resection of neoplastic tissue in parenchymatous organs, and interstitial thermotherapy with coagulation of deep‐seated primary and secondary malignancies. With its different application modes the laser can be used as a surgical instrument or as a central therapeutical method, whereby perfect control of tissue interactions is always possible by using either visual control for superficial and endoscopie procedures or magnetic resonance imaging and color‐coded duplex sonography as a control for interstitial procedures. During 12 years of clinical work we have developed several application modes and have proved the NdrYAG laser to be an effective instrument in tumor therapy. © 1995 Wiley‐Liss, Inc.
Laser surgery in gynecologic oncology
Authors: Schellhas Helmut F. 
Published: February 2007

AbstractIn the treatment of premalignant epithelial cancers of the female lower genital tract, the CO2 laser beam is used with precision through a surgical microscope for tissue ablation and excision. Intra‐abdominal vaporization of abnormal tissues can be performed endoscopically through fiberoptics. Surgical lasers provide thermal scalpels for hemo‐static excision of malignant lesions. Photodynamic therapy is applied in the treatment of isolated malignancies persistent after conservative treatment. Surgical laser systems are important tools in the treatment of gynecologic malignancies. © 1995 Wiley‐Liss, Inc.
Endoscopie treatment of gastrointestinal tumors: Indications and results of laser photocoagulation and photodynamic therapy
Authors: Spinelli Pasquale , Mancini Andrea , Fante Marco Dai 
Published: February 2007

AbstractBoth Nd:YAG laser and photodynamic therapy (PDT) have ideal indications in endoscopie treatment of gastrointestinal (GI) tumors. A retrospective analysis of 3,505 Nd:YAG laser treatments in 1,015 patients revealed that recanalization of inoperable tumors can be obtained in 93% and 97% of patients with upper and lower GI neoplasms, respectively. Subjective improvement of symptoms was achieved in 74% and 97%, respectively. The overall morbidity and mortality rates were 3% and 1%, respectively, for upper GI tumors and 3% and 0.5% for lower GI tumors. Colorectal adenomas were eradicated in 84% of cases, with a morbidity and mortality of 5% and 0%, respectively. Early stage esophageal and gastric carcinomas were treated with Nd:YAG laser when lesions had well‐defined borders or protruded over the mucosal surface and with PDT (38 PDT cycles in 27 patients) in the case of undefined borders or ulcerated lesions. The cure rate was 73% for esophageal tumors and 85% for gastric tumors. Sunburns after photosensitization and local complications occurred in 7% and 6% of patients, respectively. No death was related to endoscopie treatment. © 1995 Wiley‐Liss, Inc.
Lasers in rectosigmoid tumors
Authors: Brunetaud Jean Marc , Maunoury Vincent , Cochelard Dominique 
Published: February 2007

AbstractOver a 14‐year period, 746 patients were treated at the Lille Laser Center for rectosigmoid tumor. Two hundred seventy‐two patients were treated for palliation of symptoms from rectosigmoid cancer and 474 patients were treated for a benign rectosigmoid villous adenoma. The immediate success rate and complication rate were 85% and 2%, respectively, for patients with advanced cancer, and 92.8% and 1.8% for those with a villous adenoma. Patients with an advanced cancer remained functionally improved during a 10.1‐month average period after initial improvement. The recurrence rate after initial treatment for villous adenomas was 18% during a 29.7‐month average follow‐up. Immediate results were influenced by reason for treatment, initial symptoms, and circumferential extension for patients with a cancer, and only by circumferential extension for patients with a villous adenoma. Long‐term results were influenced by reason for treatment and circumferential extension for patients with cancer, and by reason for treatment, initial histology and localization for patients with a villous adenoma. Laser treatment provided relief of symptoms in inoperable patients with advanced rectosigmoid carcinomas. Because treatment is long and difficult and the cancer rate is high, endoscopic laser should be limited in patients with a circumferential villous adenoma to non‐surgical candidates. The risk of complication after surgery (some being fatal) has to be balanced against the risk of undetected carcinoma and the indication for endoscopic laser treatment should be discussed case by case. © 1995 Witey‐Liss, Inc.
Photodynamic therapy of brain tumors
Authors: Popovic Emil A. , Kaye Andrew H. , Hill John S. 
Published: February 2007

AbstractPhotodynamic therapy (PDT) is a binary treatment modality suitable for various malignant tumors including brain. It involves the selective uptake of a photosensitizer into tumor followed by intraoperative irradiation of the tumor with light of an appropriate wavelength to cause activation of the sensitizer and subsequent selective tumor destruction. PDT has been extensively investigated in laboratory studies and has been used in clinical trials to treat a variety of brain tumors, particularly gliomas. The main advantage of PDT lies in its ability to select out infiltrating tumor cells that are responsible for local tumor recurrence. The therapy has been shown to be safe clinically but adequate trials have yet to be undertaken to prove its efficacy and much work remains to be done to optimize treatment. The biological basis, laboratory studies, and clinical trials involving PDT in the treatment of cerebral tumors are discussed. © 1995 Wiley‐Liss, inc.
Use of photodynamic therapy for the management of pleural malignancies
Authors: Pass Harvey I. , Donington Jessica S. 
Published: February 2007

AbstractPhotodynamic therapy (PDT) is a surface oriented, locally cytotoxic intervention being investigated for oncologic therapy. Surfaces such as the pleura or the peritoneum are frequently involved with primary or metastatic cancer, and the chance for cure in such situations is low due to the inability to eradicate all the disease. A series of investigations have been performed at the National Cancer Institute since 1985 studying the possible use of PDT for large cavity treatment. This report details evolution of the methodology, toxicity, and overall feasibility of the delivery of intrapleural PDT to patients after debulking of primary and malignant chest neoplasms, with an emphasis on malignant pleural mesothelioma. These investigations have culminated in an ongoing Phase III trial to define the efficacy of intrapleural PDT. © 1995 Wiley‐Liss, Inc.This article is a U.S. Government work, and, ans such, is in the public domain in the United States of America.
Intracavitary photodynamic therapy for malignant pleural mesothelioma
Authors: Takita Hiroshi , Dougherty Thomas J. 
Published: February 2007

AbstractA total of 31 patients with malignant pleural mesothelioma disease, limited to one hemithorax, were entered into a phase II study of surgery and intracavitary photodynamic therapy. Photofrinr̀, 2 mg/kg, was injected intravenously, and 48 hours later the patient was taken to the operating room. Bulk tumor was excised by a pleurop‐neumonectomy or pleurectomy. The patient then received 20–25 J/cm2 of 630 nm light energy from an argon dye laser. The overall estimated median survival of patients of all stages was 12 months. Survival of stage III and stage IV patients was 8 months. The median survival of 9 patients with stage I and II disease was 21 months. We plan to continue this clinical trial; however, entry will be limited to patients with stage I and II disease. The light dose for photodynamic therapy will be carefully increased to find the maximal tolerated dose. © 1995 Wiley‐Liss, Inc.