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This Viewpoint compares MammoSite® brachytherapy with other forms of partial breast irradiation. Although very few reports on clinical efficacy have been published, indications so far are that the MammoSite®catheter is technically simple, adequately spares normal tissues, and is associated with a favorable cosmetic outcome and toxicity profile. The choice of the optimal irradiation method remains complex and requires input from both treating physicians and their patients.
This Viewpoint compares external-beam-based partial breast irradiation with other forms of partial breast irradiation. With appropriate patient selection, delivery of partial breast irradiation through an external-beam approach presents many advantages, including patient acceptability, ease of use and cost effectiveness. Silvia Formenti discusses the relative merits of prone and supine patient positioning during external-beam radiotherapy and the important challenges that remain.
Malignant pleural mesothelioma (MPM) is a common primary tumor of the pleura. Current therapeutic regimens that involve surgery, chemotherapy and radiotherapy have offered marginal clinical benefits. Histological subtype, lymph-node involvement, resection margins and invasion beyond the pleura are significant factors that dictate survival. This review discusses the multimodality approach, which is considered the cornerstone of treatment of MPM, although the authors emphasize that the exact combination of treatment options for this disease have yet to be defined.
Fertility preservation is an important component of cervical cancer treatment, and recently radical surgical procedures have been used in favor of more conservative techniques in an effort to decrease morbidity and preserve fertility without compromising overall survival. The authors of this Review suggest radical vaginal trachelectomy is a safe and feasible procedure in women wishing to preserve fertility, and they review the preoperative considerations, surgical complications and the risk factors associated with this technique.
Brain tumors are currently diagnosed on the basis of their histology, but recent findings indicate that in some cases response to conventional therapy correlates with genetic characteristics rather than histopathology. An understanding of the molecular mechanisms that underlie the malignant phenotype of gliomas also provides the possibility of rational design of molecular targeted therapies, as discussed in this review.
Cervical cancer is one of the most frequent malignancies diagnosed during pregnancy. Karam et al. report the case of a 28-year-old woman who was diagnosed with poorly-differentiated stage IB2 squamous-cell cervical carcinoma at 23 weeks of gestation. The patient received neoadjuvant cisplatin, underwent radical cesarean hysterectomy and after delivery commenced pelvic radiation therapy with cisplatin chemosensitization. The authors discuss the treatment and management options for women diagnosed with cervical carcinoma during pregnancy and review the reported experience with the use of chemotherapy in such cases.
