Volume 4 Issue 7, July 2007

This Viewpoint compares multicatheter brachytherapy with other forms of partial breast irradiation. As the forerunner of other ABPI techniques, interstitial brachytherapy has to its credit the best intermediate-term to long-term oncological and cosmetic results, and to its discredit some of the highest recurrence and complication rates. Enhancements to quality assurance and patient selection criteria could hold the key to best practice.

This Viewpoint compares targeted intraoperative radiotherapy with other forms of partial breast irradiation. Advantages of targeted intraoperative radiotherapy include reduced risk of the target area being untreated, the potential to add external-beam whole-breast radiotherapy, cost-effectiveness of this technique and relatively straightforward technical requirements.

The goal of allogeneic hematopoietic stem-cell transplantation (alloHSCT) in the treatment of hematological malignancies is to harness the graft-versus-leukemia (GVL) effect, while minimizing the risk of graft-versus-host disease (GVHD). AlloHSCT research has focused on the GVL target antigens and effector mechanisms, and on potential approaches to exploit the GVL effect independently of GVHD. In this review, the authors focus on the currently available approaches to exploit these GVL mechanisms and discuss some of the newer approaches that have been explored in clinical practice.

Breast cancer is a heterogeneous group of diseases and hormone receptor status defines important clinical and etiologic differences between breast cancer subtypes. This article reviews the epidemiologic data on differences in risk factor associations by hormone receptor status, and highlights the limitations of commonly used prediction models. The authors describe how receptor status information can be applied to risk analysis for screening and preventive therapies.

Hepatocellular carcinoma (HCC) generally develops as a consequence of underlying liver disease, most commonly viral hepatitis. Currently, surgery remains the treatment of choice for HCC; however, due to underlying liver disease only a minority of those affected are candidates for resection, and access to transplantation is limited by organ availability. The authors of this review discuss when liver resection, nonsurgical HCC treatment and management before liver transplantation should be considered, and the applications of nonsystemic therapies.

Children with Down syndrome who develop transient myeloproliferative disorder or acute megakaryoblastic leukemia harbor somatic mutations in theGATA1 gene, a phenomenon specific to this syndrome. Heald and colleagues report the first case of a stillborn fetus with Down syndrome-associated acute megakaryoblastic leukemia/transient myeloproliferative disorder and a GATA1mutation. The authors discuss the management of fetuses with suspected or confirmed diagnosis of Down syndrome and highlight the need for genetic screening and counseling based on maternal age.