Radiotherapy

Eleven cases of cardiac metastases from soft-tissue sarcomas Takenaka, S. et al. Jpn. J. Clin. Oncol. 41, 514–518 (2011)

Cardiac metastases are a life-threatening complication that, although uncommon, occur in patients with soft-tissue sarcoma. In many cases, cardiac metastasis is asymptomatic, but it should be treated and therefore clinicians managing patients with soft-tissue sarcoma should be aware of the necessity of screening for these metastases. A recent study showed that echocardiography is more effective than CT scans at detecting cardiac metastasis. After detection, in those treated with radiotherapy, median survival was 10.5 months; in untreated patients it was 3.5 months. These findings indicate that radiotherapy should be the first treatment option for patients with soft-tissue sarcoma and cardiac metastasis.

Surgery

Successful treatment of postchemotherapy azoospermia with microsurgical testicular sperm extraction: the Weill Cornell experience Hsiao, W. et al. J. Clin. Oncol. doi:10.1200/JCO.2010.33.7808

The increased survival of many men treated for cancer during childhood has implications for later fertility. Although prechemotherapy sperm preservation is the recommended course of action, in patients where this option is not available, or was not carried out, a recent study offers hope. In 73 patients who were azoospermic after chemotherapy treatment (mean time since chemotherapy was 18.6 years), microdissection testicular sperm extraction and intracytoplasmic sperm injection was carried out. A 57.1% fertilization rate was achieved and 20 live births resulted from 15 pregnancies, showing the potential for this technique.

Chemotherapy

Cytarabine dose for acute myeloid leukemia Löwenberg, B. et al. N. Engl. J. Med. 364, 1027–1036 (2011)

Increasingly, studies have shown that less can be more when it comes to treating patients with toxic chemotherapies. In the case of using cytarabine for induction in patients with acute myeloid leukemia (AML), it had been shown that high doses can increase relapse-free survival compared with the conventional lose-dose treatment. However, intermediate doses have not been analyzed. A recent study demonstrated, at a median follow up of 5 years, that an intermediate cytarabine dose (200 mg/m2 during cycle one and 1,000 mg/m2 during cycle two) produced the maximal antileukemic effect in 431 patients with AML. This finding indicates that the higher dose would have no clinical impact, just an increased level of toxic effects.