Preoperative therapy

Table 3 Paclitaxel in Preoperative Therapy for Carcinoma of the Esophagus ...

Recent preoperative chemoradiation studies of resectable pancreatic cancer have demonstrated improved survival. One of the first of these evaluated preoperative therapy using 50.4 Gy standard fractionation irradiation with a concurrent continuous infusion of low-dose 5-FU in patients having resectable pancreatic adenocarcinoma (52). The recurrence rate and median survival duration were better than those historically reported for patients only undergoing pancreatoduodenectomy (53). These findings prompted further studies evaluating the role of preoperative chemoradiation in patients having resectable pancreatic cancer. Data on 132 consecutive patients who received preoperative 5-FU and... 

Gy of irradiation demonstrated a median survival duration of 21 mo (54). Using similar preoperative therapies, smaller studies demonstrated similar findings of improved survival (50,55,56). 

The role of preoperative therapy for resectable disease remains ill defined. Local recurrence after curative resection of gallbladder cancer can be as high as 86% (70). Resected bile duct cancers have a rate of local recurrence of 25-40% (71). 

This study has again confirmed that endometrial problems can be induced by tamoxifen early in the course of treatment and that these problems do not arise with aromatase inhibitors, which may actually reduce the endometrial changes induced by tamoxifen. The idea that the new oral aromatase inhibitors might well replace tamoxifen in breast cancer was tentatively advanced in SEDA-26 (p. 445) and has now been supported by some of the material cited above, as well as by a panel consensus (25). Citing efficacy and safety data on anastrozole, exemestane, and letrozole, the authors concluded that third-generation aromatase inhibitors may be considered first-line therapy of hormone-receptor-positive advanced breast cancer in postmenopausal women and may also be used for preoperative therapy of breast cancer. 

Dibenamine has been employed with excellent results in the diagnosis and preoperative therapy of pheochromocytoma (90, 91). The pressor response evoked by the histamine test in these patients is completely blocked and reversed, and the injection of Dibenamine at 72-hour intervals has been found to provide complete symptomatic relief. In human essential hypertension, therapy with Dibenamine produces a very significant fall in both systolic and diastolic pressures in some patients (see 12). In severe hypertension, particularly the malignant form, the drug has been found to lower the blood pressure significantly in most cases, but rarely to return it to the normotensive range. However,... 

Schonberger, J.P., Bredee, JJ., van Oeveren, W., van Zundert, A A., Verkroost, M., Terwoorst, J., Bavinck, J.H., Berreklouw, E., and Wildevuur, CJi. (1993) Preoperative Therapy of Low-Dose Aspirin in Internal Mammary Artery Bypass Operations with and without Low-Dose Aprotinin. J. Thorac. Cardiovasc. Surg. 106, 262-267. 

Vecchio FM et al. (2005) The relationship of pathologic tumor regression grade (TRG) and outcomes after preoperative therapy in rectal cancer. Int J Radiat Oncol Biol Phys 62(3) 752-760... 

There are numerous applications and indications for neurovascular MDCT. These include comprehensive stroke imaging, evaluation of the extra- and intracranial vasculature of head and neck, as well as preoperative therapy planning. In this chapter we wiU focus on the most commonly used and on more specialized, but highly relevant neurovascular MDCT applications. 

Wanebo HJ, Chung MA, Levy AI, Turk PS, Vezeridis MP, Bel-liveau JF (1996) Preoperative therapy for advanced pelvic malignancy by isolatedpelvic perfusion with the balloon-occlusion technique. Ann Surg Oncol 3(3) 295-303 Wieberdinck K, Benckhuijsen C, Braat RP et al (1982) Dosimetry in isolation perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions. Eur J Cancer Clin Oncol 18 905-910... 

Tournade ME, Com-Nougue C, de Kraker J et al (2001) Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms tumor in children older than 6 months results of the Ninth International Society of Pediatric Oncology Wilms Tumor Trial and Study. J Clin Oncol 19(2) 488-500... 

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