ONCOLOGY Vol 11 No 9

It is now established that the treatment of choice for limited small-cell lung cancer (SCLC) in the United States, Canada, and Japan is thoracic radiotherapy (TRT)

Breast-conserving therapy with lumpectomy and breast irradiation is an accepted standard treatment for patients with early-stage invasive breast cancer or ductal carcinoma in situ (DCIS). For both diseases, investigators have tried to identify subgroups of patients who can be "safely" treated with lumpectomy without radiation. Some data suggest that it may be reasonable to omit radiation therapy in patients with small, low-grade invasive or noninvasive tumors and/or in "elderly" patients. Additional studies are needed to better identify criteria to prospectively select appropriate patients for treatment with lumpectomy alone. [ONCOLOGY 11(9):1361-1374, 1997]

To irradiate or not to irradiate, that is the question posed by Marks and Prosnitz for women with early invasive breast cancer or ductal carcinoma in situ (DCIS) undergoing breast conservation therapy (BCT). Due in large part to mammography, there has been in the 1990s a significant increase in the percentage of women presenting with stage 0 (DCIS) and stage I breast cancer, as recorded by the Surveillance, Epidemiology and End-Results Program of the National Cancer Institute (NCI). The generally excellent outcome of these tumors with current therapy has focused research efforts on studies directed at improving quality of life and minimizing the side-effects and expense of local therapy. In this regard, Marks/Prosnitz present a concise and balanced summary of results from randomized and non-randomized clinical trials, and develop a rationale for current treatment recommendations and future studies regarding the role of breast irradiation (RT).

A solitary pulmonary nodule (SPN) is the most common radiographic presentation of lung cancer. The imaging characteristics of solitary pulmonary nodules are described and illustrated. The appearance and implications of

Drs. Enright and McGlave succinctly review the biology of chronic myelogenous leukemia (CML) and highlight the therapeutic role of allogeneic stem-cell transplantation. Two points, however, warrant further discussion. The first is that a regimen containing interferon-alfa (Intron A, Roferon-A) is optimal front-line therapy for the great majority of CML patients.[1] The second is that use of an interferon-alfa-based regimen prior to allogeneic stem-cell transplantation does not adversely affect post-transplant mortality, morbidity, or anti-CML efficacy.