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Dr. Sardi and colleagues lay out, in a clear and concise fashion, current alternatives for the management of primary and metastatic liver tumors. Their emphasis on "high-value" treatments is crucial. In this group of patients, unnecessary treatments not only are costly in terms of dollars but also reduce the quality of the short life remaining in patients with unresectable disease.

Primary and metastatic liver tumors continue to be a significant health problem in the United States. Hepatic resection or, in selected cases, transplantation are the only curative therapies for patients with resectable

Historically, new therapeutic strategies for cancer have been evaluated on the basis of safety and clinical efficacy. However, the current national emphasis on efficiency of resource allocation has led to the inclusion of economic assessments in oncology studies. Economic assessments measure patients' health status and resource consumption associated with a therapeutic strategy, and combine these in a cost-effectiveness analysis. Study design can include prospective analysis of clinical trials, retrospective analysis of a clinical trial or administrative databases, or a decision analytic model. Economic analysis is being used increasingly in oncology and will continue to provide meaningful data to assist clinicians in determining the optimal treatment strategies for cancer patients and to help inform health policy decision-makers about the importance of specific cancer therapeutic strategies. [ONCOLOGY 9(6):523-538, 1995]

Radiation therapy of tumors near the eye or optic nerves often requires incidental irradiation of these structures, even when they are not clinically involved by tumor. Depending on the radiation treatment volume and dose required, radiation injury to the lens, lacrimal apparatus, retina, or optic nerve may result. The time to expression and severity of injury are dose-dependent. This paper reviews the results of 157 patients who were followed for a minimum of 3 years after radiotherapy for primary extracranial tumors at the University of Florida, in which the lacrimal gland, lens, retina, and/or optic nerve(s) received irradiation. This review shows that, after treatment at approximately 1.8 to 2.0 Gy per fraction, the incidence of severe dry-eye syndrome, retinopathy, and optic neuropathy appears to increase steeply after doses of 40, 50, and 60 Gy, respectively. [ONCOLOGY 10(6):837-852, 1996]

WASHINGTON--Put GAR in your patients' records. It can prove extremely useful should you find yourself being sued for medical malpractice, Marvin A. Dewar, MD, JD, said at the National Conference on Prevention and Early Detection, sponsored by the American Cancer Society.

This review focuses on the clinical utility and potential value of cell cycle analysis and DNA ploidy interpretation in the diagnosis of human tumors, the application of these techniques to cytologic diagnosis, and their capability

CARDIFF, Wales--Breast imaging studies can proceed immediately after fine-needle aspiration (FNA) cytology without concern that the biopsy procedure will distort tissue architecture and compromise diagnostic accuracy, said Neil Fenn, MD, a breast disease specialist at the University of Wales.

Pediatric Cancer Guidelines Are a National Effort

WASHINGTON--The Environmental Protection Agency (EPA) is proposing that scientists rely less on animal testing and more on microbiological studies in calculating the cancer risk of chemicals and pollutants. The new regulations would place more emphasis on how chemicals actually affect human cells.

BOTHELL, Wash--A High Definition Imaging (HDI) digital ultrasound system from Advanced Technology Laboratories (ATL) has been granted FDA approval for a new indication--adjuvant use with mammog-raphy and physical examination to help physicians determine if a biopsy is necessary after discovery of a suspicious breast lesion.

Radiation therapy targeted at the cellular level can halt the advance of lymphoma while avoiding the major drawbacks of chemotherapy, according to a Stanford University study in the March 1996 issue of Clinical Cancer Research.

BETHESDA, Md--Although only 10 mg/day of vitamin C is enough to prevent deficiency, the optimal daily intake is probably 200 mg, according to results of a new NIH-sponsored study. The current Recommended Dietary Allowance (RDA) is 60 mg.

NEW YORK--The more that is learned about the natural history of the human immunodeficiency virus (HIV), the stronger the case for early intervention. Recent research confirms "the notion that HIV infection is a dynamic process throughout the course of infection," said H. Clifford Lane, MD, clinical director, National Institute of Allergy and Infectious Diseases (NIAID).

Meriden, Conn--A 5-year study at Walter Reed Army Institute of Research found no significant clinical benefit for patients receiving MicroGenesys, Inc's therapeutic AIDS vaccine,VaxSyn rpg 160,compared with placebo, the company has announced.

WASHINGTON--Representative John Edward Porter of Illinois has received an American Academy of Otolaryngology--Head and Neck Surgery, Inc. award for "superb legislative leadership for medical research."

WASHINGTON--Caring for patients and conducting research in the age of managed care raises tough problems for all involved, said Peter Quesenberry, MD, director, University of Massachusetts Cancer Center, Worcester. "How can we assure access to treatment, support research, and still be cost effective?"

On May 26, 1995, Philip Morris USA* announced a voluntary recall of 36 cigarette product lines (approximately 8 billion cigarettes) because, during production, the company detected unusual tastes and peculiar odors and identified methyl

PRINCETON, NJ--Blenoxane (bleomycin), Bristol-Myers Squibb Co.'s anticancer agent, has received FDA clearance for a new indication as intrapleural therapy for the relief of symptoms resulting from malignant pleural effusion (MPE) and prevention of recurrent pleural effusions.

MARINA DEL REY, Calif--The changing reimbursement system in California provides a "real challenge" for academic institution to compete on cost with other area hospitals, said Robert B. Smith, MD, professor of surgery/urology, UCLA School of Medicine, at a conference cosponsored by the Clark Urological Cancer Center and the UCLA School of Medicine.

DUMONT, NJ--The Berlex On-cology Foundation is seeking applicants for two workshops: Epidemiology and Clinical Trial Design, to be held August 23-29, 1996, in Brewster, Mass, and The Clinical Pharmacology of Anticancer Drugs, which will take place October 4-8, 1996, in Leesburg, Va.

WASHINGTON--Community hospitals gain immensely in enhanced patient care when they form partnerships with universities, Allen S. Lichter, MD, said at the annual national meeting of the Association of Community Cancer Centers (ACCC). The benefits of such a joint venture, however, flow both ways, said Dr. Lichter, chairman of the Department of Radiation Oncology, University of Michigan.

BETHESDA, Md--Of the more than 1,300 biotech companies in North America, up to 70% are involved in health care, and many are working on cancer research, Frederick Craves, PhD, of Burrill & Craves, a merchant bank in San Francisco, said at a meeting of the National Cancer Advisory Board (NCAB).

The current health-care environment is creating many new challenges for physicians, and addressing these challenges has led to new ideas in office practice management.

NEW YORK--What with inflation, budget cutting, burgeoning grant applications, and dueling disease advocacy groups, it isn't easy being director of the National Institutes of Health. Harold E. Varmus, MD, gave an audience at the Irvington Institute a peek at what he is up against.

Researchers presented the first comprehensiveresults of Neoprobe Corporation's pivotal multicenter studies of its RIGScan product at The Society of Surgical Oncology's (SSO) 49th Annual Cancer Symposium in Atlanta on March 22.

Even couples who have been happily married for decades can suffer negative health effects from the stress of marital arguments, a new study suggests.

WILMINGTON, Del--Zeneca Inc. has reached an agreement with Faulding Services Inc. (Adelaide, South Australia) for exclusive US rights to purchase, distribute, and promote Faulding's sustained-release morphine sulfate product Kadian, an oral medication taken once or twice daily.

Should an insurance company be able to deny children medical coverage because their mother died of an inherited heart defect that her children may or may not carry? That is the dilemma facing a California father who cannot get family medical coverage under his group plan as a result of his wife's death. And that is a dilemma crying out for congressional intervention.

BUFFALO, NY--Adding a chimeric anti-CD20 antibody to standard CHOP chemotherapy appears to produce a synergistic therapeutic effect in low-grade B-cell lymphomas. Patients on the regimen have achieved complete remissions and disappearance of the bcl-2 translocation, principal investigator Myron Czuczman, of the Roswell Park Cancer Institute, said at the annual Chemotherapy Foundation symposium.

BETHESDA, Md--The National Center for Human Genome Research at the NIH has announced six research grants that are expected to propel forward the final phase of the Human Genome Project, headed by Dr. Francis Collins.