Tuesday, May 29, 2012

RT for prevention of nodal recurrences of Melanoma

Lancet Oncology this week:

The  Australian trial of adjuvant RT for nodal basins for melanoma, initially presented in ASTRO several years ago, has finally seen publication - again confirming a local control benefit to 48Gy in 24 fractions.  The entry criteria was slightly complex, depending on size and # of nodes that was different per site, with extranodal extension always qualifying.  Perhaps not surprisingly, there was no benefit for survival in such a small trial, but it was not powered for this regardless.  In light of the relative lack of efficacy of standard chemotherapy, RT still seems to be the most reasonable option of any treatment outside of those with BRAF mutations.


[Articles] Adjuvant radiotherapy versus observation alone for patients at risk of lymph-node field relapse after therapeutic lymphadenectomy for melanoma: a randomised trial: Adjuvant radiotherapy improves lymph-node field control in patients at high risk of lymph-node field relapse after therapeutic lymphadenectomy for metastatic melanoma. Adjuvant radiotherapy should be discussed with patients at high risk of relapse after lymphadenectomy.

Capecitabine for Rectal Cancer

In Lancet Oncology:

A phase III trial comparing RT + capecitabine vs 5FU for rectal cancer - fortunately has confirmed what is already common practice in the US - capecitabine proved no worse (by their criteria).  All trends as well favored capcitabine for disease control.  Capcitabine proved more toxic however, in all but leukopenia.


[Articles] Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial: Capecitabine could replace fluorouracil in adjuvant or neoadjuvant chemoradiotherapy regimens for patients with locally advanced rectal cancer.