- The document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Colon Cancer. It lists the panel members and provides a summary of recent updates made in Version 3.2022.
- Key updates include adding tucatinib in combination with trastuzumab as a treatment option for HER2-amplified metastatic colon cancer, and revising dosing information for HER2-targeted therapies.
Management of Early Breast Cancer (by Dr. Akhil Kapoor)Akhil Kapoor
Comprehensive discussion on Management of Early Breast Cancer along with NCCN guidelines.
Slides prepared by Dr. Akhil Kapoor
(Resident, Department of Radiation Oncology,
Acharya Tulsi Regional Cancer Treatment & Research Institute, Bikaner, Rajasthan, India
Radiation therapy plays an evolving role in the treatment of lung cancer beyond just causing DNA double strand breaks.
1) Stereotactic body radiation therapy (SBRT) can provide curative treatment for early stage lung cancer with high local control rates.
2) For locally advanced lung cancer, dose escalation with conventional fractionation in RTOG 0617 did not improve overall survival, highlighting the importance of fractionation and sequencing with other therapies.
3) Radiation induces tumor cell death that can elicit anti-tumor immune responses, known as abscopal effects, especially when combined with immunotherapy like anti-CTLA4 and anti-PD1/PDL1 agents which play complementary roles.
Intermediate and high risk prostate cancerShreya Singh
This document discusses the management of intermediate and high risk prostate cancer. It covers risk stratification, routes of spread including lymphatic and direct extension, clinical manifestations, diagnostic workup including imaging modalities, and treatment options including active surveillance, radiation, surgery, brachytherapy, and androgen deprivation therapy. Imaging techniques like bone scans, MRI, and PET scans are used for staging. Treatment depends on risk level and life expectancy and may involve a combination of local therapy and systemic therapy.
This document summarizes several landmark trials in breast cancer treatment. It describes trials evaluating chemoprevention using tamoxifen and raloxifene, surgery including lumpectomy versus mastectomy, sentinel node biopsy versus axillary dissection, and the role of radiation therapy. Key findings include that lumpectomy with radiation was found to have similar survival as mastectomy, sentinel node biopsy reduced arm morbidity compared to axillary dissection, and radiation therapy after lumpectomy lowered the risk of recurrence in early-stage breast cancer patients.
The document discusses triple negative breast cancer (TNBC) and early stage disease. It covers molecular subtypes of breast cancer, challenges in treating TNBC due to lack of targeted therapies, and evidence that neoadjuvant chemotherapy can improve outcomes for TNBC patients who achieve a pathological complete response. Ongoing research aims to better predict which patients will respond to neoadjuvant treatment and identify new targeted therapies for TNBC subtypes.
Management of Early Breast Cancer (by Dr. Akhil Kapoor)Akhil Kapoor
Comprehensive discussion on Management of Early Breast Cancer along with NCCN guidelines.
Slides prepared by Dr. Akhil Kapoor
(Resident, Department of Radiation Oncology,
Acharya Tulsi Regional Cancer Treatment & Research Institute, Bikaner, Rajasthan, India
Radiation therapy plays an evolving role in the treatment of lung cancer beyond just causing DNA double strand breaks.
1) Stereotactic body radiation therapy (SBRT) can provide curative treatment for early stage lung cancer with high local control rates.
2) For locally advanced lung cancer, dose escalation with conventional fractionation in RTOG 0617 did not improve overall survival, highlighting the importance of fractionation and sequencing with other therapies.
3) Radiation induces tumor cell death that can elicit anti-tumor immune responses, known as abscopal effects, especially when combined with immunotherapy like anti-CTLA4 and anti-PD1/PDL1 agents which play complementary roles.
Intermediate and high risk prostate cancerShreya Singh
This document discusses the management of intermediate and high risk prostate cancer. It covers risk stratification, routes of spread including lymphatic and direct extension, clinical manifestations, diagnostic workup including imaging modalities, and treatment options including active surveillance, radiation, surgery, brachytherapy, and androgen deprivation therapy. Imaging techniques like bone scans, MRI, and PET scans are used for staging. Treatment depends on risk level and life expectancy and may involve a combination of local therapy and systemic therapy.
This document summarizes several landmark trials in breast cancer treatment. It describes trials evaluating chemoprevention using tamoxifen and raloxifene, surgery including lumpectomy versus mastectomy, sentinel node biopsy versus axillary dissection, and the role of radiation therapy. Key findings include that lumpectomy with radiation was found to have similar survival as mastectomy, sentinel node biopsy reduced arm morbidity compared to axillary dissection, and radiation therapy after lumpectomy lowered the risk of recurrence in early-stage breast cancer patients.
The document discusses triple negative breast cancer (TNBC) and early stage disease. It covers molecular subtypes of breast cancer, challenges in treating TNBC due to lack of targeted therapies, and evidence that neoadjuvant chemotherapy can improve outcomes for TNBC patients who achieve a pathological complete response. Ongoing research aims to better predict which patients will respond to neoadjuvant treatment and identify new targeted therapies for TNBC subtypes.
This document discusses treatment options for operable gastric cancer. It notes that surgical resection is currently the only potentially curative treatment, and recommends resection for all non-metastatic cancers. While the optimal extent of lymphadenectomy is still debated, removing a minimum of 15 lymph nodes is recommended. Adjuvant chemotherapy, chemoradiation, and perioperative chemotherapy are strategies that can increase cure rates. Preoperative chemotherapy followed by postoperative chemoradiation may also improve outcomes compared to postoperative treatment alone.
This document discusses several clinical trials comparing different treatment approaches for esophageal cancer, including:
- Preoperative chemotherapy improved survival compared to surgery alone in some trials but not in others. High toxicity reduced benefits in some studies.
- Perioperative chemotherapy with fluorouracil and cisplatin significantly improved resection rates, survival, and disease-free survival compared to surgery alone.
- Chemoradiotherapy resulted in improved survival over radiotherapy alone or surgery alone in some trials for resectable esophageal cancer.
- Existing evidence did not clearly show preoperative radiotherapy alone improved survival over surgery alone for resectable esophageal cancer. Larger trials were needed.
This document provides information about breast cancer trends and facts. It discusses:
- Breast cancer is the most common cancer in women and the second leading cause of cancer death in women. Incidence rates have been rising but mortality rates have been declining since 1989 due to earlier detection and improved treatments.
- Risk factors include age, family history, dense breasts, obesity, hormone therapy use, alcohol consumption and lack of physical activity. Molecular subtypes have different survival rates and prevalence among racial groups.
- Screening guidelines and risk assessment tools can help determine screening recommendations for average and high-risk women. Lifestyle changes like diet, exercise and weight management may lower risk. Targeted therapies have improved survival for HER2
This document discusses several landmark trials comparing different treatment approaches for esophageal cancer. The CALGB 9781 trial compared trimodality therapy (chemotherapy, radiation therapy, and surgery) to surgery alone and found improved overall survival and progression-free survival with trimodality therapy. Median overall survival was 4.48 years with trimodality therapy versus 1.79 years with surgery alone. The trial was closed early due to poor accrual, resulting in a small sample size.
management of metastatic colorectal cancer Sujay Susikar
1) Metastatic colorectal cancer presents significant challenges, as around 40% of patients initially present with metastatic disease and 50% of those initially diagnosed without metastases will eventually develop them.
2) Management depends on whether metastases are synchronous or metachronous. For potentially resectable metastases, surgical resection offers the best chance of cure, with 5-year survival rates of 24-58% after resection of liver metastases.
3) For unresectable metastases, options include ablation techniques like radiofrequency ablation or cryotherapy, regional therapies like chemoembolization, systemic chemotherapy, and targeted agents. The goal is conversion to resectability with chemotherapy when possible.
This document provides information on the management of soft tissue sarcoma. It discusses the clinical presentation, patterns of spread, imaging, histology, grading, staging, prognostic factors and management of soft tissue sarcomas. The key points are:
1) Soft tissue sarcomas most commonly present as painless swellings in the extremities and can invade locally along fascial planes. Imaging like MRI is important for assessing tumor extent.
2) Histologically, the most common subtypes are undifferentiated pleomorphic sarcoma and liposarcoma. Grading systems consider tumor differentiation, mitosis and necrosis.
3) Staging is based on tumor size, depth, nodal status and metastasis
Chemotherapy can be used to treat hormone-resistant prostate cancer (HRPC) to help palliate symptoms and provide a survival benefit. Docetaxel plus prednisone was established as the standard first-line treatment based on results from the TAX 327 trial showing a median overall survival of around 18 months. Several prognostic factors can help predict survival outcomes on chemotherapy. For patients who progress after first-line docetaxel treatment, metronomic cyclophosphamide with prednisone shows promise as a well-tolerated second-line option based on early clinical trials. Ongoing research continues to evaluate new agents for first- and second-line HRPC.
Standardized Surgery for Colonic Cancer - Complete Mesocolic Excision (CMF)SociedadColoprocto
The document discusses the technique of complete mesocolic excision (CME) for colon cancer surgery. It describes CME as the standardized removal of the entire mesocolon and central ligation of supplying arteries based on embryological planes. Studies from Erlangen, Germany show that using CME results in improved lymph node harvest, lower complication rates, reduced local recurrence, and increased 5-year cancer-related survival for colon cancer patients compared to conventional surgery. The expertise of the surgeon also impacts postoperative outcomes.
1) Around 60-70% of breast cancer patients have estrogen receptor positive tumors, making them candidates for hormonal therapy which has been shown to improve survival rates.
2) Tamoxifen is the standard adjuvant hormonal therapy and has been shown to reduce breast cancer recurrence rates by 24-43% and mortality by 14-23% depending on duration of therapy.
3) Aromatase inhibitors like letrozole and anastrazole are also used as adjuvant therapy and have been shown in trials to further reduce recurrence rates compared to tamoxifen alone.
1) There are multiple options for adjuvant and perioperative treatment of resectable gastric cancer according to different guidelines.
2) Adjuvant chemotherapy is supported by evidence from trials like INT-0116 and CALGB 80101, while adjuvant chemoradiotherapy has evidence from the Macdonald trial for less than D2 surgery.
3) Perioperative chemotherapy has level 1 evidence from trials like MAGIC, FNCLCC, and FLOT4 showing improved survival compared to surgery alone. Regimens include ECF/ECX, PF, and FLOT.
The CROSS trial found that neoadjuvant chemoradiotherapy followed by surgery significantly improved long-term overall and progression-free survival compared to surgery alone for patients with resectable esophageal or esophagogastric junction cancer. At a minimum follow-up of 5 years, median overall survival was 48.6 months for chemoradiotherapy plus surgery versus 24 months for surgery alone. Both squamous cell carcinoma and adenocarcinoma subtypes benefited. Neoadjuvant chemoradiotherapy using carboplatin and paclitaxel is now considered the standard of care for these patients.
SHARE Presentation: New Developments in the Medical Treatment of Breast Cance...bkling
Dr. Cliff Hudis on the latest information on new breast cancer treatments. Dr. Hudis is Chief of Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center.
Gastroesophageal junction tumors present unique challenges due to their location between the esophagus and stomach. Siewert classification categorizes these tumors as type I, II, or III based on their epicenter location relative to the gastroesophageal junction. Type I and II tumors are typically treated with esophagectomy while type III tumors are treated with gastrectomy. Neoadjuvant chemotherapy or chemoradiation is commonly used to downstage locally advanced adenocarcinomas prior to surgery. Ongoing studies are evaluating the optimal multimodality treatment approaches for gastroesophageal junction tumors.
Soft tissue sarcomas account for less than 1% of malignant tumors but around 40% of patients die from the disease. While most soft tissue sarcomas have no clear cause, some risk factors include genetic predispositions, prior radiation therapy, and chemical exposure. A recent study found that over 50% of soft tissue sarcoma patients have a germline genetic variant contributing to tumor development. Diagnosis involves biopsy or imaging like CT or MRI. Treatment depends on location and grade, with surgery to remove the tumor with margins. High-risk cases may also receive radiation therapy or chemotherapy.
Gastric cancer discussion slides final version.pptnew.pptzoezettemarc
1) Peri-operative chemotherapy with ECX before and after surgery improves overall survival compared to surgery alone in resectable gastric cancer based on the MAGIC trial.
2) The ACTS-GT trial showed adjuvant S-1 chemotherapy improves 3-year survival compared to observation alone after D2 gastrectomy for stage II-III gastric cancer.
3) Combination chemotherapy improves survival over best supportive care alone in advanced gastric cancer, with regimens including anthracyclines and cisplatin or oxaliplatin showing better efficacy.
http://cancer-treatment-madurai.com Breast cancer is a type of cancer that starts in the tissues of the breast. Dr.S.G.Balamurugan is one of the best cancer doctor in India, offers low cost breast cancer diagnosis, breast cancer treatments and breast cancer care at Guru Cancer Hospital, Madurai.
1) Total neoadjuvant therapy (TNT) involves chemotherapy before and after chemoradiotherapy for locally advanced rectal cancer, aiming to increase downstaging and improve outcomes.
2) A review found TNT achieved a 22% pathological complete response rate compared to 13% for chemoradiotherapy alone, with possibly improved survival.
3) However, most evidence comes from observational studies. Two randomized controlled trials found TNT reduced distant metastases and improved disease-free survival compared to chemoradiotherapy alone.
Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC):
This document provides the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Neuroendocrine and Adrenal Tumors. It was last updated in January 2019 and is authored by an expert panel assembled by NCCN. The guidelines provide evidence-based recommendations for diagnosis, staging, treatment and surveillance of neuroendocrine tumors and adrenal tumors. The key updates from the previous version include expanding the name to include adrenal tumors, preferring gallium-68 dotatate PET/CT for somatostatin receptor imaging, and adding peptide receptor radionuclide therapy with lutetium-177 as a treatment option.
The document summarizes updated guidelines for the treatment of colon cancer from the National Comprehensive Cancer Network. Key updates include splitting treatment algorithms between patients with proficient mismatch repair/microsatellite stable tumors and those with deficient mismatch repair/microsatellite high tumors. New pages were added to cover treatment for dMMR/MSI-H patients. Terminology was also modified to be more inclusive. Additional changes were made to footnotes and recommendations for workup, staging, and treatment of localized and metastatic colon cancer.
- This document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for colon cancer. It provides recommendations on diagnosis, treatment including surgery, chemotherapy and radiation, surveillance, and management of recurrence for colon cancer.
- The guidelines were updated in February 2022. Key updates include clarifying use of targeted therapies like cetuximab and panitumumab for left-sided tumors only, modifying recommendations for local ablative therapies versus surgery for resectable metastases, and adding dosing information for chemotherapy regimens.
- The panel members who developed and updated the guidelines are listed, including their specialties and affiliated cancer centers.
This document discusses treatment options for operable gastric cancer. It notes that surgical resection is currently the only potentially curative treatment, and recommends resection for all non-metastatic cancers. While the optimal extent of lymphadenectomy is still debated, removing a minimum of 15 lymph nodes is recommended. Adjuvant chemotherapy, chemoradiation, and perioperative chemotherapy are strategies that can increase cure rates. Preoperative chemotherapy followed by postoperative chemoradiation may also improve outcomes compared to postoperative treatment alone.
This document discusses several clinical trials comparing different treatment approaches for esophageal cancer, including:
- Preoperative chemotherapy improved survival compared to surgery alone in some trials but not in others. High toxicity reduced benefits in some studies.
- Perioperative chemotherapy with fluorouracil and cisplatin significantly improved resection rates, survival, and disease-free survival compared to surgery alone.
- Chemoradiotherapy resulted in improved survival over radiotherapy alone or surgery alone in some trials for resectable esophageal cancer.
- Existing evidence did not clearly show preoperative radiotherapy alone improved survival over surgery alone for resectable esophageal cancer. Larger trials were needed.
This document provides information about breast cancer trends and facts. It discusses:
- Breast cancer is the most common cancer in women and the second leading cause of cancer death in women. Incidence rates have been rising but mortality rates have been declining since 1989 due to earlier detection and improved treatments.
- Risk factors include age, family history, dense breasts, obesity, hormone therapy use, alcohol consumption and lack of physical activity. Molecular subtypes have different survival rates and prevalence among racial groups.
- Screening guidelines and risk assessment tools can help determine screening recommendations for average and high-risk women. Lifestyle changes like diet, exercise and weight management may lower risk. Targeted therapies have improved survival for HER2
This document discusses several landmark trials comparing different treatment approaches for esophageal cancer. The CALGB 9781 trial compared trimodality therapy (chemotherapy, radiation therapy, and surgery) to surgery alone and found improved overall survival and progression-free survival with trimodality therapy. Median overall survival was 4.48 years with trimodality therapy versus 1.79 years with surgery alone. The trial was closed early due to poor accrual, resulting in a small sample size.
management of metastatic colorectal cancer Sujay Susikar
1) Metastatic colorectal cancer presents significant challenges, as around 40% of patients initially present with metastatic disease and 50% of those initially diagnosed without metastases will eventually develop them.
2) Management depends on whether metastases are synchronous or metachronous. For potentially resectable metastases, surgical resection offers the best chance of cure, with 5-year survival rates of 24-58% after resection of liver metastases.
3) For unresectable metastases, options include ablation techniques like radiofrequency ablation or cryotherapy, regional therapies like chemoembolization, systemic chemotherapy, and targeted agents. The goal is conversion to resectability with chemotherapy when possible.
This document provides information on the management of soft tissue sarcoma. It discusses the clinical presentation, patterns of spread, imaging, histology, grading, staging, prognostic factors and management of soft tissue sarcomas. The key points are:
1) Soft tissue sarcomas most commonly present as painless swellings in the extremities and can invade locally along fascial planes. Imaging like MRI is important for assessing tumor extent.
2) Histologically, the most common subtypes are undifferentiated pleomorphic sarcoma and liposarcoma. Grading systems consider tumor differentiation, mitosis and necrosis.
3) Staging is based on tumor size, depth, nodal status and metastasis
Chemotherapy can be used to treat hormone-resistant prostate cancer (HRPC) to help palliate symptoms and provide a survival benefit. Docetaxel plus prednisone was established as the standard first-line treatment based on results from the TAX 327 trial showing a median overall survival of around 18 months. Several prognostic factors can help predict survival outcomes on chemotherapy. For patients who progress after first-line docetaxel treatment, metronomic cyclophosphamide with prednisone shows promise as a well-tolerated second-line option based on early clinical trials. Ongoing research continues to evaluate new agents for first- and second-line HRPC.
Standardized Surgery for Colonic Cancer - Complete Mesocolic Excision (CMF)SociedadColoprocto
The document discusses the technique of complete mesocolic excision (CME) for colon cancer surgery. It describes CME as the standardized removal of the entire mesocolon and central ligation of supplying arteries based on embryological planes. Studies from Erlangen, Germany show that using CME results in improved lymph node harvest, lower complication rates, reduced local recurrence, and increased 5-year cancer-related survival for colon cancer patients compared to conventional surgery. The expertise of the surgeon also impacts postoperative outcomes.
1) Around 60-70% of breast cancer patients have estrogen receptor positive tumors, making them candidates for hormonal therapy which has been shown to improve survival rates.
2) Tamoxifen is the standard adjuvant hormonal therapy and has been shown to reduce breast cancer recurrence rates by 24-43% and mortality by 14-23% depending on duration of therapy.
3) Aromatase inhibitors like letrozole and anastrazole are also used as adjuvant therapy and have been shown in trials to further reduce recurrence rates compared to tamoxifen alone.
1) There are multiple options for adjuvant and perioperative treatment of resectable gastric cancer according to different guidelines.
2) Adjuvant chemotherapy is supported by evidence from trials like INT-0116 and CALGB 80101, while adjuvant chemoradiotherapy has evidence from the Macdonald trial for less than D2 surgery.
3) Perioperative chemotherapy has level 1 evidence from trials like MAGIC, FNCLCC, and FLOT4 showing improved survival compared to surgery alone. Regimens include ECF/ECX, PF, and FLOT.
The CROSS trial found that neoadjuvant chemoradiotherapy followed by surgery significantly improved long-term overall and progression-free survival compared to surgery alone for patients with resectable esophageal or esophagogastric junction cancer. At a minimum follow-up of 5 years, median overall survival was 48.6 months for chemoradiotherapy plus surgery versus 24 months for surgery alone. Both squamous cell carcinoma and adenocarcinoma subtypes benefited. Neoadjuvant chemoradiotherapy using carboplatin and paclitaxel is now considered the standard of care for these patients.
SHARE Presentation: New Developments in the Medical Treatment of Breast Cance...bkling
Dr. Cliff Hudis on the latest information on new breast cancer treatments. Dr. Hudis is Chief of Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center.
Gastroesophageal junction tumors present unique challenges due to their location between the esophagus and stomach. Siewert classification categorizes these tumors as type I, II, or III based on their epicenter location relative to the gastroesophageal junction. Type I and II tumors are typically treated with esophagectomy while type III tumors are treated with gastrectomy. Neoadjuvant chemotherapy or chemoradiation is commonly used to downstage locally advanced adenocarcinomas prior to surgery. Ongoing studies are evaluating the optimal multimodality treatment approaches for gastroesophageal junction tumors.
Soft tissue sarcomas account for less than 1% of malignant tumors but around 40% of patients die from the disease. While most soft tissue sarcomas have no clear cause, some risk factors include genetic predispositions, prior radiation therapy, and chemical exposure. A recent study found that over 50% of soft tissue sarcoma patients have a germline genetic variant contributing to tumor development. Diagnosis involves biopsy or imaging like CT or MRI. Treatment depends on location and grade, with surgery to remove the tumor with margins. High-risk cases may also receive radiation therapy or chemotherapy.
Gastric cancer discussion slides final version.pptnew.pptzoezettemarc
1) Peri-operative chemotherapy with ECX before and after surgery improves overall survival compared to surgery alone in resectable gastric cancer based on the MAGIC trial.
2) The ACTS-GT trial showed adjuvant S-1 chemotherapy improves 3-year survival compared to observation alone after D2 gastrectomy for stage II-III gastric cancer.
3) Combination chemotherapy improves survival over best supportive care alone in advanced gastric cancer, with regimens including anthracyclines and cisplatin or oxaliplatin showing better efficacy.
http://cancer-treatment-madurai.com Breast cancer is a type of cancer that starts in the tissues of the breast. Dr.S.G.Balamurugan is one of the best cancer doctor in India, offers low cost breast cancer diagnosis, breast cancer treatments and breast cancer care at Guru Cancer Hospital, Madurai.
1) Total neoadjuvant therapy (TNT) involves chemotherapy before and after chemoradiotherapy for locally advanced rectal cancer, aiming to increase downstaging and improve outcomes.
2) A review found TNT achieved a 22% pathological complete response rate compared to 13% for chemoradiotherapy alone, with possibly improved survival.
3) However, most evidence comes from observational studies. Two randomized controlled trials found TNT reduced distant metastases and improved disease-free survival compared to chemoradiotherapy alone.
Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC):
This document provides the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Neuroendocrine and Adrenal Tumors. It was last updated in January 2019 and is authored by an expert panel assembled by NCCN. The guidelines provide evidence-based recommendations for diagnosis, staging, treatment and surveillance of neuroendocrine tumors and adrenal tumors. The key updates from the previous version include expanding the name to include adrenal tumors, preferring gallium-68 dotatate PET/CT for somatostatin receptor imaging, and adding peptide receptor radionuclide therapy with lutetium-177 as a treatment option.
The document summarizes updated guidelines for the treatment of colon cancer from the National Comprehensive Cancer Network. Key updates include splitting treatment algorithms between patients with proficient mismatch repair/microsatellite stable tumors and those with deficient mismatch repair/microsatellite high tumors. New pages were added to cover treatment for dMMR/MSI-H patients. Terminology was also modified to be more inclusive. Additional changes were made to footnotes and recommendations for workup, staging, and treatment of localized and metastatic colon cancer.
- This document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for colon cancer. It provides recommendations on diagnosis, treatment including surgery, chemotherapy and radiation, surveillance, and management of recurrence for colon cancer.
- The guidelines were updated in February 2022. Key updates include clarifying use of targeted therapies like cetuximab and panitumumab for left-sided tumors only, modifying recommendations for local ablative therapies versus surgery for resectable metastases, and adding dosing information for chemotherapy regimens.
- The panel members who developed and updated the guidelines are listed, including their specialties and affiliated cancer centers.
The document provides updated guidelines for the treatment of biliary tract cancers from the National Comprehensive Cancer Network (NCCN). Key updates include: revised recommendations for molecular testing in gallbladder, intrahepatic, and extrahepatic cholangiocarcinoma; changing the recommendation for fluoropyrimidine-based chemoradiation after surgery from category 2A to 2B; and the addition of a new section on principles of molecular testing. The guidelines are intended for use by oncology clinicians in determining treatment approaches for patients with biliary tract cancers.
The document provides updated guidelines for biliary tract cancers from the National Comprehensive Cancer Network. Key updates include reorganizing the guidelines to separate biliary tract cancers from hepatocellular carcinoma. Additional molecular testing recommendations were revised for gallbladder, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. Guidelines for principles of molecular testing and systemic therapy were also added.
This document provides updates to the 2022 National Comprehensive Cancer Network (NCCN) clinical practice guidelines for pancreatic adenocarcinoma. Key updates include revising terminology related to genetic testing and molecular profiling, emphasizing multidisciplinary review for diagnosis and treatment planning, and recommending genetic testing for inherited mutations and tumor molecular profiling to identify potentially targetable biomarkers. The guidelines provide evidence-based recommendations for diagnosis, staging, treatment and surveillance of pancreatic adenocarcinoma.
The document provides guidelines for the treatment of ovarian cancer from the National Comprehensive Cancer Network (NCCN). It includes algorithms and treatment recommendations for various types and stages of ovarian cancer, including epithelial ovarian cancer, less common histologies like clear cell carcinoma, and recurrent or persistent disease. The guidelines were last updated in September 2022 and are developed by an expert panel to aid in clinical decision making.
The document summarizes updates made in Version 5.2021 of the National Comprehensive Cancer Network (NCCN) Guidelines for Hepatobiliary Cancers. Key updates include adding dostarlimab-gxly as a treatment option for patients with mismatch repair deficient tumors across hepatocellular carcinoma and biliary tract cancer guidelines. Reference sections were also updated to include studies on dostarlimab. Guidelines for hepatocellular carcinoma screening criteria and surgical assessment were revised.
This document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Uterine Neoplasms. It includes guidelines for endometrial carcinoma, uterine sarcoma, and general principles. The guidelines were updated in September 2023 and include revisions to recommendations for initial evaluation, treatment options, and molecular testing considerations for various stages of disease.
This document provides guidelines for the treatment of gastric cancer from the National Comprehensive Cancer Network (NCCN). It was updated in January 2022 and includes:
1) Revisions to the recommended workup, including universal testing for microsatellite instability by PCR, next-generation sequencing, or mismatch repair immunohistochemistry for all newly diagnosed patients.
2) A recommendation for perioperative chemotherapy as the preferred primary treatment for medically fit patients with locoregional cT2 or higher gastric cancer.
3) Revisions to the principles of pathologic biomarker testing, including consideration of next-generation sequencing if sufficient tissue is available after initial testing.
The document provides updates to the NCCN Guidelines for Hepatocellular Carcinoma from Version 5.2022 to Version 1.2023. Key updates include: separating the Guidelines for Biliary Tract Cancers from Hepatocellular Carcinoma; emphasizing patient-centered language; changing external beam radiation therapy to radiation therapy; revising treatment pathways and footnotes for potentially resectable or transplantable disease; revising screening and surveillance recommendations; and adding a recommendation to consider biopsy for patients with more advanced disease being considered for systemic therapy.
The document provides guidelines for the treatment of penile cancer from the National Comprehensive Cancer Network. It includes recommendations for evaluating suspicious penile lesions, determining the clinical diagnosis and pathologic diagnosis, and recommendations for primary treatment based on tumor stage and grade. It also provides recommendations for managing non-palpable and palpable inguinal lymph nodes, surveillance schedules, and treatment of recurrent or metastatic disease. The guidelines are regularly updated based on the latest evidence and consensus of the expert panel.
This document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Head and Neck Cancers. It includes updates made in Version 3.2021, which add a footnote regarding biosimilar substitutes for trastuzumab. The guidelines provide evidence-based recommendations for multidisciplinary treatment of various head and neck cancers, including cancer of the oral cavity, oropharynx, hypopharynx, larynx, paranasal sinuses, and salivary glands. Recommendations cover evaluation, staging, surgery, radiation, systemic therapies, follow-up, and management of advanced or recurrent cancers.
This document provides guidelines for the treatment of hepatobiliary cancers from the National Comprehensive Cancer Network (NCCN). It was last updated on October 14, 2022. The guidelines include the latest recommendations for screening, diagnosing, and treating hepatocellular carcinoma, gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. New recommendations include durvalumab plus chemotherapy as a preferred regimen for unresectable biliary tract cancer, and selpercatinib for RET fusion-positive hepatobiliary tumors.
This document provides the updated National Comprehensive Cancer Network (NCCN) clinical practice guidelines for pancreatic adenocarcinoma. The updates include revisions to recommendations for imaging, biomarkers, molecular profiling, neoadjuvant therapy duration, and performance status criteria. Key changes are noted for pages addressing workup, resectable vs. borderline resectable disease, neoadjuvant therapy options, and eligibility for first-line systemic therapy. The guidelines are developed by the NCCN pancreatic cancer panel to aid treatment decisions based on the latest evidence and consensus.
This document provides the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Prostate Cancer Version 4.2022, dated May 10, 2022. It includes:
1) An overview of the panel members and their affiliations that developed the guidelines.
2) A summary of updates made in this version compared to previous versions.
3) The full clinical practice guidelines for diagnosis, staging, risk stratification, and treatment of prostate cancer.
The document summarizes guidelines from the National Comprehensive Cancer Network (NCCN) for diagnosing and treating multiple myeloma. It includes:
1) Definitions of key terms like smoldering myeloma and what findings indicate initial diagnosis.
2) Guidelines for primary treatment and follow-up of solitary plasmacytoma, smoldering myeloma, and symptomatic multiple myeloma.
3) Information on staging, imaging principles, response criteria, and supportive care considerations for multiple myeloma.
- The document presents updated guidelines from the National Comprehensive Cancer Network (NCCN) for the treatment of anal carcinoma.
- Key updates include revising treatment recommendations for metastatic disease and surveillance, capping the mitomycin dose for concurrent chemoradiation regimens, and revising target volume definitions and quality assurance procedures for radiation therapy.
- The guidelines are intended to help clinicians determine the best evidence-based approaches for treating patients with this cancer.
The document provides updates to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Breast Cancer. Key updates include:
- Recommendations for lobular carcinoma in situ were removed and can now be found in the NCCN Guidelines for Breast Cancer Screening and Diagnosis.
- Guidance on adjuvant abemaciclib treatment was revised based on recent data.
- Terminology in all NCCN Guidelines is being modified to advance equity, inclusion, and representation.
- Options were added for targeted therapy in recurrent disease based on biomarker status.
This document presents the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Esophageal and Esophagogastric Junction Cancers Version 2.2023. It lists the panel members and provides an overview of the guideline updates. The guidelines provide recommendations on screening, diagnosis, staging, treatment and surveillance for squamous cell carcinoma and adenocarcinoma of the esophagus and esophagogastric junction.
Similar to NCCN Guidelines Version 3.2022 Colon Cancer.pdf (20)
This document provides information on direct and indirect inguinal hernias, including their anatomy and symptoms. It also describes the laparoscopic procedure for treating inguinal hernias, including positioning the patient, dissecting the hernia sac, placing and securing mesh to cover the defect laparoscopically, and post-operative care considerations. The advantages of the laparoscopic approach are less tissue disruption, smaller incisions, less pain, and earlier return to normal activities compared to open surgery.
The document outlines the recommended pre-operative workup for bariatric surgery patients. It includes: 1) completing a medical history and physical exam; 2) conducting routine lab tests, nutritional screening, and women's health evaluations; 3) assessing patients psychosocially and for any endocrine, pulmonary, cardiovascular, or gastrointestinal conditions that could impact surgery. The goal is to optimize patient health and identify any risks prior to their bariatric procedure.
This tumor conference case discusses a 75-year-old female patient who presented with abdominal pain and fever. Imaging found a pancreatic tail mass, as well as lesions in both kidneys suspected to be metastases. She underwent a distal pancreatectomy with splenectomy. Pathology revealed a 6.1cm neuroendocrine tumor of the pancreas, grade 2. Staging was stage II. Surveillance with follow up CT was recommended for curative intent.
Bariatric surgery guidelines have been updated based on long-term studies demonstrating its effectiveness in treating severe obesity and related conditions. The guidelines now recommend considering bariatric surgery for patients with a BMI ≥30 who have obesity-related medical issues, especially if other treatments have failed. Bariatric procedures lead to greater weight loss than other options and higher remission rates of diabetes and other metabolic conditions. Risks of bariatric surgery are low with mortality rates below 1% for most patients.
This meta-analysis compared the efficacy and tolerability of same-day (SaD) versus split-dose (SpD) bowel preparation regimens for colonoscopy. Fourteen randomized controlled trials with over 4,000 participants were included. The analysis found that the proportion of adequate bowel preparation was comparable between SaD and SpD regimens. SaD with bisacodyl was found to have higher odds of adequate preparation than SpD without bisacodyl. SaD also resulted in better sleep quality than SpD. However, overall rates of optimal preparation remained low for both regimens due to heterogeneous protocols. Further research is still needed to determine optimal purgative agents and dosing.
This meta-analysis compared the efficacy and tolerability of same-day (SaD) versus split-dose (SpD) bowel preparation regimens for colonoscopy. Fourteen randomized controlled trials with over 4,000 participants were included. The analysis found that the proportion of adequate bowel preparation was comparable between SaD and SpD regimens. SaD with bisacodyl was found to have higher odds of adequate preparation than SpD without bisacodyl. SaD also resulted in better sleep quality than SpD. However, overall rates of optimal preparation remained low for both regimens due to heterogeneous protocols. Further research is still needed to determine optimal purgative agents and dosing.
This randomized clinical trial compared the effectiveness and tolerability of split-dose vs same-day whole-dose administration of reduced-volume polyethylene glycol electrolyte lavage solution (PEG-ELS) for bowel preparation prior to morning colonoscopy. The study found that split-dose preparation was as effective as same-day whole-dose preparation for bowel cleanliness, but was better tolerated by patients with fewer experiencing nausea, vomiting, or inability to complete the preparation. Patients in the split-dose group also reported being less likely to refuse the same preparation in the future or want to try another option. The split-dose reduced-volume PEG-ELS preparation may provide an improved bowel cleansing regimen for morning colonoscopy.
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Mr. Brainwash ❤️ Beautiful Girl _ FRANK FLUEGEL GALERIE.pdfFrank Fluegel
Mr. Brainwash Beautiful Girl / Mixed Media / signed / Unique
Year: 2023
Format: 96,5 x 127 cm / 37.8 x 50 inch
Material: Fine Art Paper with hand-torn edges.
Method: Mixed Media, Stencil, Spray Paint.
Edition: Unique
Other: handsigned by Mr. Brainwash front and verso.
Beautiful Girl by Mr. Brainwash is a mixed media artwork on paper done in 2023. It is unique and of course signed by Mr. Brainwash. The picture is a tribute to his own most successful work of art, the Balloon Girl. In this new creation, however, the theme of the little girl is slightly modified.
In Mr. Brainwash’s mixed media artwork titled “Beautiful Girl,” we are presented with a captivating depiction of a little girl adorned in a summer dress, with two playful pigtails framing her face. The artwork exudes a sense of innocence and whimsy, as the girl is shown in a dreamy state, lifting one end of her skirt and looking down as if she were about to dance. Through the use of mixed media, Mr. Brainwash skillfully combines different artistic elements to create a visually striking composition. The vibrant colors and bold brushstrokes bring the artwork to life, evoking a sense of joy and happiness. The attention to detail in the girl’s expression and body language adds depth and character to the piece, allowing viewers to connect with the young protagonist on a personal and emotional level. “Beautiful Girl” is a testament to Mr. Brainwash’s unique artistic style, blending elements of street art, pop art, and contemporary art to create a visually captivating and emotionally resonant artwork.
The use of mixed media in “Beautiful Girl” adds an additional layer of complexity to the artwork. By combining different artistic techniques and materials, such as stencils, spray paint, and collage, Mr. Brainwash creates a dynamic and textured composition that grabs the viewer’s attention. The juxtaposition of different textures and patterns adds depth and visual interest to the piece, while also emphasizing the artist’s eclectic and experimental approach to art-making. The inclusion of collage elements, such as newspaper clippings and torn posters, further enhances the artwork’s urban and contemporary feel. Overall, “Beautiful Girl” is a visually captivating and thought-provoking artwork that showcases Mr. Brainwash’s talent for blending different artistic elements to create a truly unique and engaging piece.
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Tanjore Painting: Rich Heritage and Intricate Craftsmanship | Cottage9Cottage9 Enterprises
Explore the exquisite art of Tanjore Painting, known for its vibrant colors, gold foil work, and traditional themes. Discover its cultural significance today!
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