[MOL] Left sided brain tumors..... [01328] Medicine On Line

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[MOL] Left sided brain tumors.....

Extra Psychopathology in Left-Sided Brain Tumors

BOSTON-If the malignant brain tumor is in the left hemisphere, radiation oncologists should screen for depression, with the possibility of improving patients’ quality of life.

That’s the suggestion of a Duke team that prospectively evaluated 68 newly diagnosed brain-tumor patients, 22 to 76 years old, with standard neuropsychological tests before radiotherapy. The group concluded that antidepressants may improve the quality of life for some patients with left-sided tumors.

There were significantly more memory problems and depressive symptoms among the 18 patients with left-sided tumors, said Dr. Carol A. Hahn and colleagues in a report on Oct. 23 to the American Society for Therapeutic Radiology and Oncology meeting here. These patients also exhibited poorer attention and were more distractible. They had poorer verbal fluency and verbal learning, particularly in recall and recognition.

What’s more, the 31 glioblastoma multiforme patients showed poorer psychomotor speed and visual tracking than patients with other histologies, the group reported.


Gastric-Cancer Survival Bolstered by Triple Therapy

BOSTON-Radiation turned out to be the charm for locally advanced stomach cancer.

Adjuvant chemotherapy alone didn’t significantly increase survival or reduce the risk of recurrence over surgery. Nor did aggressive surgery. But when radiation was added to the adjuvant mix along with chemotherapy, there was marked improvement, according to a large multicenter trial reported this week.

In the study, 281 patients randomized to a cycle of 5-FU and leucovorin, then 45 Gy of radiation with concomitant chemotherapy, followed by two more cycles of chemotherapy, had a three-year relapse-free survival rate of 48%, said Dr. Stephen Smalley of Olathe Regional Radiation Oncology Center in Olathe, Kan. This compared with 30% for 275 patients treated with surgery alone.

Dr. Smalley, reporting for the Southwest Oncology Group, said patients receiving the adjuvant treatment had a 50% overall three-year survival rate, vs. 40% among those who had surgery alone. Other cooperative trial groups contributed patients.

This was the first large study to document a significant improvement in the treatment of the disease by combining the three therapies, Dr. Smalley told the American Society for Therapeutic Radiology and Oncology meeting here on Oct. 23.

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