Medical Oncology

Chapter

Abstract

The focus of this chapter is to discuss the impact of modern systemic therapy on the outcomes of patients with advanced malignancy. Gastrointestinal cancer is an ideal example where outcomes have improved and opportunities for surgery of palliative benefit have therefore multiplied. For advanced colorectal cancer in particular, where without effective systemic therapy the median survival was 6 months, there is now the potential for cure when surgery and chemotherapy are incorporated into the treatment plan. Here we will give a concise review of systemic agents along with their potential toxicities and highlight interventions that have now become evermore relevant for the surgeon to consider given the longer survival times of patients with advanced cancer.

Abbreviations

CT

Computed tomography

EGFR

Epidermal growth factor receptor

FDG-PET

Fluorodeoxyglucose positron emission tomography

FOLFIRINOX

5-fluorouracil irinotecan, oxaliplatin

HER2

Human epidermal growth factor receptor 2

VEGF

Vascular endothelial growth factor

References

  1. 1.
    Tournigand C, André T, Achille E, Lledo G, Flesh M, Mery-Mignard D, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol. 2004;22(2):229–37.PubMedCrossRefGoogle Scholar
  2. 2.
    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.PubMedCrossRefGoogle Scholar
  3. 3.
    Glimelius B, Hoffman K, Graf W, Påhlman L, Sjödén PO. Quality of life during chemotherapy in patients with symptomatic advanced colorectal cancer. The Nordic Gastrointestinal Tumor Adjuvant Therapy Group. Cancer. 1994;73(3):556–62.PubMedCrossRefGoogle Scholar
  4. 4.
    Bennett L, Zhao Z, Barber B, Zhou X, Peeters M, Zhang J, et al. Health-related quality of life in patients with metastatic colorectal cancer treated with panitumumab in first- or second-line treatment. Br J Cancer. 2011;105(10):1495–502.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Kabbinavar FF, Wallace JF, Holmgren E, Yi J, Cella D, Yost KJ, et al. Health-related quality of life impact of bevacizumab when combined with irinotecan, 5-fluorouracil, and leucovorin or 5-fluorouracil and leucovorin for metastatic colorectal cancer. Oncologist. 2008;13(9):1021–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Belani CP, Brodowicz T, Ciuleanu TE, Krzakowski M, Yang SH, Franke F, et al. Quality of life in patients with advanced non-small-cell lung cancer given maintenance treatment with Pemetrexed versus placebo (H3E-MC-JMEN): results from a randomised, double-blind, phase 3 study. Lancet Oncol. 2012;13(3):292–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Chibaudel B, Maindrault-Goebel F, Lledo G, Mineur L, André T, Bennamoun M, et al. Can chemotherapy be discontinued in unresectable metastatic colorectal cancer? The GERCOR OPTIMOX2 study. J Clin Oncol. 2009;27(34):5727–33.PubMedCrossRefGoogle Scholar
  8. 8.
    The Cancer Genome Atlas Network. Comprehensive molecular characterization of human colon and rectal cancer. Nature. 2012;487(7407):330–7.PubMedCentralCrossRefGoogle Scholar
  9. 9.
    The Cancer Genome Atlas Network. Comprehensive molecular portraits of human breast tumours. Nature. 2012;490(7418):61–70.PubMedCentralCrossRefGoogle Scholar
  10. 10.
    Merrill RM, Hunter BD. Conditional survival among cancer patients in the United States. Oncologist. 2010;15(8):873–82.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Yu XQ, Baade PD, O’Connell DL. Conditional survival of cancer patients: an Australian perspective. BMC Cancer. 2012;12(1):460.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Wang SJ, Emery R, Fuller CD, Kim J-S, Sittig DF, Thomas CR. Conditional survival in gastric cancer: a SEER database analysis. Gastric Cancer. 2007;10(3):153–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Buyse M, Thirion P, Carlson RW, Burzykowski T, Molenberghs G, Piedbois P. Relation between tumour response to first-line chemotherapy and survival in advanced colorectal cancer: a meta-analysis. Meta-Analysis Group in Cancer. Lancet. 2000;356(9227):373–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Suzuki C, Blomqvist L, Sundin A, Jacobsson H, Byström P, Berglund Å, et al. The initial change in tumor size predicts response and survival in patients with metastatic colorectal cancer treated with combination chemotherapy. Ann Oncol. 2012;23(4):948–54.PubMedCrossRefGoogle Scholar
  15. 15.
    Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50 Suppl 1:122S–50.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Von Hoff DD, Ramanathan RK, Borad MJ, Laheru DA, Smith LS, Wood TE, et al. Gemcitabine plus nab-paclitaxel is an active regimen in patients with advanced pancreatic cancer: a phase I/II trial. J Clin Oncol. 2011;29(34):4548–54.CrossRefGoogle Scholar
  17. 17.
    Hendlisz A, Golfinopoulos V, Garcia C, Covas A, Emonts P, Ameye L, et al. Serial FDG-PET/CT for early outcome prediction in patients with metastatic colorectal cancer undergoing chemotherapy. Ann Oncol. 2012;23(7):1687–93.PubMedCrossRefGoogle Scholar
  18. 18.
    Gwilliam B, Keeley V, Todd C, Roberts C, Gittins M, Kelly L, et al. Prognosticating in patients with advanced cancer – observational study comparing the accuracy of clinicians’ and patients' estimates of survival. Ann Oncol. 2013;24(2):482–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Chabner BA. Clinical strategies for cancer treatment: the role of drugs. In: Chabner BA, Longo DL, editors. Cancer chemotherapy and biotherapy: principles and practice. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 3–14.Google Scholar
  20. 20.
    Karapetis CS, Khambata-Ford S, Jonker DJ, O’Callaghan CJ, Tu D, Tebbutt NC, et al. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med. 2008;359(17):1757–65.PubMedCrossRefGoogle Scholar
  21. 21.
    Seidman AD, Fornier MN, Esteva FJ, Tan L, Kaptain S, Bach A, et al. Weekly trastuzumab and paclitaxel therapy for metastatic breast cancer with analysis of efficacy by HER2 immunophenotype and gene amplification. J Clin Oncol. 2001;19(10):2587–95.PubMedGoogle Scholar
  22. 22.
    Baselga J. Targeting tyrosine kinases in cancer: the second wave. Science. 2006;312(5777):1175–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Bhojani N, Jeldres C, Patard J-J, Perrotte P, Suardi N, Hutterer G, et al. Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma. Eur Urol. 2008;53(5):917–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Sternberg CN, Davis ID, Mardiak J, Szczylik C, Lee E, Wagstaff J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol. 2010;28(6):1061–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Je Y, Schutz FAB, Choueiri TK. Risk of bleeding with vascular endothelial growth factor receptor tyrosine-kinase inhibitors sunitinib and sorafenib: a systematic review and meta-analysis of clinical trials. Lancet Oncol. 2009;10(10):967–74.PubMedCrossRefGoogle Scholar
  26. 26.
    Hapani S, Sher A, Chu D, Wu S. Increased risk of serious hemorrhage with bevacizumab in cancer patients: a meta-analysis. Oncology. 2010;79(1–2):27–38.PubMedCrossRefGoogle Scholar
  27. 27.
    Kesmodel SB, Ellis LM, Lin E, Chang GJ, Abdalla EK, Kopetz S, et al. Preoperative bevacizumab does not significantly increase postoperative complication rates in patients undergoing hepatic surgery for colorectal cancer liver metastases. J Clin Oncol. 2008;26(32):5254–60.PubMedCrossRefGoogle Scholar
  28. 28.
    Scappaticci FA, Fehrenbacher L, Cartwright T, Hainsworth JD, Heim W, Berlin J, et al. Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol. 2005;91(3):173–80.PubMedCrossRefGoogle Scholar
  29. 29.
    Erinjeri JP, Fong AJ, Kemeny NE, Brown KT, Getrajdman GI, Solomon SB. Timing of administration of bevacizumab chemotherapy affects wound healing after chest wall port placement. Cancer. 2011;117(6):1296–301.PubMedCrossRefGoogle Scholar
  30. 30.
    Starlinger P, Alidzanovic L, Schauer D, Maier T, Sommerfeldt S, Herberger B, et al. Activity of bevacizumab at the time of surgery after 6 weeks of preoperative cessation. J Clin Oncol. 2012;30 Suppl 4:abstract 455.Google Scholar
  31. 31.
    Boleti E, Sarwar N, Jones RR, Chowdhury S, Crabb SJ, Shamash J, et al. The safety and efficacy of pazopanib prior to planned nephrectomy in metastatic clear cell renal cancer. J Clin Oncol. 2012;30 Suppl 5:abstract 427.Google Scholar
  32. 32.
    Powles T, Kayani I, Blank C, Chowdhury S, Horenblas S, Peters J, et al. The safety and efficacy of sunitinib before planned nephrectomy in metastatic clear cell renal cancer. Ann Oncol. 2011;22(5):1041–7.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Cowey CL, Amin C, Pruthi RS, Wallen EM, Nielsen ME, Grigson G, et al. Neoadjuvant clinical trial with sorafenib for patients with stage II or higher renal cell carcinoma. J Clin Oncol. 2010;28(9):1502–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Demetri GD, Von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347(7):472–80.PubMedCrossRefGoogle Scholar
  35. 35.
    Pessaux P, Marzano E, Casnedi S, Bachellier P, Jaeck D, Chenard M-P. Histological and immediate postoperative outcome after preoperative cetuximab: case-matched control study. World J Surg. 2010;34(11):2765–72.PubMedCrossRefGoogle Scholar
  36. 36.
    Meyerhardt JA, Mayer RJ. Systemic therapy for colorectal cancer. N Engl J Med. 2005;352(5):476–87.PubMedCrossRefGoogle Scholar
  37. 37.
    Cunningham D, Atkin W, Lenz H-J, Lynch HT, Minsky B, Nordlinger B, et al. Colorectal cancer. Lancet. 2010;375(9719):1030–47.PubMedCrossRefGoogle Scholar
  38. 38.
    Grothey A, Sargent D, Goldberg RM, Schmoll H-J. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol. 2004;22(7):1209–14.PubMedCrossRefGoogle Scholar
  39. 39.
    Kopetz S, Chang GJ, Overman MJ, Eng C, Sargent DJ, Larson DW, et al. Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009;27(22):3677–83.PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Folprecht G, Gruenberger T, Bechstein WO, Raab H-R, Lordick F, Hartmann JT, et al. Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol. 2010;11(1):38–47.PubMedCrossRefGoogle Scholar
  41. 41.
    Fiori E, Lamazza A, Schillaci A, Femia S, Demasi E, Decesare A, et al. Palliative management for patients with subacute obstruction and stage IV unresectable rectosigmoid cancer: colostomy versus endoscopic stenting: final results of a prospective randomized trial. Am J Surg. 2012;204(3):321–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Meisner S, González-Huix F, Vandervoort JG, Repici A, Xinopoulos D, Grund KE, et al. Self-expanding metal stenting for palliation of patients with malignant colonic obstruction: effectiveness and efficacy on 255 patients with 12-Month’s follow-up. Gastroenterol Res Pract. 2012;2012:296347.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Karoui M, Charachon A, Delbaldo C, Loriau J, Laurent A, Sobhani I, et al. Stents for palliation of obstructive metastatic colon cancer: impact on management and chemotherapy administration. Arch Surg. 2007;142(7):619–23.PubMedCrossRefGoogle Scholar
  44. 44.
    Bielawska B, Hookey LC, Jalink D. Large-diameter self-expanding metal stents appear to be safe and effective for malignant colonic obstruction with and without concurrent use of chemotherapy. Surg Endosc. 2010;24(11):2814–21.PubMedCrossRefGoogle Scholar
  45. 45.
    Scheer MGW, Sloots CEJ, Van der Wilt GJ, Ruers TJM. Management of patients with asymptomatic colorectal cancer and synchronous irresectable metastases. Ann Oncol. 2008;19(11):1829–35.PubMedCrossRefGoogle Scholar
  46. 46.
    McCahill LE, Yothers G, Sharif S, Petrelli NJ, Lai LL, Bechar N, et al. Primary mFOLFOX6 plus bevacizumab without resection of the primary tumor for patients presenting with surgically unresectable metastatic colon cancer and an intact asymptomatic colon cancer: definitive analysis of NSABP trial C-10. J Clin Oncol. 2012;30(26):3223–8.PubMedCentralPubMedCrossRefGoogle Scholar
  47. 47.
    Poultsides GA, Servais EL, Saltz LB, Patil S, Kemeny NE, Guillem JG, et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. J Clin Oncol. 2009;27(20):3379–84.PubMedCentralPubMedCrossRefGoogle Scholar
  48. 48.
    Tebbutt NC, Norman AR, Cunningham D, Hill ME, Tait D, Oates J, et al. Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases. Gut. 2003;52(4):568–73.PubMedCentralPubMedCrossRefGoogle Scholar
  49. 49.
    Hapani S, Chu D, Wu S. Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol. 2009;10(6):559–68.PubMedCrossRefGoogle Scholar
  50. 50.
    Damjanov N, Weiss J, Haller DG. Resection of the primary colorectal cancer is not necessary in nonobstructed patients with metastatic disease. Oncologist. 2009;14(10):963–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Karoui M, Roudot-Thoraval F, Mesli F, Mitry E, Aparicio T, Des Guetz G, et al. Primary colectomy in patients with stage IV colon cancer and unresectable distant metastases improves overall survival: results of a multicentric study. Dis Colon Rectum. 2011;54(8):930–8.PubMedCrossRefGoogle Scholar
  52. 52.
    Faron M, Bourredjem A, Pignon J-P, Bouche O, Douillard J-Y, Adenis A, et al. Impact on survival of primary tumor resection in patients with colorectal cancer and unresectable metastasis: pooled analysis of individual patients’ data from four randomized trials. J Clin Oncol. 2012;30 Suppl 15:abstract 3507.Google Scholar
  53. 53.
    Costi R, Mazzeo A, Di Mauro D, Veronesi L, Sansebastiano G, Violi V, et al. Palliative resection of colorectal cancer: does it prolong survival? Ann Surg Oncol. 2007;14(9):2567–76.PubMedCrossRefGoogle Scholar
  54. 54.
    Gonsalves WI, Wolpert J, Tashi T, Ganti AK, Subbiah S, Ternent C, et al. Assessment of prognostic factors after primary tumor resection in metastatic colon cancer patients: a Veteran’s Affairs Central Cancer Registry (VACCR) analysis, 1995–2008. J Surg Oncol. 2012;106(4):486–90.PubMedCrossRefGoogle Scholar
  55. 55.
    Gervaz P, Rubbia-Brandt L, Andres A, Majno P, Roth A, Morel P, et al. Neoadjuvant chemotherapy in patients with stage IV colorectal cancer: a comparison of histological response in liver metastases, primary tumors, and regional lymph nodes. Ann Surg Oncol. 2010;17(10):2714–9.PubMedCrossRefGoogle Scholar
  56. 56.
    Fernandez FG, Drebin JA, Linehan DC, Dehdashti F, Siegel BA, Strasberg SM. Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET). Ann Surg. 2004;240(3):438–50.PubMedCentralPubMedCrossRefGoogle Scholar
  57. 57.
    Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995;19(1):59–71.PubMedCrossRefGoogle Scholar
  58. 58.
    Steele BG, Bleday R, Mayer RJ, Lindblad A, Petrelli N, Weaver D. A prospective evaluation of hepatic resection for colorectal carcinoma metastases to the liver: Gastrointestinal Tumor Study Group Protocol 6584. J Clin Oncol. 1991;9(7):1105–12.PubMedGoogle Scholar
  59. 59.
    Delaunoit T, Alberts SR, Sargent DJ, Green E, Goldberg RM, Krook J, et al. Chemotherapy permits resection of metastatic colorectal cancer: experience from Intergroup N9741. Ann Oncol. 2005;16(3):425–9.PubMedCrossRefGoogle Scholar
  60. 60.
    Gonzalez M, Robert JH, Halkic N, Mentha G, Roth A, Perneger T, et al. Survival after lung metastasectomy in colorectal cancer patients with previously resected liver metastases. World J Surg. 2012;36(2):386–91.PubMedCrossRefGoogle Scholar
  61. 61.
    Iida T, Nomori H, Shiba M, Nakajima J, Okumura S, Horio H, et al. Prognostic factors after pulmonary metastasectomy for colorectal cancer and rationale for determining surgical indications: a retrospective analysis. Ann Surg. 2013;257(6):1059–64.PubMedCrossRefGoogle Scholar
  62. 62.
    Fiorentino F, Hunt I, Teoh K, Treasure T, Utley M. Pulmonary metastasectomy in colorectal cancer: a systematic review and quantitative synthesis. J R Soc Med. 2010;103(2):60–6.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Wagner AD, Unverzagt S, Grothe W, Kleber G, Grothey A, Haerting J et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2010;(3):CD004064.Google Scholar
  64. 64.
    Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358(1):36–46.PubMedCrossRefGoogle Scholar
  65. 65.
    Bang Y-J, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376(9742):687–97.PubMedCrossRefGoogle Scholar
  66. 66.
    Thuss-Patience PC, Kretzschmar A, Bichev D, Deist T, Hinke A, Breithaupt K, et al. Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer – a randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Eur J Cancer. 2011;47(15):2306–14.PubMedCrossRefGoogle Scholar
  67. 67.
    Kang JH, Lee II S, Lim DH, Park K-W, Oh SY, Kwon H-C, et al. Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol. 2012;30(13):1513–8.PubMedCrossRefGoogle Scholar
  68. 68.
    Loehrer PJ, Feng Y, Cardenes H, Wagner L, Brell JM, Cella D, et al. Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial. J Clin Oncol. 2011;29(31):4105–12.PubMedCentralPubMedCrossRefGoogle Scholar
  69. 69.
    Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 2007;25(15):1960–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Burris HA, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15(6):2403–13.PubMedGoogle Scholar
  71. 71.
    Romanus D, Kindler HL, Archer L, Basch E, Niedzwiecki D, Weeks J, et al. Does health-related quality of life improve for advanced pancreatic cancer patients who respond to gemcitabine? Analysis of a randomized phase III trial of the cancer and leukemia group B (CALGB 80303). J Pain Symptom Manage. 2012;43(2):205–17.PubMedCentralPubMedCrossRefGoogle Scholar
  72. 72.
    Vaccaro V, Sperduti I, Milella M. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;365(8):768–9.PubMedCrossRefGoogle Scholar
  73. 73.
    Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, Ychou M, Bouché O, Guimbaud R, et al. Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol. 2013;31(1):23–9.PubMedCrossRefGoogle Scholar
  74. 74.
    Jeurnink SM, Van Eijck CHJ, Steyerberg EW, Kuipers EJ, Siersema PD. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18–27.PubMedCentralPubMedCrossRefGoogle Scholar
  75. 75.
    Larssen L, Medhus AW, Hauge T. Treatment of malignant gastric outlet obstruction with stents: an evaluation of the reported variables for clinical outcome. BMC Gastroenterol. 2009;9:45–50.PubMedCentralPubMedCrossRefGoogle Scholar
  76. 76.
    Conrad C, Lillemoe KD. Surgical palliation of pancreatic cancer. Cancer J. 2012;18(6):577–83.PubMedCrossRefGoogle Scholar
  77. 77.
    Tey J, Back MF, Shakespeare TP, Mukherjee RK, Lu JJ, Lee KM, et al. The role of palliative radiation therapy in symptomatic locally advanced gastric cancer. Int J Radiat Oncol Biol Phys. 2007;67(2):385–8.PubMedCrossRefGoogle Scholar
  78. 78.
    Field KM, Michael M. Part II. Liver function in oncology: towards safer chemotherapy use. Lancet Oncol. 2008;9(12):1181–90.PubMedCrossRefGoogle Scholar
  79. 79.
    Moss AC, Morris E, Mac Mathuna P. Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst Rev 2006;(2):CD004200.Google Scholar
  80. 80.
    Kasuga A, Ishii H, Ozaka M, Matsusaka S, Chin K, Mizunuma N, et al. Clinical outcome of biliary drainage for obstructive jaundice caused by colorectal and gastric cancers. Jpn J Clin Oncol. 2012;42(12):1161–7.PubMedCrossRefGoogle Scholar
  81. 81.
    Feuer DJ, Broadley KE, Shepherd JH, Barton DP. Surgery for the resolution of symptoms in malignant bowel obstruction in advanced gynaecological and gastrointestinal cancer. Cochrane Database Syst Rev. 2000;4, CD002764.PubMedGoogle Scholar
  82. 82.
    Hoda D, Jatoi A, Burnes J, Loprinzi C, Kelly D. Should patients with advanced, incurable cancers ever be sent home with total parenteral nutrition? A single institution’s 20-year experience. Cancer. 2005;103(4):863–8.PubMedCrossRefGoogle Scholar
  83. 83.
    Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Database Syst Rev. 2004;1, CD002916.PubMedGoogle Scholar
  84. 84.
    Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA. 2012;307(22):2383–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Medical OncologyThe Queen Elizabeth HospitalWoodville SouthAustralia
  2. 2.Department of Medical OncologyThe Queen Elizabeth Hospital and University of AdelaideAdelaideAustralia

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