Journal of Oncology Medicine & Practice

Background: Optimal clinical management of ovarian cancer patients requires prompt and accurate determination of whether primary or recurrent disease is responding to chemotherapy. If CA125 is to fill this need, we must understand the design and outcomes of clinical trials that have established a correlation between CA125 levels and growth or shrinkage of tumor burden. It is particularly important to define the magnitude of changes in CA125 concentrations that indicate cancer growth and prompt cessation of ineffective therapy. Objective: To review clinical trials which test the ability of CA125 to monitor ovarian cancer growth during chemotherapy for primary disease and detection of recurrence. Methods: The Medline and Embase databases were searched for original articles published in English between January 1982 and May 2014 that evaluated the utility of CA125 for monitoring ovarian cancer growth. Results: CA125 was evaluated in 13 reports during primary therapy and in eight reports during subsequent follow-up. CA125 sensitivity for detecting tumor growth was not reported consistently, but could be calculated from data provided in the articles. During primary therapy, the median sensitivity for recurrence was 60% (range 33%-95%) and during follow-up the median sensitivity was 85% (range 62%-93%). Conclusion: Consistent criteria for indicating disease progression with CA125 could not be defined due to differences in trial design and selection of patients. The most promising criteria should be re-evaluated under similar and standardized conditions. Computer simulation models and change point algorithms may aid in identifying CA125 assessment criteria to be further validated in prospective clinical trials.

The skin is a unique marker for malignancy as these cutaneous manifestation not only often precede the development of other symptoms, but also often cause patients to seek medical attention sooner than they would for other symptoms. Common cutaneous markers for malignancy include: acanthosis nigricans, carcinoid syndrome, Leser-Trelat sign, and necrolytic migratory erythema. Although these skin signs can also be associated with benign disease, the clinician should have a low threshold for carefully evaluating patients with a cutaneous complaint for underlying systemic disease, as these signs are often harbingers of underlying malignancy.

The goal of this work was verification of treatment dose distribution in the VMAT method assuming gamma index minimization and dependence between the points with γ>1 and the position of the gantry’s arm.

An Extraosseous Osteosarcoma (EOS) arising in mesentery is exceedingly rare with only six previous cases documented in English literature worldwide. This manuscript describes the clinical, radiological and histological features of the first known case of mesenteric EOS in Australia. The collation of additional cases will help ameliorate our understanding of its clinical course and guide appropriate management, planning and prognostication.