Steven E. Schild

Pineal parenchymal tumors. Clinical, pathologic, and therapeutic aspects.

Background. Pineal parenchymal tumors are rare; therefore, only limited clinical data regarding their behavior is available. This study was performed to provide further information regarding the pathologic features, clinical behavior, and response to therapy of these tumors.

Histologically confirmed pineal tumors and other germ cell tumors of the brain

This study examined the outcome of patients with histologically confirmed pineal region tumors.

A prospective evaluation of two radiotherapy schedules with 10 versus 20 fractions for the treatment of metastatic spinal cord compression: Final results of a multicenter study

The optimal treatment of patients with metastatic spinal cord compression (MSCC) is still being debated. The current observational multicenter study, performed prospectively by the authors, evaluated two radiotherapy (RT) schedules and prognostic factors with respect to functional outcome

Treatment of atypical neurocytomas

The majority of central neurocytomas are benign. Approximately 25% of these rare central nervous system tumors are more aggressive, with an MIB‐1 labeling index > 2% or atypical histologic features, and are classified as atypical neurocytomas. The objective of this analysis was to define the optimal treatment for patients with these atypical tumors.

Results of combined-modality therapy for limited-stage small cell lung carcinoma in the elderly

A Phase III trial was conducted by the North Central Cancer Treatment Group to determine whether chemotherapy (etoposide and cisplatin) plus either twice‐daily radiotherapy (BIDRT) or once‐daily radiotherapy (QDRT) resulted in a better outcome for patients with limited‐stage small cell lung carcinoma (LD‐SCLC). No difference in survival was identified between the two arms. The current analysis examined the relation between age and outcome for patients treated during this trial.

Value of postoperative stereotactic radiosurgery and conventional radiotherapy for incompletely resected typical neurocytomas.

Two groups of central neurocytomas have been identified: typical and atypical neurocytomas. The more benign typical neurocytomas have a better prognosis. Complete resection of typical neurocytomas results in significantly better outcome than incomplete resection. The current study investigated whether the outcome after incomplete resection can be improved by postoperative stereotactic radiosurgery (SRS) or by conventional radiotherapy.

Radiation Therapy (RT) after Prostatectomy: The Case for Salvage Therapy as Opposed to Adjuvant Therapy

Patients with pathologic stage T3 or T4 prostate cancer who have undetectable PSA levels following radical retropubic prostatectomy (RRP) have a substantial risk of recurrence. Radiotherapy (RT) can be administered immediately following the RRP (immediate adjuvant RT) or may be postponed until the PSA level has risen to a level that is indicative of residual or recurrent prostate cancer (salvage RT). Immediate adjuvant RT can significantly reduce the risk of relapse, but does not appear to increase the rate of survival. Approximately two‐thirds of patients with rising PSA levels after RRP can be salvaged with RT alone. This result was achieved in patients treated with an adequate dose of radiation before the PSA rose to > 1.1 ng/ml. While no one can be certain which approach (adjuvant or salvage RT) is better, future studies should examine this issue. Whether immediate postoperative adjuvant RT is of value to patients is the subject of two randomized prospective studies. The benefit of adjuvant RT is a matter of controversy. Salvage RT treats only those patients with proven residual prostate cancer. The salvage RT approach has several advantages. This approach spares approximately 40% of patients who have had an RRP for T3 or T4 prostate cancer and eliminates the risks and costs associated with adjuvant RT. Additionally, it appears that the results of immediate adjuvant RT are similar to those achieved with early salvage RT.

Tonsil cancer. Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy

Background. The authors determined the patterns of treatment failure in patients treated with surgery alone or surgery combined with postoperative radiation therapy for squamous cell carcinoma of the tonsil.

Prognostic factors in the nonsurgical treatment of esophageal carcinoma with radiotherapy or radiochemotherapy: the importance of pretreatment hemoglobin levels.

The current study was performed to evaluate prognostic factors for overall survival (OS), distant metastasis (DM), and local failure (LF) in patients with Stage II/III esophageal carcinoma.

Epoetin-α during radiotherapy for stage III esophageal carcinoma: A prospective, nonrandomized study

It has been suggested that hemoglobin levels of 12–14 g/dL are optimal for tumor oxygenation, radiosensitivity, and prognosis. In this prospective study, the authors evaluated the effectiveness of epoetin‐α to maintain hemoglobin levels at 12–14 g/dL during radiotherapy (RT) for patients with UICC Stage III esophageal carcinoma, and they examined the impact of erythropoetin on overall survival (OS), metastatic‐free survival (MFS), and local control (LC).