Proceedings of the 40th Annual AS'FRO Meeting

REFRESHER COURSE DESCRIPTIONS

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107 Carcinoma of the Endometrium Manjeet Chadha, M.D., Beth Israel Medical Center, New York, NY

Uterine cancer is the fourth most common malignancy in women and the most prevalent among the gynecologic malignancies. In 1998, approximately 36,100 new cases will be diagnosed and there will be an estimated 6,300 deaths from this disease. The current understanding of the natural history i.e. etiology, preliminary data on molecular markers, pathologic variants and associated patterns of failure will be presented. With FIGO surgical staging a complete assessment of surgical pathologic risk factors of disease are known at diagnosis. As a result, within each stage, there are identifiable subsets of patients by prognosis. This course will review the contemporary treatment recommendations for all stages of endometrial carcinoma. A variety of clinical and technical issues within early and advanced stage of disease will be covered. The management of inoperable and recurrent cases will also be discussed. The controversy on the role of brachytherapy alone or in combination with external beam therapy in surgically managed early stage disease will be presented. Despite the relatively high overall survival rates in endometrial cancer, there is the need for a critical appraisal of the treatment approach for this disease. In low risk and early stage disease, the goal of therapy should be to minimize treatment morbidity without compromising clinical outcome. In high risk and advanced stage of disease, treatment strategies are needed to improve on control of Ioco-regional disease and distant metastases.

In summary, the course will include a) a review of the natural history of disease; b) the role and limitations of surgical staging; c) overview of clinical and surgical pathologic prognostic factors and their impact on therapy; and d) current controversies and ongoing clinical trials.

108 RTOG: Updated Results of Randomized Trials Walter J. Curran, Jr., M.D., Thomas Jefferson University Hospital/Bodine Treatment Center, Philadelphia, PA

Purpose/Objective: To review the background, radionale and available results for recently completed randomized comparative clinical trials of the Radiation Therapy Oncology Group (RTOG), including inter group trials in which the RTOG has been the

managing group or a major participant. When available, laboratory studies will be correlated with clinical results.

109 Chemotherapy for Head and Neck Cancer David G. Pfister, M.D., Memorial Sloan Kettering Cancer Center, New York, NY

Purpose/Objective: The role of chemotherapy in the management of squamous cell carcinoma of the upper aerodigestive tract is undergoing rapid evolution. Historically, the use of chemotherapy was limited to patients with incurable disease who had exhausted all surgical and radiation therapy options. The results of recent randomized trials, however, suggest an increasing role for chemotherapy as part of primary management in patients with unresectable disease; advanced larynx or hypopharynx cancer with the intent of larynx preservation, or advanced nasopharynx cancer. This refresher course will provide a comprehensive overview of the current indications for chemotherapy in the management of these malignancies, and will highlight areas of controversy and future directions of investigation.

110 Thyroid Cancer: Natural History, Management Strategies (Surgery, XRT and RAI) and Outcomes Ashok Shaha, M.D., Memorial S/oan Kettering Cancer Center, Head and Neck Services, New York, NY

Objectives: 1. To discuss evaluation of thyroid cancer 2. To discuss treatment of thyroid cancer 3. Prognostic factors and risk group analysis 4. Role of radioactive iodine treatment 5. Role of external radiation therapy 6. Survival in thyroid cancer

111 Breast Cancer: Postoperative Irradiation and Management of Locally Advanced Disease Robert R. Kuske, M.D., Ochsner Center Radiation Oncology, New Orleans, LA

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Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer.