© Oxford University Press 2006.
IN THIS ISSUE
Survival and Postmastectomy Adjuvant Radiation TherapyTo determine whether postmastectomy radiation therapy reduces mortality among women with operable breast cancer, Gebski et al. (p. 26) reanalyzed results from 36 clinical trials, in which giving radiation therapy was the only difference between groups in each trial. They found a 2.9% absolute increase in 5-year survival and a 6.4% absolute increase in 10-year survival associated with radiation therapy, compared with no radiation therapy, among trials that used a biologically equivalent dose (BED) of 40–60 Gy in 2 Gy fractions with an appropriate target volume. No statistically significant change in survival was associated with radiation therapy delivered in an inadequate or excessive dose or to an inappropriate target volume. They conclude that adjuvant radiation therapy with an optimal BED was associated with improved survival for up to 10 years.
In an accompanying editorial, Prosnitz and Marks (p. 3) note that the quality of postmastectomy radiation therapy is important for outcome and that evidence is now strong for use of radiation therapy after both mastectomy and lumpectomy. They note that emphasis should shift to developing better selection criteria for patients who should receive postsurgical radiation therapy.
Cholesterol-Lowering Drugs and Colorectal Cancer Incidence
A large study recently reported that use of cholesterol-lowering statins for 5 years was associated with a 47% reduction in colorectal cancer risk. Jacobs et al. (p. 69) examined the association between use of cholesterol-lowering drugs and colorectal cancer incidence among more than 100,000 men and women in the Cancer Prevention Study II Nutrition Cohort. They found that use of cholesterol-lowering drugs, even for 5 or more years, was not associated with colorectal cancer incidence. The authors note, however, that they could not rule out a small reduction in risk or an effect associated with a specific type or dose of statins.
In an editorial, McLaughlin (p. 4) notes the contribution of large, well-characterized cohort studies to monitoring disease and behavior patterns. Although the cohort study analyzed began before statins were developed, it was estimated that 17.6% of the participants were current statin users. He concludes that the study by Jacobs et al. was instructive for the association it explored and for the changes detected in exposures, risks, and benefits, which can be dramatic and occur constantly across populations.
G207 and Temozolomide Combination for Glioma
Some gliomas are resistant to the alkylating agent temozolomide because they can repair the DNA damage it induces. The G207 herpes simplex virus with mutated ribonucleotide reductase and 
34.5 genes has limited oncolytic activity. To determine whether temozolomide-induced DNA repair could enhance G207 oncolytic activity, Aghi et al. (p. 38) measured G207 and temozolomide interactions in human glioblastoma cell lines and compared survival of mice with intracranial xenograft gliomas that were treated with a single agent or the drug combination. The authors found that the drug interactions were synergistic in the cell lines and that mice treated with the combination survived longer than those treated with either G207 or temozolomide alone. They conclude that temozolomide-resistant cells may be a target for herpes simplex virus-based chemotherapy.
Autoimmune and Inflammatory Disorders and NHL Risk
The few known risk factors for non-Hodgkin lymphoma (NHL) include several autoimmune disorders and inflammatory conditions. In this issue (p. 51), Ekström Smedby et al. investigated the association between NHL subtypes and specific autoimmune and inflammatory conditions in a population-based case–control study in Denmark and Sweden. Risks of all NHL and of diffuse large Bcell lymphoma were increased in association with four autoimmune and inflammatory conditions: rheumatoid arthritis, primary Sjögren syndrome, systemic lupus erythematosus, and celiac disease. Some of these disorders were associated with marginal zone, lymphoplasmacytic, or T-cell lymphoma. The increased risks were not associated with treatment for autoimmune and inflammatory disorders but did show an association with indicators of disease severity. The authors note that the observed NHL subtype pattern in the four conditions is consistent with the hypothesis that chronic B-cell stimulation and antigenic drive play roles in autoimmunity-related lymphomagenesis.
Reliability of Self-Reported Family History of Cancer
To evaluate the reliability of self-reported data on familial cancer in casecontrol studies, Chang et al. (p. 61) analyzed self-reported and registry-based data on familial cancer from 1508 lymphoma patients and 1229 control subjects in a population-based case–control study of malignant lymphoma. Participants were interviewed by telephone about their family history of cancer and were linked to the Swedish Multi-Generation Register and Cancer Register to identify confirmed cancers in first-degree relatives. The authors found that the cancer patients reported a family history of any cancer with higher sensitivity but with lower specificity than the control subjects. The reliability of reporting family history of site-specific cancers was similar among patients and control subjects, except for hematopoietic cancer, which was reported with higher sensitivity by patients than by control subjects. The authors conclude that differences in accuracy of reporting between case patients and control subjects may produce biased results in case–control studies of familial cancer risk.
Carbonated Soft Drinks and Risk of Esophageal Cancer
Carbonated soft drinks are associated with reflux, and both carbonated soft drink consumption and incidence of esophageal adenocarcinoma have sharply increased in the past 30 years. Using a U.S. population-based multicenter case–control study of 1095 cancer patients and 687 control subjects, Mayne et al. (p. 72) evaluated a possible association between carbonated soft drink intake and risks of esophageal and gastric cancer. The authors found that carbonated soft drink consumption was inversely associated with esophageal adenocarcinoma risk, mainly attributable to diet soda, and that high intake did not increase risk of any esophageal or gastric cancer subtype in men or women. They conclude that carbonated soft drink consumption is not likely to have contributed to the rising incidence of esophageal adenocarcinoma.
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