Phase III Trial of Trimodality Therapy With Cisplatin, Fluorouracil, Radiotherapy, and Surgery Compared With Surgery Alone for Esophageal Cancer: CALGB 9781

The primary treatment modality for patients with carcinoma of the esophagus or gastroesophageal junction has been surgery, although primary radiation therapy with concurrent chemotherapy produces similar results. As both have curative potential, there has been great interest in the use of trimodality therapy. To this end, we compared survival, response, and patterns of failure of trimodality therapy to esophagectomy alone in patients with nonmetastatic esophageal cancer

International Conference on Advances in Radiation Oncology (ICARO): Outcomes of an IAEA Meeting

The IAEA held the International Conference on Advances in Radiation Oncology (ICARO) in Vienna on 27-29 April 2009. The Conference dealt with the issues and requirements posed by the transition from conventional radiotherapy to advanced modern technologies, including staffing, training, treatment planning and delivery, quality assurance (QA) and the optimal use of available resources. The current role of advanced technologies (defined as 3-dimensional and/or image guided treatment with photons or particles) in current clinical practice and future scenarios were discussed

Interdisciplinary Coordination for Breast Healthcare: A Rational Approach to Detection, Diagnosis, and Treatment

Breast disease diagnosis and management is a quintessential example of a process requiring multidisciplinary coordination. European guidelines consider a coordinated team approach to be the standard of care. While the necessity of multidisciplinary coordination of breast healthcare is recognized in the US, its adoption in a practical sense has been fragmented and incomplete. Interdisciplinary communication and coordination has become the cornerstone of effective cancer care, but it is not supported financially or practically by a healthcare infrastructure that primarily focuses on the reimbursement of individual specialists for procedures and therapies rather than the process by which these therapies are optimally selected and integrated. Practical obstacles to interdisciplinary care are complicated by the heterogeneity of healthcare systems that must necessarily adapt to differences in population distribution, variability in access to care, availability of trained specialists, varied models of medical care delivery, and structure of insurance coverage. The American Society of Breast Disease (ASBD) is a multidisciplinary group that focuses on how interdisciplinary breast cancer care can be successfully delivered. Since much of quality improvement hinges on outcome measurement, metrics of quality interdisciplinary care are needed to assess how well we are doing in different healthcare venues. In November 2006, the ASBD held a colloquium entitled Ensuring Optimal Interdisciplinary Breast Care in the United States, the purpose of which was to develop a framework of quality indicators related to multidisciplinary and interdisciplinary care that can be used to assess the degree to which interdisciplinary communication and coordination is taking place.Breast-cancer, Disease-management-programmes