Chemotherapy in XXXX .

@entity1 @entity5 @entity1138 @entity262 @entity344 @entity1820 @entity3 @entity14
The frequency of @entity1820 mandates innovative and individualized therapies. Chemotherapy used as sole treatment for these diverse @entity5 has not been generally successful in providing palliation or improving @entity1 survival. Radiotherapy has been more successful at controlling local manifestations of disease, but the high incidence of systemic @entity3 in most @entity5 limits the impact of this modality on curability. Combinations of radiotherapy and chemotherapy may prove to be more valuable than single modality treatment in improving local control of @entity5 , @entity262 , and improving @entity1 tolerance to treatment. A model for this approach is the current management of @entity5 , in which combined modality therapy has largely supplanted primary surgery. Data from trials in other primary @entity5 sites strongly suggest further exploration of combined treatments--surgical, radiotherapeutic, and chemotherapeutic--in @entity344 . Nearly 25% of all @entity5 diagnosed in the United States each year involve the GI tract; thus, there is a powerful imperative for the development of new therapeutic strategies in these diseases. Any discussion of the role of chemotherapy in @entity1820 must necessarily be broad, because assessment must include diseases with highly variable surgical curability, histologies, and sensitivities to chemotherapeutic agents. In addition, whereas it has been quite easy to perform standard phase II trials in @entity14 , other disease sites, such as the esophagus, the pancreas, and the biliary tract, have been much less extensively studied. In spite of these limitations, there is a wealth of data in the literature concerning the use of chemotherapy in @entity344 . This article, while not exhaustive, describes the current status of chemotherapy for these diverse diseases, with emphasis on the role of @entity1138 .
