LWBK1006-40 LWW-Govindan-Review December 12, 2011 20:33
Chapter 40•Treatment of Metastatic Cancer 515progression on therapy, positive resection margins, less than complete
tumor necrosis and history of≤2 hepatectomies.Answer 40.15. The answer is B.
In a phase II trial involving 31 patients with breast cancer who had expe-
rienced progressive bone metastases or skeletal-related events (SRE) while
on pamidronate benefit was seen by switching to the more potent zole-
dronic acid. Treatment with zoledronic acid was associated with signifi-
cant reductions in both severity of pain (p<0.001) and urinary markers
of bone turnover (P=0.008).Answer 40.16. The answer is E.
Contraindications to peritoneovenous shunts include chylous and hemor-
rhagic ascites which are associated with high rates of shunt clotting and
occlusion. Also underlying cardiac, pulmonary, and renal insufficiency
could be exacerbated from the increased volumes draining via the perito-
neovenous shunts.