ABSTRACT
Epidermoid tumors comprise 5% of posterior fossa tumors and are the third among tumors of the cerebellopontine region in frequency. In the review of recent literature, there are several case reports but few case series. In this retrospective study, we evaluated the surgical results of our patients, reviewed the existing literature and compared our results with other series. Surgical results of 8 patients with epidermoid tumor that originated mostly in the posterior fossa from 1980-2008 in Mehrad Hospital, in Tehran, are presented. The age, sex, duration, signs and symptoms, topographical location, surgical approach, the extent of resection and outcome are analyzed and compared with other series. This study is based on the clinical data of 8 patients operated from 1980-2008 in Mehrad Hospital, in Tehran, due to posterior fossa epidermoid tumors. 62.5% of the patients were female. The average age of our patients were 34.1 years [range: 2453 years]. The most common symptom was headache [87.5%]. The most common tumor location was cerebellopontine angle. Supratentorial extension was observed in half of our patients. In 37.5% of the cases, the tumor was resected totally. The mean followup period was 31.5 months [range: 1-115 months]. In the post operative period, 37.5% of our patients suffered from complicating events, but we had no mortality in our series. In contrast with other posterior fossa benign tumors, in which the cure is obtained by overcoming surgical technical difficulties, the main problems in the management of epidermoids remain misdiagnosis, incomplete removal at the first operation, and delayed detection of recurrences. With the use of modern microneurosurgical techniques, our surgical results are comparable with other series. Extended multicentric prospective studies are recommended for more definitive results
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Infratentorial Neoplasms/pathology , Treatment Outcome , Retrospective Studies , Carcinoma, Squamous CellABSTRACT
This prospective phase III study was designed to compare the activity of two combinations chemotherapy drugs in advanced gastric adenocarcinoma In a double blinded clinical trial, From Jan. 2002 to Jan. 2005, ninety patients with advanced gastric adenocarcinoma were randomly assigned to 1] Cisplatin and continuous infusion of 5FU and Epirubicin [ECF], and 2] Cisplatin and continuous infusion of 5FU with Docetaxel [TCF]. Reduction in tumor mass, overall survival [OS], time to progression [TTP], and safety were measured outcome. About 90% of patients had stage III or IV disease and the most common sites of tumor spread were peritoneal surfaces, liver and Paraaortic lymph nodes in either group. The objective clinical response rate [more than 50% decreases in tumor mass] was 38% and 43% in ECF and TCF group respectively. Global quality of life increased [p=0 002] and symptoms of pain and insomnia decreased after chemotherapy. Patients in TCF had more grade one or two skin reactions, neuropathy and diarrhea. Fourteen patients underwent surgery. Complete microscopic [R0] resection had done in two of ECF and six of TCF tumors [p=0.015]. Two cases in TCF group showed complete pathologic response. Median TTP was nine months and 10 months in ECF and TCF group respectively. Median OS was 12 months in both groups. Although there wasn't statistically significant difference regarded to clinical response or survival between two groups, TCF showed more complete pathologic response