Prognostic importance of p53 and c-erbB-2 oncoproteins overexpression in patients with breast cancer.

Using immunohistochemistry, 119 breast cancer tissues were examined for overexpression of p53 and c-erbB-2 oncogene proteins. In 46 (38.7%) of the cases p53 was overexpressed, while 35 (29.4%) demonstrated positive c-erbB-2 immunostaining. Expression of these two oncogene products was closely correlated (p < 0.01). There was no significant association between p53 protein expression and age of the patients, clinical stage, tumor size, number of involved nodes or estrogen receptor status. However, we found significant correlation between p53 protein expression and 5-year disease-free survival (p = 0.0113). In addition, the findings in this study clearly indicated that the co-overexpression of p53 and c-erbB-2 proteins was a powerful predictor for early recurrence in the patients with breast cancer.

Ondansetron: prevention of nausea & vomiting in cisplatin based chemotherapy.

Ondansetron in the prophylaxis of Cisplatin-induced emesis and nausea. The 5-HT3 antagonist ondansetron clearly offers a new approach to the control of Cisplatin-induced emesis and has been evaluated in Thailand. To evaluate anti-emetic efficacy of ondansetron in the prevention of nausea and vomiting induced by Cisplatin containing cancer chemotherapy regimen, we carried out an open multicentre study from January 1991 to December 1992. In this study, patients receiving Cisplatin based chemotherapy received ondansetron 32 mg as a single intravenous dose over 15 minutes prior to the administration of Cisplatin. This was followed by oral ondansetron 8 mg three times a day, preferably one hour before each meal for 5 days. All patients were chemotherapy naive in-patients and were at least 18 years or older with Karnofsky performance status of at least 60 per cent. The number of emetic episodes, nausea and food intake were recorded during the 24 hours following Cisplatin administration. A total of 103 patients were recruited with 84 (81.6%) evaluable patients (48 men and 36 women) scheduled to receive cisplatin chemotherapy at dose 60 mg/m2 or more (60-100 mg/m2), either as single agent or combination therapy. Complete response (complete control of emesis) was achieved in 60 per cent; major response (1-2 emetic episodes) was 13 per cent; minor response (3-5 emetic episodes) was 13 per cent; and failure (5+ emetic episodes) was 10 per cent. Side effects were very mild and not significant. We conclude that ondansetron is efficacious in protecting patients from Cisplatin induced emesis and nausea.

Five years survival result of twenty-two breast cancers treated by breast conserving therapy at NCI Bangkok.

From November 1984 to July 1992 Breast Conserving Therapy (BCT) has been offered to clinical stage 1 & 2 breast cancers. Twenty two breast cancers were treated and passed the five year period. Only one patient was lost in follow-up. The treatment consisted of tumorectomy, full axillary nodal dissection and total breast irradiation with a booster dose at the biopsy site. Adjuvant chemotherapy is administered in cases of positive axillary nodes. There are seventeen living and four deaths. The 5 year survival was 80.95 per cent. The four deaths were node negative and in the young age group (under 36 years of age). Three out of four who died of distant metastasis showed precedent local recurrence. Local recurrence was noted in four patients (19.04%). Second primary breast cancers were found in four patients and two of them died of distant metastasis and one of these two had local recurrence in the first breast carcinoma. There were two survivors from distant metastasis, one with single pulmonary metastasis and another with spine and pelvic bony metastases. Slight to moderate arm edema was found in 5 patients. (22.73%). From our study we have been convinced that BCT seems to give poorer results in terms of survival in the young age group (especially under 36 years of age). Those who are under 36 years of age and have T2 lesion with negative node or local recurrence as well as second primary breast carcinoma should receive adjuvant chemotherapy.