ABSTRACT
Patients with stage IIIB breast carcinoma represent only a small proportion of women with breast cancer in western countries but may constitute up to 50% of cases in underdeveloped countries. The prognosis remains poor despite aggressive treatment. Nineteen patients (11 with inflammatory breast carcinoma) received at least three courses of neoadjuvant chemotherapy of methotrexate, vinblastine, adriamycin, cisplatin, and folinic acid (MVAC/FA) followed by mastectomy. Six months of cyclophosphamide, methotrexate, and 5-fluorouracil were given after surgery. Radiation therapy followed chemotherapy. Seventy percent of patients achieved complete and 14% partial response after MVAC/FA chemotherapy alone. Eleven patients (58%) survived 5 years, and 30% survived at least 8 years. The addition of cisplatin in combination chemotherapy used as first-line treatment for stage IIIB breast carcinoma was well tolerated, resulted in higher response rates, and appeared to have an effect on overall survival.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/mortality , Cisplatin/administration & dosage , Doxorubicin/administration & dosage , Drug Administration Schedule , Female , Fluorouracil/administration & dosage , Humans , Leucovorin/administration & dosage , Methotrexate/administration & dosage , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Survival Analysis , Vinblastine/administration & dosageABSTRACT
Two hundred and twenty one consecutive cases of bronchogenic carcinomas were studied histologically for evidence of associated lesions. Seventy eight lesions were seen in 55 patients (24.8%). The most frequent was tuberculosis, seen in 29 patients. The next in frequency were scars, in 22, emphysema in 12 and thickened pleura in 7. Interstitial fibrosis, chronic bronchitis, lobar pneumonia and bronchiectasis, were other lesions, seen in very few cases. The types of carcinoma, in which associated lesions seen were, undifferentiated carcinoma (76%), adeno-carcinoma (56%), mixed tumor (37%), large cell anaplastic (25%), small cell anaplastic (23.7%) and epidermoid carcinoma in (5.44%). The incidence of tuberculous lesions in autopsies unassociated with tumor is 7%, as compared to 24.8% incidence of association with carcinoma; which is significant. There were seven scar cancers; with origin in tuberculous scars in two. The study indicates necessity of prospective study in this field.
Subject(s)
Carcinoma, Bronchogenic/complications , Lung Neoplasms/complications , Tuberculosis, Pulmonary/complications , Adenocarcinoma/complications , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle AgedABSTRACT
A 32-year-old woman with human immunodeficiency virus (HIV) infection and progressive anemia presented to University Hospital with a hemoglobin of 3.4 g/dl. Because of her religious beliefs, she refused transfusion, and no iron or vitamin deficiency was found. She responded to recombinant human erythropoietin 150 U/kg intramuscularly thrice weekly with a rise in hemoglobin to 9.3 g/dl by 3 months of treatment. The serum erythropoietin level before treatment was markedly elevated at 1,340 mU/ml.
