ABSTRACT
INTRODUCTION: Curative therapy for patients with small-cell lung cancer (SCLC) is based on multidrug chemotherapy combinations and radiotherapy. After a long time follow-up, the aim of the study was to evaluate the efficacy and toxicity of sequential chemo-radiotherapy and the effect of prophylactic cranial irradiation (PCI). METHODS: From 1995-2005, 96 patients with SCLC (64 limited-disease [LD], 32 extensive-disease [ED]; median age 61 years [range 39-79]) were treated at our department with varying chemotherapy regimens and sequential mediastinal radiotherapy (50 Gy + 10 Gy boost in case of residual disease after chemotherapy). Afterwards, 15 patients with LD, good general condition and at least partial response after local treatment received PCI (30 Gy). RESULTS: After a median follow-up of 78.6 months, 20 patients remained alive (20.8%, median survival time 18.2 months). The 2-/5-year overall survival rates were 33.8% and 12.6%, the 2-/5-year loco-regional control rates were 30.3% and 24.5%, respectively. Distant metastases occurred in 43 patients (24 cerebral). Cerebral metastasis occurred in 6.7% and 27.2% of the patients with PCI and without PCI respectively. Only tumor stage showed a statistically significant impact on overall survival and loco-regional control in multivariate analysis. Radiotherapy was well tolerated. Grade 3/4 toxicity occurred in seven patients. Prognosis of patients with SCLC remains poor. Administration of PCI in selected patients bears a decrease in the incidence of cerebral metastases. Alternative chemotherapy schemes as well as irradiation schemes and techniques should be the substance of future randomized trials.
Subject(s)
Brain Neoplasms/prevention & control , Cranial Irradiation , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/radiotherapy , Adult , Analysis of Variance , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/secondary , Combined Modality Therapy/methods , Female , Follow-Up Studies , Hemoglobin A/analysis , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Neoplasm Staging , Neoplasm, Residual , Radiotherapy Dosage , Remission Induction , Small Cell Lung Carcinoma/mortality , Small Cell Lung Carcinoma/secondary , Survival Rate , Young AdultABSTRACT
Vesicles and bullae developed in six patients with psoriasis while they were undergoing therapy for their psoriasis. Skin biopsy specimens were taken from their lesions and studied for regular histopathologic findings and direct immunofluorescence. These studies confirmed that they had coexistent psoriasis and bullous pemphigoid. A review of the therapy that the patients were given incriminates anthralin, crude coal tar, ultraviolet light, and salicylic acid in the possible cause of the development of their bullous pemphigoid lesions.
Subject(s)
Psoriasis/complications , Skin Diseases, Vesiculobullous/complications , Aged , Anthralin/adverse effects , Dermatologic Agents/adverse effects , Female , Humans , Male , Middle Aged , Psoriasis/pathology , Skin Diseases, Vesiculobullous/etiology , Skin Diseases, Vesiculobullous/pathology , Ultraviolet Rays/adverse effectsABSTRACT
Twenty-six tattoos were treated by salabrasion. The salt was left on the abraded surface from zero to 24 hours. The percentage of residual pigment varied from 50%, when the salt was removed immediately after salabrasion, to 5%, when the salt was left in place for over 12 hours. When the salt was left on for variable periods, some degree of scarring and hypopigmentation occurred in 79% and in 59% of the tattoos, respectively. When the salt was removed immediately after salabrasion, 29% of the tattoos showed scarring and 29% showed hypopigmentation. Our results show that the best method is to remove the salt immediately after salabrasion, but that this form of therapy should only be done on those lesions where the eventual cosmetic result is not important.
