ABSTRACT
Cancer patients commonly develop anaemia. Erythropoiesis-stimulating agents (ESAs) are frequently used in cancer treatment. Numerous controlled studies indicate that ESAs can raise haemoglobin levels, reduce transfusion requirements and improve quality of life in anaemic cancer patients receiving chemotherapy. They were previously used to enhance response to radiation therapy, via increasing tumour cell oxygenation. Since the 2002 guideline, there has been increasing attention to the safety of ESA treatment in patients with cancer. Two placebo-controlled phase III randomised clinical trials published in 2003 showed evidence of harmful effects of ESAs on survival and/or tumour outcomes. Subsequently, recent trials and several large meta-analyses have confirmed negative impact on survival and/or disease progression. To comprehensively examine whether ESA use affects safety outcomes in cancer patients in different settings (chemotherapy, radiotherapy and targeted therapies), we conducted a literature review of all clinical trials, small and large meta-analyses from 1990 to 2012.
Subject(s)
Anemia/etiology , Hematinics/adverse effects , Neoplasms/drug therapy , Neoplasms/mortality , Blood Transfusion , Disease Progression , Hematinics/therapeutic use , Humans , Neoplasms/complications , Prognosis , Survival RateABSTRACT
INTRODUCTION: Transitional cell carcinoma (TCC) of the ovary is a rare, recently recognized, subtype of ovarian surface epithelial cancer. CASE PRESENTATION: A 69-year-old postmenopausal woman presented with a 2-year history of progressive enlargement of an abdominal mass. Abdominal computed tomography showed a pelvic mass. CA-125 was normal. A staging operation with total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy and pelvic lymph node dissection was performed. After surgery, the pathologic report of the right ovarian tumour was TCC, grade 3, stage IC. The patient underwent 3 cycles of chemotherapy: carboplatin and paclitaxel. She is regularly followed up and has been disease free for 10 months CONCLUSION: Transitional cell carcinoma (TCC) of the ovary is a rare subtype of epithelial ovarian cancer. Surgical resection is the primary therapeutic approach, and patient outcomes after chemotherapy are better than for other types of ovarian cancers.
Subject(s)
Carcinoma, Transitional Cell/diagnosis , Hysterectomy/methods , Ovarian Neoplasms/diagnosis , Ovariectomy/methods , Aged , Antineoplastic Agents/therapeutic use , Biopsy , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/surgery , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Lymph Node Excision , Neoplasm Staging , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , Pelvis , Tomography, X-Ray ComputedSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma, Neuroendocrine/drug therapy , Breast Neoplasms/pathology , Carcinoma, Neuroendocrine/pathology , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Fatal Outcome , Female , Fluorouracil/administration & dosage , Humans , Immunohistochemistry , Treatment FailureABSTRACT
Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm. We report two observations occurring in female patients, 54 and 65 years old, who consulted for a mastodynia. Clinical examination showed limited painful breast nodules. On ultrasound and mammography they are well-limited bulky mass without microcalcifications. Diagnosis was based on final histopathological exam completed by immunohistochemistry or after slides review. The two patients were treated by mammectomy plus adjuvant radiotherapy and remain alive in remission with a follow-up of 29 and 36 months.
Subject(s)
Breast Neoplasms , Carcinoma, Adenoid Cystic , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Carcinoma, Adenoid Cystic/diagnosis , Carcinoma, Adenoid Cystic/radiotherapy , Carcinoma, Adenoid Cystic/surgery , Female , Humans , Immunohistochemistry , Lymph Node Excision , Mammography , Mastectomy , Middle Aged , Physical Examination , Postoperative Care/methods , Prognosis , Radiotherapy, Adjuvant , Rare Diseases , Treatment Outcome , Tunisia , Ultrasonography, MammaryABSTRACT
UNLABELLED: Nasopharyngeal carcinoma (NC), especially the undifferenciated type, is a rare malignant disease. Prevalence is high in Southeast Asia and North Africa. OBJECTIVES: To determine the role of chemotherapy in the treatment of cancers of the nasopharynx. MATERIAL AND METHODS: [corrected] A search of the MEDLINE databases from 1970 to 2005, for articles testing chemotherapy in nasopharyngeal carcinoma. The key words: Nasopharyngeal carcinoma, chemotherapy, concurrent chemo-radiation, were used to access to principal trials. RESULTS: Nine phase III randomised trials, testing the combination of chemotherapy and radiotherapy in nasopharyngeal carcinoma were found. There us increasing evidence attesting to the beneficial effect of adding of chemotherapy to radiotherapy in the treatment of locally advanced disease (stage III and IV), especially concurrent chemo-radiation, considering the benefit in terms of overall survival. Associations containing cisplatin proved to be most effective. New molecules (capecitabine, taxanes, gemcitabine...) are currently in the course of testing, in phase II studies, for recurrent and metastatic NC, for which there is not still standard treatment. CONCLUSION: Medline review reveals that concurrent chemo-radiation, containing cisplatin, is standard treatment for locally advanced nasopharyngeal carcinoma. Metastatic disease is treated by palliative chemotherapy.