ABSTRACT
Four hundred and ten patients with epithelial ovarian cancer FIGO stages I and II were registered by a Danish multicenter study group (The Danish Ovarian Cancer Group - DACOVA). Two-thirds were stage I, the most frequent substage was Iai which was the classification in 27%. Five-year survival for stage I was 72%, and 38% for stage II. Multivariate analysis showed that age, stage, residual tumor, histologic grade and adjuvant treatment had prognostic value. For stage, three significantly different groups could be identified: (1) stage Iai, (2) stage Iaii-Ic, and (3) stage II. Histologic grade showed a significant survival difference between all grades. Adjuvant treatment had a moderate but significant impact on survival. Patients in stage Iai had a good survival with surgery alone and will probably not benefit from adjuvant therapy. Adjuvant treatment improved survival for the remaining patients in stages I and II without residual tumor. A difference between treatment modalities was not observed. However, the data need to be confirmed by a randomized trial. Patients in stage II with residual tumor should be treated as stage III.
ABSTRACT
Cancer of the pancreas is most often not diagnosed before it has reached unresectable stages. The development of effective palliative treatment for these patients and for those with recurrence after resection is clearly needed. The present study reports the results of ultrasonically guided percutaneous implantation of 125I seeds in 19 patients with cancer of the pancreas. Twelve patients had further adjuvant external radiation. Despite satisfactory seed placement and delivery of the planned radiation dose in most cases, clinical improvement was lacking or only slight and short-lived. No difference in survival or palliation was observed between patients treated with seeds alone compared with patients treated with seeds and external radiation. Survival after seed implantation was short (median 140 days, range 7-401 days). Ultrasonically guided percutaneous implantation of 125I seeds cannot be recommended in the treatment of unresectable carcinoma of the pancreas.
Subject(s)
Brachytherapy , Iodine Radioisotopes/therapeutic use , Palliative Care , Pancreatic Neoplasms/radiotherapy , Adult , Aged , Female , Humans , Iodine Radioisotopes/administration & dosage , Male , Middle Aged , Pancreatic Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
From 1 September 1981 to 1 January 1987, 118 patients with FIGO Stage IB, IC, IIA, IIB, and IIC epithelial ovarian cancer were randomized to abdominal irradiation or pelvic irradiation + cyclophosphamide. There was no difference between the regimens with respect to recurrence-free survival (55%) and 4-year overall survival (63%). At routine second-look laparotomy, 16% of patients without clinical detectable tumor showed recurrence. Twenty-five percent of the patients treated with pelvic irradiation + cyclophosphamide had hemorrhagic cystitis, probably caused by radiation damage and cyclophosphamide cystitis. Eight percent had late gastrointestinal symptoms requiring surgery.
Subject(s)
Abdomen/radiation effects , Cyclophosphamide/therapeutic use , Ovarian Neoplasms/radiotherapy , Pelvis/radiation effects , Aged , Cyclophosphamide/adverse effects , Female , Humans , Intestines/drug effects , Intestines/pathology , Laparotomy , Neoplasm Recurrence, Local , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , Patient Compliance , Radiation Injuries , Random Allocation , Reoperation , Survival AnalysisABSTRACT
Twenty-two patients with bladder cancer stage T2 or T3NxM0 received preirradiation treatment with cisplatin. Three complete and seven partial remissions were achieved. Responders received additional cisplatin concomitantly with radiotherapy, for a total of eight complete remissions. Toxicity from cisplatin alone or in combination with radiotherapy was moderate. Seven of the ten responders following preirradiation cisplatin are alive without evidence of disease. All nonresponders have died due to relapse (follow-up time, 46-80 months). Randomized trials with and without preirradiation cisplatin are warranted to establish whether cisplatin improves the prognosis of patients with invasive bladder cancer.
Subject(s)
Carcinoma/drug therapy , Cisplatin/therapeutic use , Urinary Bladder Neoplasms/drug therapy , Adult , Aged , Carcinoma/pathology , Carcinoma/radiotherapy , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/radiotherapyABSTRACT
Two hundred sixty-seven patients with advanced epithelial ovarian carcinoma were randomized to cis-platinum and cyclophosphamide versus cis-platinum, cyclophosphamide, and doxorubicin. Complete pathological response, evaluated at second-look laparotomy and survival, showed no differences between the two treatment groups. Recurrence-free survival after negative second look was 61% at 24 months.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/drug therapy , Ovarian Neoplasms/drug therapy , Carcinoma/mortality , Cisplatin/administration & dosage , Clinical Trials as Topic , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Female , Humans , Middle Aged , Ovarian Neoplasms/mortality , Random AllocationABSTRACT
A new method is described for precise transperineal insertion of radioactive 125iodine seeds in patients with prostatic cancer. The procedure is done under transrectal ultrasonography guidance using a special multichannel puncture attachment and a simple, efficient insertion technique. The advantages of the method are 1) the patients are spared the inconvenience and risk of an operation, 2) improved dose calculations are possible, and 3) seed application is easy and more precise than by the conventional operative free-hand technique.
Subject(s)
Brachytherapy/methods , Iodine Radioisotopes/administration & dosage , Prostatic Neoplasms/radiotherapy , Ultrasonography , Humans , MaleABSTRACT
The absorption of doxorubicin hydrochloride (Adriamycin) in or through the urothelium has been determined as the difference between the instilled amount and the amount recovered after complete drainage of the bladder in 9 patients suffering from superficial urinary bladder tumors (grade I-II). A total of 22 absorption experiments were done. The relative deficit was found to be between 0 and 16 per cent (median 4 per cent). One of the reasons for the variations in the relative deficit was probably intravesical bleedings. One hundred seventy-two mumol. (100 mg.) doxorubicin was dissolved in 100 ml. isotonic saline, and the instilled liquid was retained in the bladder for one hour. No patient showed any sign of systemic side effects caused by doxorubicin. The results seem to indicate that it is possible to use a dose for intravesical instillation which is five times as high as the maximum dose for intravenous administration.
Subject(s)
Doxorubicin/metabolism , Urinary Bladder Neoplasms/drug therapy , Absorption , Doxorubicin/administration & dosage , Doxorubicin/therapeutic use , Drainage , Humans , Urinary Bladder Neoplasms/metabolism , Urinary Bladder Neoplasms/surgeryABSTRACT
A new method for ultrasonically guided percutaneous interstitial implantation of 125I seeds in abdominal tumours is described. A linear array puncture transducer mounted on a special x-y-z co-ordinate frame is used in combination with a special insertion technique. Following in vitro experiments the technique was applied in two patients with pancreatic cancer. There were no immediate complications after the implantation of 36 and 37 125I seeds.
Subject(s)
Iodine Radioisotopes/administration & dosage , Pancreatic Neoplasms/radiotherapy , Aged , Brachytherapy/methods , Female , Humans , Iodine Radioisotopes/therapeutic use , Male , Middle Aged , UltrasonographySubject(s)
Etoposide/therapeutic use , Neoplasms/drug therapy , Podophyllotoxin/therapeutic use , Administration, Oral , Alopecia/chemically induced , Clinical Trials as Topic , Drug Evaluation , Etoposide/administration & dosage , Etoposide/adverse effects , Gastrointestinal Diseases/chemically induced , Hematologic Diseases/chemically induced , HumansABSTRACT
PIP: The effectiveness of megestrol acatate (350 mcg/day) was studied in 194 women over a total of 2048 woman-months of use. There were 23 pregn ancies, 7 of which could be attributed to patient error, for an adjusted pregnancy rate of 9.4/100 woman-years of use. Abnormal bleeding was the most dominant side effect (22.2%). 11.8% of the women discontinued the regimen because of unwanted pregnancy, and 8.2% did so because of abnormal bleeding. The acceptability rate was 73.3%. Similar results were reported in another trial.^ieng
Subject(s)
Contraceptives, Oral , Megestrol/administration & dosage , Adolescent , Adult , Female , Humans , Megestrol/adverse effects , Menorrhagia/chemically induced , Metrorrhagia/chemically induced , Ovulation/drug effects , Pregnancy , TabletsABSTRACT
Abstract The clinical effects of treatment with a trimethoprim (TMP)-sulphamethoxazole (SM) combination were studied in 40 patients with urinary tract infection. The indication for treatment was symptoms of urinary tract infection with > 10(5) colonies per ml of urine. The dosage was 160 mg of TMP and 800 mg of SM administered orally twice daily for 10 days. The bacteriological in vitro examination revealed synergic effect of the two agents on 30 out of 55 bacterial strains (55%). Out of 32 strains which were resistant or slightly sensitive to SM, synergy was revealed in 14 instances (44%). Development of resistance to TMP was seen in one case. In 20 patients with non-complicated urinary tract infections, sterile urine was found 3 and 14 days after termination of treatment in 100% and 89%, respectively. In one case there was recurrence, and in one case reinfection occurred. In 20 patients with complicated urinary tract infections, sterile urine was found 3 and 14 days after termination of treatment in 80% and 55%, respectively. In 4 cases infection recurred, and in 5 cases the treatment had no effect. Side effects were seen in 3 patients; one case of exanthem, one of nausea, and one of leucopenia. In one case treatment had to be withdrawn because of exanthem, in another because of nausea.
