ABSTRACT
OBJECTIVES: To determine the safety and efficacy of combination chemotherapy with docetaxel (DTX), estramustine phosphate (EMP), and carboplatin (CBDCA) in patients with hormone-refractory prostate cancer (HRPC). METHODS: This study included a total of 40 HRPC patients. We evaluated the activity of the following schedule: weekly DTX 30 mg/m(2) iv, daily EMP 10mg/kg po, and CBDCA AUC=6 iv on day 1 of a every 4-wk cycle. Treatment was continued until disease progression or excessive toxicity. RESULTS: All patients were assessable for response. A median of six consecutive cycles was administered per patient. Levels of prostate-specific antigen decreased by more than 50% in 95.0% of the patients. Consumption of medication for cancer-induced pain was reduced in 84.6%. Partial response was attained in 66.7% of measurable lesions. Of patients with bone metastasis, 8.3% demonstrated partial response. With a median follow-up of 11.4 mo, the median time to progression was 12.0 mo, and the median overall survival time was 26.6 mo. The predominant toxicities were grade-3 or -4 anemia in 32.5% of the patients, leukopenia in 20.0%, and thrombocytopenia in 17.5%. However, all toxicity was temporary and reversible with dose reduction or temporary cessation of chemotherapeutic agents. There were no therapy-related deaths. CONCLUSIONS: Combination chemotherapy with DTX/EMP/CBDCA was found to have significant clinical activity with an acceptable toxicity profile in HRPC patients. More suitable selection of patients may be beneficial in terms of improved overall survival in the future.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Aged, 80 and over , Androgen Antagonists/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carboplatin/adverse effects , Disease-Free Survival , Docetaxel , Estramustine/administration & dosage , Estramustine/adverse effects , Humans , Male , Middle Aged , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Taxoids/administration & dosage , Taxoids/adverse effectsABSTRACT
Emergency embolization for a bleeding pelvic fracture was performed in a patient with persistent sciatic artery, a rare anatomic variation in which the internal iliac artery continues to the popliteal artery. Successful hemostasis was achieved without complications by means of selective catheterization into each branch of the internal iliac artery. Awareness of this unusual vascular anatomy is critically important to avoid serious complication of emergency embolization.
Subject(s)
Embolization, Therapeutic , Fractures, Bone/complications , Hemorrhage/therapy , Iliac Artery/abnormalities , Pelvis/injuries , Angiography , Female , Hemorrhage/diagnostic imaging , Hemorrhage/etiology , Humans , Middle Aged , Pelvis/diagnostic imagingABSTRACT
A 23-year-old woman at 35 weeks of gestation was scheduled for emergency cesarean section because of preeclampsia. Anesthesia was induced with thiopental 250 mg, and her trachea was intubated following administration of vecuronium 7 mg. Anesthesia was maintained with oxygen and sevoflurane (0.5%). Immediately after the start of the surgical procedure, she developed severe bradycardia and hypotension followed by cardiac arrest. She was resuscitated, and her heart beat resumed 30 min after the start of the resuscitation. Her babies were delivered without sequela during resuscitation. She was transferred to the intensive care unit of our university hospital. She was diagnosed as having peripartum cardiomyopathy from her history and echocardiography. She was discharged from the hospital with only slight disturbance of consciousness two months after surgery.
