RESUMEN
The palliative effect of endoscopic Nd:YAG laser treatment of malignant strictures of the oesophagus and cardia was prospectively evaluated in 30 patients. Most (n = 28) were primarily treated for dysphagia, and swallowing was improved in 21 and normalized in 14 of these patients. Two patients were successfully treated for bleeding. Six patients developed complications (including two perforations), and four of these were fatal. The median survival was 4 months (range, 17 days to 14 months). It is concluded that in a great number of patients with inoperable cancer of the oesophagus and cardia, laser treatment is better than other palliative procedures.
Asunto(s)
Neoplasias Esofágicas/cirugía , Terapia por Láser , Cuidados Paliativos/métodos , Neoplasias Gástricas/cirugía , Anciano , Anciano de 80 o más Años , Esofagoscopía , Femenino , Gastroscopía , Humanos , Terapia por Láser/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Tasa de SupervivenciaRESUMEN
The effect of cimetidine treatment in cancer of the stomach was investigated in a double-blind, multicentre study comprising eight departments in Greater Copenhagen. Immediately after operation (or the decision not to operate) 181 patients were subdivided at random to treatment with a placebo or cimetidine in a dosage of 400 mg twice daily for two years or until death. Compliance control was carried out every third month. The mean survival in the cimetidine group (450 days, 1-1,826) was significantly longer (p = 0.02) than in the placebo group (316 days, 1-1,653).
Asunto(s)
Cimetidina/uso terapéutico , Neoplasias Gástricas/tratamiento farmacológico , Adulto , Anciano , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Neoplasias Gástricas/mortalidadRESUMEN
In 1988, Nd:YAG laser treatment was employed as palliative therapy for 23 patients with cancer of the oesophagus and cardia. After treatment, half of the patients could ingest light or normal diets and the ability to swallow improved in a total of 3/4 of the patients. Perforation of the oesophagus occurred in two patients and aspiration in two other patients. It is concluded that, in a great number of patients with inoperable cancer of the oesophagus and cardia, laser treatment is better than other palliative therapeutic measures. The indications are discussed.
Asunto(s)
Neoplasias Esofágicas/cirugía , Terapia por Láser , Neoplasias Gástricas/cirugía , Adulto , Anciano , Cardias/cirugía , Femenino , Humanos , Terapia por Láser/efectos adversos , Masculino , Persona de Mediana Edad , Complicaciones PosoperatoriasRESUMEN
The effect of cimetidine on survival was investigated in 181 patients with gastric cancer. Immediately after operation or the decision not to operate, the patients were randomised in double-blind fashion to placebo or cimetidine 400 mg twice daily for two years or until death, with review every three months. Median survival in the cimetidine group was 450 days (range 1-1826) and in the placebo group 316 days (1-1653). The relative survival rates (cimetidine/placebo) were 45%/28% at 1 year, 22%/13% at 2 years, 13%/7% at 3 years, 9%/3% at 4 years, and 2%/0% at 5 years. Survival in the cimetidine group was significantly longer than in the placebo group.
Asunto(s)
Cimetidina/uso terapéutico , Neoplasias Gástricas/mortalidad , Análisis Actuarial , Adulto , Anciano , Anciano de 80 o más Años , Cimetidina/efectos adversos , Ensayos Clínicos como Asunto , Dinamarca , Método Doble Ciego , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Distribución Aleatoria , Estudios Retrospectivos , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
In a prospective study 110 patients with histologically confirmed oesophageal squamous cell carcinoma received radiation therapy combined with bleomycin or a retinoid. Surgery was initially intended in 34 patients and was later on undertaken in 25 of them after irradiation; in 12 patients the operation was regarded as radical and in 4 of these no remaining tumour was found at operation. The survival rate was significantly higher in the operated than in the non-operated patients which entirely depended on the radically operated ones. Survivals up to more than 71 months were observed and the best results were apparently obtained in patients who became tumour-free after preoperative therapy. It is concluded, that the combined treatment was curative only in a few cases and that future studies should be focused on more intensive preoperative treatment and more critical selection of patients for surgery.
Asunto(s)
Bleomicina/uso terapéutico , Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Etretinato/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirugía , Ensayos Clínicos como Asunto , Terapia Combinada , Neoplasias Esofágicas/radioterapia , Neoplasias Esofágicas/cirugía , Femenino , Humanos , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Cuidados Posoperatorios , Estudios Prospectivos , Dosificación Radioterapéutica , Distribución Aleatoria , Proyectos de InvestigaciónAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Tamoxifeno/uso terapéutico , Anciano , Neoplasias de la Mama/secundario , Ensayos Clínicos como Asunto , Terapia Combinada , Ciclofosfamida/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Metástasis Linfática , Mastectomía , Metotrexato/administración & dosificación , Persona de Mediana Edad , Dosificación Radioterapéutica , Receptores de Estrógenos/análisis , Receptores de Progesterona/análisisRESUMEN
A brief presentation is given of the Danish national program for standardized therapy of primary breast cancer within the framework of prospective randomized trials. Adjuvant systemic therapy given to high-risk patients has in preliminary studies reduced the recurrence rate in large subsets of patients and the preliminary results also indicate the possibility of improved selection of patients for different treatment modalities. It is also concluded that such a nation-wide study, although it requires extensive administrative effort, implies a number of positive effects, clinical, scientific and educational.
Asunto(s)
Neoplasias de la Mama/terapia , Programas Médicos Regionales/organización & administración , Ensayos Clínicos como Asunto , Terapia Combinada , Dinamarca , Femenino , Humanos , Estudios Prospectivos , Distribución AleatoriaRESUMEN
Ten patients with familial hypercholesterolaemia were subjected to partial ileal by-pass surgery. Plasma cholesterol fell by 41 and 38% and low-density lipoprotein cholesterol by 51 and 46% after six and 18 months respectively. High-density and very low-density lipoprotein cholesterol and plasma triglycerides were unaffected. Alanine aminotransferase increased transiently in half of the patients. Diarrhoea and slight steatorrhoea troubled most of the patients for the duration of 18 months' period of observation. Other long-term side effects were slight but significant increase in the renal excretion of oxalic acid and reduction in the intestinal absorption of calcium. The study shows that this operation has metabolic side-effects that warrant continued medical care of these patients.