RESUMO
Adults Wilms' tumor, unlike its pediatric counterpart, is extremely rare and highly lethal. Less than 200 cases have been reported in the world literature and a large proportion of these may not have been true Wilms' tumors. We report 3 cases seen at our institution who were treated with a multimodality approach, all three remaining alive without evidence of active disease at 6 years, 2.25 years and 8 months respectively from diagnosis. We also review results of multimodality management, emphasizing the poor outcome for stage III and IV tumors in spite of multi-agent chemotherapy. Alternative drugs, such as cisplatinum may have a role in management. Finally, we propose that prophylactic pulmonary irradiation may have a place in advanced stages of adult Wilms' tumor.
Assuntos
Neoplasias Renais/terapia , Pulmão/efeitos da radiação , Tumor de Wilms/terapia , Adolescente , Adulto , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Renais/mortalidade , Masculino , Taxa de Sobrevida , Tumor de Wilms/mortalidadeRESUMO
The efficacy of pivampicillin, administered in a dose of 350 mg three times daily or 500 mg twice daily, was compared in 107 patients with acute salpingitis. Both regimens were equally effective. Fortyseven out of 56 patients given the 500 mg doses were cured and four improved. Of the patients who received the 350 mg doses, 46 out of 51 were cured and three improved. Patients were divided into two groups with severe and mild infections respectively. The 500 mg dose of pivampicillin was significantly more effective in reducing pyrexia in all patients including those with severe infections. Mean treatment duration was shorter in patients with severe infections given 500 mg of pivampicillin twice daily (11.4 days) than in those receiving 350 mg three times daily (14.5 days). Slight gastrointestinal discomfort occurred in 9% of patients receiving the 500 mg dose and in 4% of those receiving the 350 mg dose. The overall incidence of exanthema was about 5%. The twice daily regimen of 500 mg pivampicillin is recommended since it is more practical for the departments concerned and patient compliance is better.
