RESUMO
Following primary maximal cytoreduction, 71 previously untreated patients with advanced epithelial ovarian carcinoma received at least six courses of combination chemotherapy consisting of cisplatin, doxorubicin, and cyclophosphamide. The cumulative dose (CD) through three (CD3) and six (CD6) courses was calculated for each drug and for all drugs combined. The dose intensity (DI) through three (DI3) and six (DI6) courses was calculated for each drug by dividing CD3 and CD6 by the interval (in weeks) between surgery and the third and sixth course. The interval from surgery to the third or sixth course had no effect on survival. Similarly, there was no significant difference in survival between patients with high and low CD3 or CD6 for any drug or for all drugs combined. Patients with high DI6 for cisplatin, doxorubicin, and all drugs combined survived significantly longer than those with low DI6. The survival difference for patients with high and low DI6 for cyclophosphamide approached, but did not attain, statistical significance at the 0.05 level. The intensity with which combination chemotherapy is administered may have an impact upon survival in patients with ovarian carcinoma.
Assuntos
Carcinoma/radioterapia , Neoplasias Ovarianas/radioterapia , Análise Atuarial , Adulto , Idoso , Carcinoma/mortalidade , Carcinoma/patologia , Relação Dose-Resposta à Radiação , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Análise de Regressão , Fatores de TempoRESUMO
Seven out of 8 patients with endometriosis demonstrated levels of CA-125 antigen above 35 U/ml. None of 15 patients with other benign gynecologic diagnoses demonstrated elevated levels. This antigen has been proposed as a tumor marker for epithelial carcinoma and other gynecologic neoplasms. However, it cannot be used to differentiate clinically between cancer and endometriosis.
Assuntos
Antígenos de Neoplasias/análise , Antígenos de Superfície/análise , Endometriose/imunologia , Adolescente , Adulto , Idoso , Antígenos Glicosídicos Associados a Tumores , Carcinoma/imunologia , Diagnóstico Diferencial , Endometriose/diagnóstico , Endometriose/patologia , Feminino , Humanos , Leiomioma/imunologia , Pessoa de Meia-Idade , Osteíte Deformante/imunologia , Cistos Ovarianos/imunologia , Neoplasias Ovarianas/imunologia , Prognóstico , Neoplasias Uterinas/imunologiaRESUMO
This paper describes the staffing aspects of an experimental community mental health centre (Melville Clinic). The different components of staff roles of members of a team consisting of different health professionals, crystallised during the three-year period with a shift from a 'nondisciplinary' to a 'multidisciplinary' approach, with preservation of 'generalised' and 'specialised', 'clinical' and 'community' roles of all staff members. The decision-making in the centre oscillated between group decisions by all staff members, and the acceptance of the leading role of the psychiatrist with the active multidisciplinary teamwork in community mental health centres.
