The British journal of cancer. Supplement
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Br. J. Cancer Suppl. · Sep 1996
Opening doors: improving access to hospice and specialist palliative care services by members of the black and minority ethnic communities. Commentary on palliative care.
To put Council's project on improving access to hospice and specialist palliative care services by members of the black and minority ethnic communities into context, palliative care will be defined, and the scope of palliative care services currently available in the UK outlined. Palliative care is the active total care of patients whose disease no longer responds to curative treatment. ⋯ Council's project on improving access was supported by Cancer Relief Macmillan Fund and Help the Hospices as well as receiving a grant from the NHS Ethnic Minorities Unit. The report describes how the specialist palliative care services are currently provided in three areas with high minority ethnic populations and contains a series of recommendations around ethnic monitoring, equal opportunities strategies, staff training, communications and the provision of a more culturally sensitive service provision.
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Br. J. Cancer Suppl. · Jul 1996
Randomized Controlled Trial Clinical TrialConventional vs accelerated fractionation in head and neck cancer.
From October 1990 to March 1994, 90 patients entered a prospectively randomised trial in head and neck cancer. All patients had verified squamous cell carcinoma and were referred for primary radiation therapy. Tumours originated in the oral cavity in 25, oropharynx in 37, larynx in 15 and hypopharynx in 13 cases. ⋯ Those patients treated with additional MMC experienced a grade III/IV haematological toxicity in 4/28 cases. Complete remission (CR) was recorded in 48% following CF, 79% after Vienna-CHART (P < 0.05) and 71% after Vienna-CHART + MMC. The overall local failure rates were 73%, 59% and 42% (P = NS) for patients treated by CF, Vienna-CHART and Vienna-CHART + MMC respectively.
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Br. J. Cancer Suppl. · Jul 1996
Evidence for a therapeutic gain when AQ4N or tirapazamine is combined with radiation.
The use of bioreductive drugs as an adjunct to radiotherapy in the treatment of cancer is presently being tested in several clinical trials worldwide. We have developed a novel bioreductive compound AQ4N (1,4-bis-¿[2-(dimethylamino-N-oxide)ethyl]amino¿ 5,8-dihydroxy-anthracene-9, 10-dione) which can be reduced to a stable cytotoxic agent AQ4. The anti-tumour efficacy of AQ4N has been studied using male BDF mice bearing the T50/80 tumour. ⋯ When combined with 10 Gy radiation neither AQ4N nor tirapazamine showed any enhancement of functional loss as compared with radiation alone. This was in contrast to mitomycin C which had a marked effect on the radiation induced functional deficit. In conclusion, in our model, an increase in the therapeutic index was obtained for radiation treatment when either AQ4N or tirapazamine was administered concurrently.
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Br. J. Cancer Suppl. · Dec 1992
Comparative StudyMethodology and assessment in clinical anti-emetic research: a meta-analysis of outcome parameters.
There have been major clinical advances in the control of chemotherapy-induced nausea and emesis. These advances were achieved partly by the introduction of new anti-emetic agents but important improvement came from the use of existing agents in ways developed from the results of studies based on new approaches and methods in anti-emetic research. By developing basic research tools, improving methodology and applying psychometrically sound assessments better management or chemotherapy-induced nausea and vomiting has been achieved. ⋯ The frequency of outcome events was most commonly the dimension assessed. Examination of size of the effect of an anti-emetic regimen for these anti-emetic studies showed it to be independent of the type of outcome measured, but to be quite dependent on how the outcome was quantified. For instance, differences in the frequency or incidence of either nausea or emesis were generally larger than measurements made of the duration of either of these.
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Br. J. Cancer Suppl. · Dec 1992
CommentNausea and vomiting and cancer patients' quality of life: a discussion of Professor Selby's paper.
It is evident from the data presented above that nausea and vomiting are frequent side effects which are often persistent and distressing to patients. Evidence suggests, and intuitively it appears that avoidance of nausea and vomiting is important to the patients' ability to maintain their quality of life during the treatment period. It is of particular interest to note that in the literature reviewed in this paper standard antiemetic prescribing and practice were followed. ⋯ Ideally, the instrument used should contain separate items for nausea and vomiting. Major side effects of antiemetic therapy should also be assessed since these may be as debilitating as the effects of nausea and vomiting. Increased awareness of total patient impact of emesis and antiemetic therapy will serve as an impetus for improvements in antiemetic therapy strategies and practices.