Onkologie
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Oncological management of pediatric cancer patients belonging to Jehovah's Witnesses: a two-institutional experience report.
Aim of this study was to analyze the feasibility of oncological treatment in pediatric patients belonging to Jehovah's Witnesses and to describe the changing policy in performing transfusions and supportive care measures at two German pediatric cancer institutions. ⋯ Pediatric cancer patients belonging to Jehovah's Witnesses can be treated similarly to other patients. A restrictive transfusion policy and the broad application of hematopoietic supportive care measures may reduce transfusions. This treatment policy and a continuous collaboration with the Hospital Liaison Committee for Jehovah's Witnesses appears to create an oncological treatment situation with a high compliance of patients and parents where court orders may not be necessary.
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We wanted to determine the factors influencing survival in a retrospective review of patients with melanoma brain metastases to permit more specific recommendations regarding therapy. ⋯ Radiotherapy, chemotherapy and especially surgery and stereotactic radiosurgery seem to significantly prolong survival, as shown by multivariate analysis. Treatment with temozolomide will possibly play an important role in the future management of patients with brain metastases from cutaneous melanoma, but further prospective studies to verify this assumption are urgently needed.
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Case Reports
Complete response of multiple melanoma brain metastases after treatment with temozolomide.
Inoperable melanoma brain metastases are usually uniformly fatal, and complete response after cytotoxic therapy is rare. ⋯ The present observation suggests that temozolomide may be an active and well tolerated treatment for malignant melanoma brain metastases.
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The need for palliative care is increasing throughout the world. Developing countries are progressively faced with an ageing population, whose changing health needs require urgent action. Insufficient access to care for both cancer and AIDS patients make palliative care the only humane and feasible response in many contexts. ⋯ The synergistic effect of motivation and knowledge, coupled with the use of local resources, has made possible the development of a network of palliative care services, available for free to terminally ill patients. The challenge of adapting such a model to other developing countries is discussed.