Acta oncologica
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The psychometric properties of a short but comprehensive quality-of-life instrument, developed especially for cancer patients in the palliative care setting are presented. Items from physical, psychological, social and existential domains are included. The findings suggest that the AQEL (Assessment of Quality of Life at the End of Life) instrument is both valid and reliable, but further trials with more patients are needed.
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Clinical Trial
High dose etretinate and interferon-alpha--a phase I study in squamous cell carcinomas and transitional cell carcinomas.
Simultaneous exposure to retinoids and interferons can result in enhanced antiproliferative and differentiating effects on malignant lesions. We studied the toxicity and the potential efficacy of an association of high dose etretinate and Interferon-alpha (IFN-alpha) in squamous cell carcinomas of the lung, head and neck, the esophagus, cervix and the penis, as well as in transitional carcinomas of the bladder. The treatment consisted of etretinate (Tigason) 4 mg/kg/d on 2, 3, 4 and finally 5 consecutive days every other week and IFN-alpha (Roferon) 6 Mio IU sc. q.d. for 5 days every week. ⋯ Toxicity was mild otherwise, mostly at grades 1 and 2 level, causing fatigue, skin peeling and erythema, mucositis and cheilitis; 3 PR (partial response) and 8 SD (stable disease) were recorded. Of the responders, one patient had become resistant to cisplatin-based chemotherapy and the other two had at no time ever received systemic therapy. We conclude that the association of high doses of etretinate and IFN-alpha has moderate activity in squamous cell carcinomas, is well tolerated, and that IFN-alpha plays a role in the improved tolerance of the retinoid.
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Comparative Study
Comparison between fractionated high dose rate irradiation and continuous low dose rate irradiation in spheroids.
Recent interest in clinical brachytherapy focuses on the possible radiobiological equivalence between fractionated high dose rate (HDR) and continuous low dose rate (LDR) irradiations. This study is designed to compare the radiobiological effects between the two in vitro using multicellular spheroids of human tumor. ⋯ We found that: (1) The fractionated HDR irradiation (8 Gy/2 fr/day) was more effective radiobiologically than continuous LDR irradiation (8 Gy/day) and the ratio of radiobiological effects of these irradiations was estimated as 0.82, based on the 50% spheroid cure dose (SCD50); (2) the radiobiological effectiveness was independent of the fraction size of HDR irradiation administrated, and the repair of sublethal damage (SLD) was absent, suggesting that the sparing effect of fractionated HDR irradiations was absent in spheroids. Our findings could provide important information for the clinical usage of the fractionated HDR radiotherapy to replace continuous LDR radiotherapy.
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It is well established that adjuvant radiotherapy (RT) reduces loco-regional recurrences in breast cancer. The effect on overall survival, on the other hand, is a much-debated issue. Some old trials with a long follow-up as well as the first report on the overview of the randomized RT trials initiated before 1975 showed a reduced survival among irradiated patients compared with the surgical controls. ⋯ There are few data concerning the cardiac side effects of RT after conservative surgery. Some studies suggest that radiation-induced heart disease may be a potential problem also among these patients. Therefore, the search for both the causes of radiation-induced heart disease and preventive measures is crucial issues in breast cancer radiation oncology.
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The aim of this study was to evaluate the effects of screening for cancer in the Nordic countries. There is sufficient scientific evidence to conclude that screening for cervical cancer, breast cancer and colorectal cancer will result in a reduction in mortality. The effects on mortality were predicted for the future up to the year 2017 assuming that the Nordic countries are covered by screening as a nation-wide population-based public health policy and comparing the predicted mortality trends with those assuming no screening programmes. ⋯ In the last considered period (2008-2012) the costs per life year gained (breast cancer $15,400, colorectal cancer $5700) are approximately one half of those at the onset of screening. The differences in the costs per LYG were relatively small between the Nordic countries and mainly dependent on the differences in baseline risk of cancer. The total cost of the three screening programmes was estimated at $4400 per life years gained in the year 2010.(ABSTRACT TRUNCATED)