Acta oncologica
-
A prospective survey was conducted of patients who began radiotherapy in Sweden during 12 weeks in the autumn of 1992. All hospitals that provided radiotherapy participated. The goal was to study the most common diagnoses, corresponding to approximately 80% of the patients. ⋯ They received an average of four treatments, three for those who also received external radiotherapy. The number of brachytherapy treatments varied widely by department. This can be explained by two different therapeutic traditions: one tradition uses agents with low radiation intensity per time unit, resulting in fewer and longer treatments, and the second tradition involves agents with high radiation intensity per time unit, resulting in more, although shorter, treatments.
-
To further investigate the antineoplastic efficacy and safety of somatostatin analogues, 2 trials were performed. Octreotide, SMS 201-995 (Sandostatin), was escalated in doses ranging from 1,500 micrograms to 6,000 micrograms daily in 14 patients with carcinoid. Somatuline, (BIM 23014C, Angiopeptin, Lanreotide) was given in doses ranging from 2,250 micrograms to 9,000 micrograms daily to 13 neuroendocrine patients (6 carcinoid, 2 atypical carcinoid, 3 pancreatic islet cell and 2 small cell lung cancer patients). ⋯ Somatuline resulted in a partial response in 4 patients (2 carcinoids, 1 gastrinoma and 1 small cell lung cancer) (31%), stable disease in 1 atypical carcinoid, and progressive disease in 8 (4 carcinoid, 1 atypical carcinoid, 2 islet cell and 1 multi-drug resistant small cell lung cancer). Six of the 8 carcinoid patients had radiographic changes of increased necrosis. Dose escalation of somatostatin analogues is well tolerated and may be associated with antitumor activity in some neuroendocrine neoplasms.
-
Monoclonal antibodies have been widely used in attempts to target anti-neoplastic agents selectively to tumours. Problems associated with the use of monoclonal antibodies as the targeting moiety include lack of complete tumour selectivity, antigenic heterogeneity, tumour access and immunogenicity. ⋯ The advantages and limitations of these different approaches are reviewed. It remains to be established in man if any of these approaches will result in significant therapeutic benefit in major solid tumours.
-
Review Case Reports
Abdominal surgery in patients with midgut carcinoid tumors.
In patients with midgut carcinoid tumors a curative, radical tumor removal should be attempted when possible. As these tumors are generally malignant, irrespective of size, the radical surgery implies that intestinal resection for excision of a primary tumor should be combined with an extended mesenteric resection. When the patients present with the carcinoid syndrome the disease is, with few exceptions, too advanced for curative surgery. ⋯ Patients with more extensive disease may thus benefit from surgical debulking of large mesenteric or hepatic metastases. Moreover, when the patients present with abdominal symptoms it is important to exclude a threatening major abdominal complication, such as intestinal obstruction or ischemia. As these complications may cause malnutrition and deterioration, it is important to treat them properly, sometimes by repeated surgery.