Gynecologic oncology
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Gynecologic oncology · Nov 2004
Multicenter Study Clinical TrialCarboplatin hypersensitivity: a 6-h 12-step protocol effective in 35 desensitizations in patients with gynecological malignancies and mast cell/IgE-mediated reactions.
The incidence of hypersensitivity reactions (HR) is increased in patients treated with multiple courses of carboplatin. The purposes of this investigation were to evaluate the effectiveness of a 12-step desensitization protocol and to characterize the immune mechanism of carboplatin HR. ⋯ The 6-h, 12-step desensitization protocol is safe and effective for treating patients with carboplatin HR. Positive skin tests to carboplatin suggest a mast cell/IgE-mediated mechanism. Conversion of the positive skin test to a negative response after desensitization supports antigen-specific mast cell desensitization.
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Gynecologic oncology · Oct 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialLong-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer.
Provide long-term follow-up data for women treated in a randomized multicenter study of pegylated liposomal doxorubicin compared with topotecan. ⋯ Long-term follow-up demonstrates that treatment with pegylated liposomal doxorubicin significantly prolongs survival compared with topotecan in patients with recurrent and refractory epithelial ovarian cancer. The survival benefit is pronounced in patients with platinum-sensitive disease.
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Gynecologic oncology · Oct 2004
Dosimetric factors predicting severe radiation-induced bowel complications in patients with cervical cancer: combined effect of external parametrial dose and cumulative rectal dose.
The purpose of this study was to analyze dosimetric factors of radiation-induced severe bowel complications among patients with cervical cancer. ⋯ Radiation-induced severe bowel complications are association on both high PMD and high CRBED. We do not suggest both external PMD > or = 54 Gy and CRBED > or = 100 Gy(3) for treatment of cervical cancer due to unacceptably high incidence of severe bowel complications.
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Gynecologic oncology · Oct 2004
Randomized Controlled Trial Clinical TrialA prospective, randomized study analyzing sartorius transposition following inguinal-femoral lymphadenectomy.
Based on the reduced morbidity seen in our retrospective study, we undertook a prospective, randomized trial to determine whether transposition of the sartorius muscle improves post-operative morbidity in women with squamous cell carcinoma of the vulva undergoing inguinal-femoral lymphadenectomy. ⋯ Sartorius transposition after inguinal-femoral lymphadenectomy does not reduce postoperative wound morbidity.
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Gynecologic oncology · Oct 2004
Reoperation for palliation of recurrent malignant bowel obstruction in ovarian carcinoma.
While initial surgical treatment for palliation of malignant bowel obstruction is well described, data on reoperation for palliation of recurrent obstruction in ovarian carcinoma are limited. The purpose of this study was to analyze the outcome of patients undergoing reoperation for repeat bowel obstruction. ⋯ Patients undergoing repeat surgery for recurrent bowel obstruction have a low likelihood of successful palliation (30%). The surgery is associated with significant complications after surgery, rapid development of subsequent bowel obstructions, and limited survival rates. Alternative management approaches such as percutaneous endoscopic gastrostomy (PEG) tube placement should be considered in this group of patients.