Gynecologic oncology
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Gynecologic oncology · May 2002
Trends among gynecologic oncology inpatient deaths: is end-of-life care improving?
The objective was to describe trends over time in key factors surrounding end-of-life care on a gynecologic oncology service at a tertiary cancer center. ⋯ Our data indicate that discussions about DNR orders are occurring earlier in relation to terminal events. However, we could not detect significant changes in the other outcome measures we studied. Major opportunities remain for further enhancements in the realm of advance planning for end-of-life care. Educational opportunities should be offered to physicians regarding communicating with patients about disease progression and end-of-life decision-making.
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Gynecologic oncology · May 2002
Cellular glutathione content, in vitro chemoresponse, and the effect of BSO modulation in samples derived from patients with advanced ovarian cancer.
The objective was to assess the relationship between glutathione content and drug sensitivity with glutathione modulation in ovarian cancer in a pilot study using 31 samples of freshly obtained ovarian tumor material from 26 patients with advanced disease. ⋯ Our study supports the use of glutathione modulation using agents such as buthionine sulfoximine in patients with heavily pretreated, drug-resistant ovarian cancer.
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Uterinesarcomas comprise three main types: carcinosarcomas, leiomyosarcomas, and endometrial stromal sarcomas. Carcinosarcomas are highly aggressive neoplasms with a biphasic histology of carcinomatous and sarcomatous elements. It is now generally accepted that carcinosarcomas are biphasic tumors that have to be regarded as endometrial carcinomas where metaplasia occurs. Mutations of the PTEN tumor suppressor gene, located on 10q23, play a significant role in the pathogenesis of the endometrioid type of endometrial carcinoma. Loss of heterozygosity of chromosome 10q has been reported in uterine leiomyosarcoma. Since little is known about the molecular pathobiology, our goal was to investigate the potential role of the PTEN gene in the carcinogenesis of uterine sarcomas. ⋯ These data suggest that intragenic PTEN mutations are involved in the genesis of uterine carcinosarcomas with endometrioid-type carcinoma components but rarely contribute to the pathobiology of uterine leiomyosarcomas.
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Gynecologic oncology · Mar 2002
Comparative StudyA comparison of two prophylactic regimens for hypersensitivity reactions to paclitaxel.
The aim of this study was to compare the rates of hypersensitivity reactions to paclitaxel with the conventional prophylactic regimen of two doses of oral corticosteroids and a modified regimen of a single dose of intravenous corticosteroid. ⋯ In this series, the single-dose intravenous corticosteroid prophylactic regimen appeared to be associated with a higher rate of hypersensitivity reactions to paclitaxel than the conventional two-dose oral corticosteroid regimen.
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Gynecologic oncology · Mar 2002
Case ReportsAnalysis of patients with epithelial ovarian cancer or fallopian tube carcinoma retreated with cisplatin after the development of a carboplatin allergy.
We report the outcome of seven patients treated for recurrent ovarian cancer with cisplatin after an allergic reaction to carboplatin. One case is presented in which a heavily pretreated patient suffered a severe anaphylactic reaction, which was refractory to standard resuscitative measures and resulted in her death. ⋯ Few patients with a carboplatin allergy are subsequently treated with cisplatin at our center. One patient suffered a serious hypersensitivity reaction following retreatment and died. Based on this limited experience, cross allergy can exist although the true incidence is not known. Routine retreatment of carboplatin-allergic patients with cisplatin in the relapsed setting cannot be recommended without careful consideration of potential risks and benefits.