Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · May 1994
Comparative StudyOn the relationship between nausea and vomiting in patients undergoing chemotherapy. Italian Group for Antiemetic Research.
In comparative trials on antiemetic efficacy of different regimens, the positive correlation between the probabilities of vomiting and of nausea could hide some confounding effect. Our work seeks to detect such effects. The data from two large studies on prevention of cisplatin-induced emesis were re-analyzed using two multifactorial logistic models. ⋯ Instead, in the second study, the greater efficacy of Mtc/Dex/Dip in preventing both nausea and vomiting was confirmed. The results indicate that, when a correlation between two responses is detected, multifactorial analyses should be performed to identify the possible presence of some confounding effect. The proof that the presence/absence of vomiting is a confounding factor for the relationship between the different efficacy of the two antiemetic regimens for complete protection from nausea, highlighting the same efficacy of the two therapies in preventing nausea, supports the hypothesis of the existence of two kinds of nausea, one independent of vomiting, the other concomitant with it.
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Support Care Cancer · May 1994
Case ReportsClinical application of nebulized opioids for treatment of dyspnoea in patients with malignant disease.
This article describes our experience in the clinical use of nebulized opioids for the management of dyspnoea in patients with terminal cancer by reviewing three specific patient case studies in which this treatment was found to be both safe and effective in controlling breathlessness. The patients were treated with morphine, hydromorphone or anileridine in various doses according to their prior use of opioids. Additional formal studies are being initiated at this Centre.
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Support Care Cancer · Mar 1994
Clinical TrialTransdermal fentanyl in uncontrolled cancer pain: titration on a day-to-day basis as a procedure for safe and effective dose finding--a pilot study in 20 patients.
All communications on the use of transdermal fentanyl as well as the recommendations of the manufacturer include the direction that patients should be titrated with a short-acting narcotic to control their cancer pain before they are converted to a fentanyl transdermal therapeutic system (TTS). We investigated the possibility of avoiding this titration phase by immediate fentanyl TTS therapy in patients with uncontrolled cancer pain. Dose finding was performed by direct titration of fentanyl TTS according to clinical necessity on a day-to-day basis. ⋯ There were statistically significant lower VAS values at all follow-up times compared to pretreatment values (e.g. pretreatment to day 1: P = 0.019; pretreatment to day 28: P = 0.002; Wilcoxon sign-rank test). The mean fentanyl TTS doses were 70 micrograms/h (week 1), 98 micrograms/h (week 2), 107 micrograms/h (week 3) and 116 micrograms/h (week 4). The differences of mean fentanyl TTS does were significantly different between days 1 and 7 (P < 0.001) and between days 8 and 14 (P = 0.006), but not between days 15 and 21 and days 22 and 28.(ABSTRACT TRUNCATED AT 250 WORDS)
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Support Care Cancer · Jan 1994
Editorial Case ReportsPalliative care in high-tech medicine: defining the point of no return.
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Support Care Cancer · Nov 1993
Randomized Controlled Trial Clinical TrialRespiratory distress syndrome in patients with advanced cancer treated with pentoxifylline: a randomized study.
The inappropriate endogenous secretion of tumour necrosis factor (TNF) could play a role in the pathogenesis of acute respiratory distress syndrome (ARDS), one of the most frequent causes of death in cancer patients. Because of its capacity to inhibit TNF secretion in vitro, pentoxifylline (PTX) could be extremely useful in ARDS therapy. In this study 30 advanced cancer patients with ARDS were randomized to receive either the conventional care or conventional care plus PTX (100 mg i.v. twice a day for 7 days followed by an oral administration of 400 mg three times a day) to evaluate the efficacy of PTX in reducing TNF serum levels and in improving the symptoms of this syndrome. ⋯ TNF mean levels significantly decrease in the PTX-treated group. These data confirm in vivo the capacity of PTX to inhibit TNF secretion in patients with ARDS. Moreover PTX therapy may improve the symptoms related to ARDS without particular toxic effects.