British journal of cancer
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British journal of cancer · Apr 1998
Randomized Controlled Trial Clinical TrialCombined intravenous and intraperitoneal chemotherapy with fluorouracil + leucovorin vs fluorouracil + levamisole for adjuvant therapy of resected colon carcinoma.
Adjuvant chemotherapy with fluorouracil (FU) and levamisole or FU/leucovorin (LV) has been established as effective adjuvant treatment for patients with stage III colon cancer. Among several other promising treatment strategies in resected colon cancer, intraperitoneal anti-cancer drug administration with its appealing rationale of counteracting microscopic residual disease on peritoneal surfaces and occult metachronous liver metastases by achieving high intraportal drug concentrations has not yet undergone sufficient clinical evaluation. To determine whether a combination of this locoregional therapeutic concept with systemic intravenous administration of FU/LV would yield better results than conventional adjuvant chemoimmunotherapy with FU/levamisole, the present randomized study was initiated. ⋯ In agreement with its theoretical rationale, combined intraperitoneal and intravenous FU/LV was particularly effective in reducing locoregional tumour recurrences with or without liver or other organ site involvement (9 vs 25 patients in the FU/levamisole arm; P = 0.005). Treatment-associated side-effects were infrequent and generally mild in both arms, although a lower rate of severe (WHO grade 3) adverse reactions was noted in patients receiving locoregional plus intravenous chemotherapy (3% vs 12%; P = 0.01). The results of this trial suggest that combined intraperitoneal plus systemic intravenous chemotherapy with FU/LV is a promising adjuvant treatment strategy in patients with surgically resected stage III colon carcinoma.
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British journal of cancer · Apr 1998
Chromosome division figures reveal genomic instability in tumorigenesis of human colon mucosa.
A variety of chromosomal gains and losses has been detected with comparative genomic hybridization during tumorigenesis in the colon mucosa. The aim of this investigation was to corroborate increasing genomic instability and to elucidate those lesions in which the record from comparative genomic hybridization has remained unexpectedly negative. Replicate paraffin-embedded samples were investigated in detail using image microphotometry. ⋯ The DNA content of chromosome division figures was measured with a mean 4.5 c exceeding rate of 25.8 +/- 4.4% standard error in 12 cases of high-grade dysplasia and of 62.1 +/- 7.1% in colon carcinoma (16 cases). The chromosome division figures were considered to be the first morphological manifestation of genomic instability attending precancerous conditions in the colon. Telophase-like chromosome division figures with unequal amounts of DNA in their hemispheres revealed gross somatic mutations before clonal selection.
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The results of two 5-year studies, for 1974-78 and 1984-88, of cutaneous malignant melanoma (CMM) in Northern Ireland show changes in the presentation of the disease. Although there is some evidence of earlier diagnosis, the rise in incidence has produced an overall increase in the number of cases with advanced disease.
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British journal of cancer · Jan 1997
Multicenter StudyFamily anxiety in advanced cancer: a multicentre prospective study in Ireland.
Six home care services in Southern Ireland collected data on a total of 757 patients over a 6-month period. Patient and family well-being were measured using the staff-rated Support Team Assessment Schedule and Karnofsky Index. Five hundred and eight patients died while in care, 75% of whom died at home. ⋯ Discriminant analysis produced two predictive models. In model 1, family anxiety at referral strongly predicts family anxiety in the last week of life. In model 2, family anxiety at referral is excluded from the analysis, and the significant predictor factors at referral for family anxiety in the last 4 weeks of life are patient symptom control, sex of patient, diagnosis and patient age.