Cancer
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Comparative Study Clinical Trial
A phase I report of paclitaxel dose escalation combined with a fixed dose of carboplatin in the treatment of head and neck carcinoma.
Standard therapy for advanced head and neck carcinoma is surgery and radiation, and the subsequent 5-year survival with this treatment has been less than 50%. New combined modality treatment strategies are being tested to improve survival. New chemotherapy combinations are being developed and administered simultaneously with, or sequenced with, radiation and surgery. This article reports the Phase I results of administering paclitaxel and carboplatin preoperatively. The authors' objective was to develop an outpatient chemotherapy that would downstage tumors and allow organ preservation with equal or improved survival as compared with standard therapy. ⋯ Toxicity was acceptable. The maximum tolerated dose of paclitaxel was 230 mg/m2 without hematopoietic growth factor, or 250 mg/m2 with hematopoietic growth factor, the carboplatin dose held constant, calculated at area under the curve of 7.5. Phase II studies of this combination are warranted in the treatment of these carcinomas.
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The National Cancer Data Base (NCDB) is an information resource and program evaluation tool of the American College of Surgeons Commission on Cancer and the American Cancer Society that uses a hospital-based cancer reporting system. The Surveillance, Epidemiology, and End Results (SEER) program is a population-based registry program of the National Cancer Institute. The purpose of this investigation was to compare the aggregate NCDB data for selected cancer types from a given year with comparable SEER data. ⋯ The 1992 NCDB data, in aggregate, described patient and disease treatment characteristics and patterns that differed only marginally from those described in the SEER data from the same year.
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Comparative Study
Quality of life and treatment outcomes: prostate carcinoma patients' perspectives after prostatectomy or radiation therapy.
Of the estimated 317,000 men in the United States diagnosed with prostate carcinoma in 1996, 57% will have localized disease, and their 5-year relative survival rate will be 98%. Limited information exists on patient-reported quality of life (QOL) and the incidence and severity of treatment-related side effects. The purpose of this study was to identify and compare patients' self-reported QOL and treatment side effects 1-5 years after radical prostatectomy or radiotherapy. ⋯ Men undergoing treatment for clinically localized prostate carcinoma continue to experience difficulty long after treatment. In this study, the prostatectomy group fared worse in regard to sexual and urinary functions, whereas the radiotherapy group experienced more bowel dysfunction. Survivor-reported QOL and treatment outcomes can assist physicians in counseling patients in the selection of the preferred course of treatment.
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Nausea and vomiting immediately after chemotherapy is a well recognized complication of cancer drug treatment; it is usually short-lived and controllable by modem antiemetics. The authors report a high incidence of prolonged nausea and vomiting after high dose chemotherapy with autologous peripheral stem cell transplantation (PSCT) in the treatment of high risk breast carcinoma patients. ⋯ PPNV is a frequent complication of high dose chemotherapy with the aforementioned regimen. It may be due to gastroparesis and represents a form of gastrointestinal toxicity to chemotherapy not previously reported.
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Review Case Reports
Pancreatic adenocarcinoma in the pregnant patient: case report and review of the literature.
In this case report, the authors discuss the presentation and treatment of pancreatic adenocarcinoma in a pregnant woman. Pancreatic adenocarcinoma is extremely rare in the pregnant patient. Only three cases of pancreatic adenocarcinoma diagnosed antepartum have been reported. ⋯ Pancreatic adenocarcinoma is very rare in the pregnant patient. However, pancreaticoduodenectomy can be performed successfully. To the authors' knowledge, this is the first report of a pregnant woman treated with pancreaticoduodenectomy for pancreatic adenocarcinoma.