Cancer
-
Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. Acute cases of SVC syndrome have been described, with the majority of these being precipitated by thrombosis after central venous catheterization. The authors report a case of acute SVC syndrome after central venous catheter placement, which was not due to thrombosis, but rather caused by a catheter occluding a previously subclinical stenosis of the SVC. Resolution of the clinical SVC syndrome occurred after catheter withdrawal.
-
This case study demonstrates the similarity between the development of dogma and the persecution of deviants during the Spanish Inquisition and that in medicine using breast cancer as an example. Regarding breast cancer, the dogma of therapy became separate from the underlying hypothesis and, like the religious dogma enforced by the Inquisition, it required inflexible adherence. ⋯ This serves to inhibit debate and the exploration of alternative hypotheses, both of which are essential for the advancement of scientific knowledge. Adherance to dogma is antithetical to the conditional and approximate nature of truth in science.
-
Randomized Controlled Trial Clinical Trial
A pilot study of hepatic artery floxuridine combined with systemic 5-fluorouracil and leucovorin. A potential adjuvant program after resection of colorectal hepatic metastases.
Most patients with colorectal carcinoma metastatic to the liver have relapses after surgical resection of hepatic metastases with failures divided equally between hepatic and extrahepatic sites. A pilot study was begun using a regimen combining intrahepatic floxuridine (FUDR) and systemic 5-fluorouracil (5-FU) and leucovorin (LV) to determine its safety and efficacy. ⋯ Systemic 5-FU and LV can be combined safely with intraarterial FUDR without loss of efficacy or increased biliary toxicity. Eight patients treated with this regimen as adjuvant therapy after liver metastasis resection were alive and disease-free after a median follow-up of 23 months.
-
Clinical Trial
A phase II trial of ifosfamide in previously untreated children and adolescents with unresectable rhabdomyosarcoma.
Children and adolescents with unresectable rhabdomyosarcoma fare poorly when treated with contemporary chemotherapeutic regimens. Evaluation of newly developed agents in these patients is important to improve their outcome. Based on a preclinical rhabdomyosarcoma xenograft model that accurately predicted the activity of new agents, the safety and efficacy of ifosfamide was evaluated as part of a Phase II clinical trial in previously untreated children with unresectable rhabdomyosarcoma. ⋯ Ifosfamide appears to have significant clinical activity in untreated patients with unresectable rhabdomyosarcomas. These findings provide an accurate estimate of the response rate to single-agent ifosfamide in this group of previously untreated patients and thus provide a foundation for its rational incorporation into multiagent clinical trials. In addition, the potential benefits of this type of new drug development were demonstrated.
-
Randomized Controlled Trial Clinical Trial
The Intergroup Rhabdomyosarcoma Study-II.
Intergroup Rhabdomyosarcoma Study (IRS)-II, (1978-1984) had the general goals of improving the survival and treatment of children with rhabdomyosarcoma (RMS). ⋯ Combining all Groups and treatments in IRS-II, the major improvement in S rate at 5 years between studies was in nonmetastatic patients (71% for IRS-II versus 63% for IRS-I, P = 0.01).