J Buon
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To determine reirradiation results of patients with recurrent non-metastatic non-small cell lung cancer (NSCLC). ⋯ In initially non-metastatic NSCLC patients, reirradiation can be a safe and effective treatment for palliation after recurrence. Large prospective studies are needed to confirm the safety, effectiveness and economical advantages of this modality.
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Review
The critically ill patient with cancer - indications for Intensive Care Unit admission and outcomes.
Critically ill cancer patients admitted to the Intensive Care Unit (ICU) have high mortality rates compared to noncancer patients. Yet, with suitable patient selection, improved ICU- and 6-month survival has been observed in these patients: admission of cancer patients to the ICU can no more be considered futile. As a general rule, patients with good performance status, who are at the initial phase of their malignant disease and with life-extending treatment options available, should be routinely admitted to the ICU, while patients being only in palliative care should not. When in doubt, an ICU trial with re-appraisal at 3-6 days may be the best policy, as the data available when ICU admission is considered, are not sufficient to identify patients who are likely to benefit from ICU management.
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Randomized Controlled Trial Comparative Study
Ketoprofen is superior to metamizole in relieving postoperative pain after head and neck tumor operation.
Recently, nonsteroidal analgoantipyretics are recommended in the management of postoperative pain, with great attention to their safety. We conducted a randomized, single blind study to compare the analgesic efficacy and safety of ketoprofen and dipyrone (metamizole) after major head and neck surgery. ⋯ The efficacy of ketoprofen to achieve postoperative analgesia was comparable to metamizole during the first 48h, while ketoprofen was superior to metamizole during the 3rd postoperative day.
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Despite progress in the area of supportive care in oncology in the last two decades, nausea and vomiting continue to be significant side effects of cancer therapy. These symptoms can escalate over time and can result in patients' refusal to continue with chemotherapy. Introduction of serotonin (5-HT3) receptor antagonists was a major therapeutic advance in the treatment of chemotherapy-induced nausea and vomiting with enhanced efficacy when corticosteroids were added. ⋯ Aprepitant appears to be well tolerated but, due to its inhibitory effect on cytochrome P450 isoenzyme 3A4, it can lead to significant drug interactions, resulting in need for dose modification of concomitant therapy. The addition of aprepitant to 5-HT(3) receptor antagonists and corticosteroids was found to be superior to the combination of 5-HT(3) receptor antagonists and corticosteroids alone in patients treated with highly and moderately emetogenic chemotherapy. Clinical trials with aprepitant and other antiemetic agents are warranted to determine a regimen that will ensure complete protection from both acute and delayed chemotherapy-induced nausea and vomiting, thus contributing to improved supportive care and patients' quality of life (QoL).