RESUMEN
Patients with inoperable head and neck cancer were treated with a spleen peptide preparation (Polyerga) in a phase III randomized, placebo-controlled double-blind study during chemotherapy (cisplatin/carboplatin, 5-fluorouracil) to investigate further the efficacy of this peptide preparation as supportive treatment under chemotherapy. Immunological changes as well as quality of life aspects were examined. Forty patients were included in this study. The peptide preparation had a significant stabilizing effect on the peripheral blood lymphocyte status during chemotherapy cycles (Student t-test, p = 0.05) and tended to stabilize the shift of granulocyte count (Student t-test, p = 0.18). In addition, the group receiving the verum showed a remarkable stabilization of body weight (Mann-Whitney U-test, p = 0.17) during chemotherapy treatment and the generally observed increase of fatigue-inertia during the chemotherapy cycles was significantly reduced (Student t-test, p = 0.01).
Asunto(s)
Glicopéptidos/uso terapéutico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Péptidos/uso terapéutico , Fenoles/uso terapéutico , Bazo/química , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Método Doble Ciego , Combinación de Medicamentos , Fatiga/prevención & control , Femenino , Granulocitos/efectos de los fármacos , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/psicología , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Monocitos/efectos de los fármacos , Cuidados Paliativos , Control de Calidad , Factores de TiempoAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Adulto , Anciano , Bleomicina/administración & dosificación , Cisplatino/administración & dosificación , Ensayos Clínicos como Asunto , Terapia Combinada , Femenino , Humanos , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Distribución Aleatoria , Vinblastina/administración & dosificación , Vinblastina/análogos & derivados , VindesinaRESUMEN
52 patients with epidermoid cancer of the head and neck region were either treated with cis-DDP and bleomycin (arm A) or with methotrexate and vindesine (arm B). In case of resistance patients were further treated with the alternative regimen (A leads to B or B leads to A). Treatment results are superior in arm A. Complete and partial remission were in A: 54%, in B: 31%, after crossover 46% and 0%, respectively. Status of pretreatment (operation and/or radiotherapy) is of minor importance for arm A than for the "soft" treatment of arm B. Preliminary analysis of survival and remission duration shows no significant difference in regard to A or B and status of pretreatment. However, those patients resistant to B and further treated with A have an increase of median survival from 3 to 9 months (p = 0.02). With primary chemotherapy inoperable tumors can be made operable with curative intention.
Asunto(s)
Antineoplásicos/administración & dosificación , Bleomicina/administración & dosificación , Carcinoma de Células Escamosas/tratamiento farmacológico , Cisplatino/administración & dosificación , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Metotrexato/administración & dosificación , Vinblastina/análogos & derivados , Adulto , Anciano , Carcinoma de Células Escamosas/mortalidad , Ensayos Clínicos como Asunto , Femenino , Neoplasias de Cabeza y Cuello/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Vinblastina/administración & dosificación , VindesinaRESUMEN
An attempt has been made to standardize the method of large volume plasma exchange in tumor patients on the basis of an albumin-electrolyte exchange solution. Problems relating to the alteration of tumor patients' serum proteins are discussed. Three patients with malignancies successfully underwent therapeutic plasmaphereses.
Asunto(s)
Carcinoma Basocelular/terapia , Neoplasias Pulmonares/terapia , Linfoma/terapia , Intercambio Plasmático , Corticoesteroides/uso terapéutico , Adulto , Combinación de Medicamentos , Fibrinógeno/análisis , Enfermedad de Hodgkin/terapia , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Persona de Mediana Edad , Plasmaféresis , Protrombina/análisisRESUMEN
The removal of uremic substances in hemofiltration, in contrast to hemodialysis, is achieved by means of a convective transport across membranes of high porosity. Since 1974, more than 30 patients with chronic renal insufficiency have been treated with regular hemofiltration three times weekly for four to five hours each. After completing a pilot study, a controlled study to compare hemodialysis and hemofiltration was initiated during January, 1978. A normalization of blood pressure in patients with severe hypertension, and remarkable stability of the circulatory system, even after dehydration in patients who had hypotension in spite of fluid overload, could be demonstrated. Hemofiltration is preferred, especially in older patients with cardiovascular or cerebrovascular problems, because of its lower frequency of hypotensive episodes compared to dialysis. An important aim--the miniaturization of the artificial kidney--has not yet been achieved, however, because of the necessity for an extensive monitoring system for the exact proportioning of the sterile substitution fluid. First results in the application of a fluid regeneration system consising of a charcoal cartridge and a bioelectric cell, for degradation of urea, are presented.