RESUMEN
A total of 83 patients with metastatic transitional cell carcinoma who had previously received no systemic therapy entered a randomized phase II evaluation of carboplatin and cis-dichloro-transdihydroxy-bis-isopropylamine platinum IV (CHIP), administered respectively at 400 and 270 mg./m.2 every 28 days. Among evaluable patients with measurable disease response rates were 3 of 22 (14%, 95% confidence interval 5 to 35%) for carboplatin and 4 of 25 (16%, 95% confidence interval 5 to 36%) for CHIP. Among 17 patients with evaluable but not measurable metastases (10 carboplatin and 7 CHIP recipients) there were no responses. Median survival for 64 evaluable patients was 4.8 months (5.0 months for carboplatin and 4.3 months for CHIP recipients). Independent factors prognostic for survival (p less than 0.01) were performance status (0 or 1 versus 2 or 3), liver metastases, prior radiation therapy and recent weight loss (p = 0.02). Multivariate analysis confirmed that a performance status of 2 or 3 and liver metastases were predictive of shorter survival. A total of 31% of the patients treated with carboplatin and 34% of those who received CHIP experienced severe or life-threatening myelosuppression. While the response rates with carboplatin and CHIP are modest, we believe that the characteristics of these agents indicate that they should be evaluated further.
Asunto(s)
Antineoplásicos/uso terapéutico , Carboplatino/uso terapéutico , Carcinoma de Células Transicionales/tratamiento farmacológico , Compuestos Organoplatinos/uso terapéutico , Neoplasias Urológicas/tratamiento farmacológico , Anciano , Carcinoma de Células Transicionales/mortalidad , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Análisis de Supervivencia , Neoplasias Urológicas/mortalidadRESUMEN
Patients with AIDS or ARC may present with parotid gland enlargement either initially or during the course of their disease. Of nine such patients, eight had unilateral gland enlargement, and one had bilateral disease. CT and MR scanning revealed that all patients except one had bilateral multiple intraparotid cysts. In addition, four of the nine patients clinically had cervical adenopathy, while all patients had adenopathy on scanning. We believe that the association of parotid cysts and cervical adenopathy is another manifestation of AIDS or ARC and, when found on scanning, should alert the clinician to the probable underlying condition.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Quistes/diagnóstico , Ganglios Linfáticos/patología , Imagen por Resonancia Magnética , Enfermedades de las Parótidas/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Quistes/etiología , Seropositividad para VIH/complicaciones , Humanos , Hiperplasia/patología , Masculino , Persona de Mediana Edad , Cuello , Enfermedades de las Parótidas/etiologíaRESUMEN
Two patients with severe proteinuria, due to renal amyloidosis complicating chronic ulcerative colitis, improved remarkably with colchicine therapy. One patient with an initial daily urine protein excretion of 13.70 g had a reduction within 2 mo to 6.50 g and to 0.37 g after 9 yr. The other patient's daily urine protein excretion was 9.00 g. This was reduced to 5.10 g/day within 3 mo and was 0.53 g/day by 8 mo. Renal function remained stable or improved during the period of therapy. Colchicine resulted in rapid and prolonged benefit for these patients, despite their amyloid-induced nephrotic syndrome.