RESUMEN
BACKGROUND: Docetaxel and gemcitabine are active against breast cancer. The purpose of this phase II study was to evaluate the efficacy and safety of monthly docetaxel combined with weekly gemcitabine in patients with chemotherapy-pretreated metastatic breast cancer. PATIENTS AND METHODS: Thirty-nine patients were enrolled, of whom thirty had received prior chemotherapy in the adjuvant setting, seven for metastatic disease, and two for both, including prior anthracycline in 33 patients. Treatment was gemcitabine 800 mg/m2 days 1, 8, 15 and docetaxel 100 mg/M2 on day 1, with cycles repeated every four weeks. RESULTS: Response rate was 79% (95% confidence interval (CI): 63%-91%), with 2 complete and 29 partial responses. Twenty-five of the responders remained progression-free for more than six months. Median survival was 24.5 months. Delivered dose intensity of gemcitabine was lower than expected (63% of planned). The predominant hematologic toxicity was grade 4 neutropenia in 36 patients, complicated by fever in three patients. With the exception of asthenia, severe non-hematological toxicities were infrequent. CONCLUSIONS: Monthly docetaxel, combined with weekly gemcitabine, has significant but manageable hematologic toxicity. Despite frequent dose adjustments, this doublet is very active in metastatic breast cancer, producing a high proportion of durable responses associated with favorable survival.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Desoxicitidina/análogos & derivados , Paclitaxel/análogos & derivados , Taxoides , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Quimioterapia Adyuvante , Desoxicitidina/administración & dosificación , Docetaxel , Femenino , Humanos , Infusiones Intravenosas , Persona de Mediana Edad , Metástasis de la Neoplasia , Neutropenia/inducido químicamente , Paclitaxel/administración & dosificación , Análisis de Supervivencia , Resultado del Tratamiento , GemcitabinaRESUMEN
This article describes the Village AIDS Day Treatment Program, a program for people living with HIV/AIDS that provides health care by using a full range of interdependent services. Opened in 1988, this program was the first of its kind in the country. It has provided leadership in developing a model of care that addresses the full spectrum of health care--promotion, prevention, maintenance, and treatment. Along with describing the program and its services, this article includes the program's history and its influencing philosophies.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/terapia , Atención a la Salud/organización & administración , Promoción de la Salud , Grupo de Atención al Paciente/organización & administración , Atención a la Salud/normas , Promoción de la Salud/normas , Humanos , Relaciones Interprofesionales , Grupo de Atención al Paciente/normas , Servicios Preventivos de SaludRESUMEN
This paper describes the Village Nursing Home's day treatment program for persons with AIDS, with an emphasis on the role of occupational therapy and the outcomes of occupational therapy interventions. The clients' demographics are included, and a general program philosophy of clients' empowerment is discussed. The health promotion framework and the use of holistic modalities address the spiritual aspect of the individual and how occupational therapy and spirituality might interconnect.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/rehabilitación , Centros de Día/organización & administración , Terapia Ocupacional , Síndrome de Inmunodeficiencia Adquirida/psicología , Salud Holística , Humanos , Masculino , Motivación , Ciudad de Nueva York , Planificación de Atención al Paciente , Poder Psicológico , Autocuidado , Apoyo SocialAsunto(s)
Antieméticos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Cisplatino/efectos adversos , Dexametasona/uso terapéutico , Adulto , Anciano , Ensayos Clínicos como Asunto , Difenhidramina/administración & dosificación , Quimioterapia Combinada , Femenino , Humanos , Lorazepam/administración & dosificación , Masculino , Metoclopramida/administración & dosificación , Persona de Mediana Edad , Neoplasias/tratamiento farmacológicoRESUMEN
A 61-year-old patient with rheumatoid arthritis receiving treatment with methotrexate developed bone marrow hypoplasia after treatment with trimethoprim-sulfamethoxazole. The bone marrow recovered after stopping methotrexate.