RESUMEN
After intubation for advanced, inoperable squamous carcinoma of the oesophagus, a prospectively controlled randomized trial was done to investigate the effect of radiotherapy (41 patients) or mono-chemotherapy (40 patients) or no further treatment (46 patients). Treatment had no significant effect on either palliation or survival (p < or = 0.7) and did not alter the natural history of the disease.
Asunto(s)
Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Esófago , Intubación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/radioterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Estudios Prospectivos , Tasa de SupervivenciaAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Esófago , Intubación/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Cisplatino/administración & dosificación , Terapia Combinada , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/radioterapia , Femenino , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estudios ProspectivosRESUMEN
Twenty-four patients with advanced epidermoid carcinoma of the esophagus were treated with trimetrexate (TMTX), a lipid soluble non-classical antifol. Patients were given TMTX 8 mg/m2 intravenously day 1-5 every 28 days. In nine of these patients the dose was escalated to 12 mg/m2 day 1-5 every 28 days. Three patients had a partial response (95% confidence limit 3-32%) with a median response duration of 14 weeks. No hematologic toxicity was documented. Two patients developed moderate stomatitis and only 3 patients experienced any nausea or vomiting. The median survival of all patients is 12 weeks. It is concluded that a higher dose of TMTX should be studied in patients with esophageal cancer in order to assess the true therapeutic value of the agent at a dose closer to the median tolerated dose. A phase II ECOG study using TMTX 12 mg/m2 intravenously day 1-5 every 21 days is currently being conducted.
Asunto(s)
Neoplasias Esofágicas/tratamiento farmacológico , Quinazolinas/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Evaluación de Medicamentos , Humanos , Quinazolinas/efectos adversos , TrimetrexatoRESUMEN
Alcoholism is the commonest cause of acute pancreatitis in South Africa. The pathogenesis and pathological abnormalities are reviewed, and stress is laid on the importance of chronic underlying changes on which an acute inflammatory process is superimposed. The clinical picture, the more important special investigations, and the present views on treatment are discussed.
Asunto(s)
Alcoholismo/complicaciones , Pancreatitis/etiología , Enfermedad Aguda , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Páncreas/patología , Pancreatitis/diagnóstico , Pancreatitis/patología , Pancreatitis/terapiaRESUMEN
A practical approach to the patient with pain in the right fossa iliaca is presented, stressing the importance of a clinical diagnosis. It is essential to select patients in need of urgent surgery, e.g. those with ectopic pregnancy, ruptured abdominal aneurysm, and perforated viscus, but not to operate on patients in whom surgery may be detrimental, e.g. those in diabetic precoma, or those with porphyria and pneumonia.