RESUMEN
The work is aimed at the occurrence of secondary malignancies after therapy for primary testicular tumors. The target of the work was determination of the number and type of secondary tumors, their effect on the survival and comparison of relative risk of the origination of secondary tumors depending on particular treatment modalities. Total of 313 patients with testicular tumors were assessed, who experienced orchiectomy in 1968 to 1998 with subsequent irradiation, chemotherapy or combination of the two modalities. Total of 22 secondary tumors, i.e. 7%, were found in the group. The relative risk of the secondary malignancy development was of 1.04. The median time till the secondary tumor occurrence was of 143 months. Total of 213 patients were subjected to radiotherapy, which was associated with enhanced risk of the secondary tumor development (RR = 8.38); the risk in 100 patients treated by chemotherapy was lower (RR = 0.38). The relative risk of the origination of the secondary malignancy located in the region of preceding irradiation is low (RR = 0.52). In the case of the occurrence of secondary malignancies, the median symptomless survival and the total survival decreased from 271 months to 187.3 and 199.8 months, respectively. Most patients with testicular tumors have favourable long-term prognosis and thus, it is desirable to know the risk of secondary malignancies and to include it into plan of long-term subsequent follow-up.
Asunto(s)
Neoplasias Primarias Secundarias/epidemiología , Neoplasias Primarias Secundarias/etiología , Neoplasias Testiculares/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Niño , Terapia Combinada , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/mortalidad , Orquiectomía , Radioterapia , Análisis de Supervivencia , Neoplasias Testiculares/terapiaRESUMEN
Oropharyngeal candidiasis is a frequent infection in cancer patients who receive cytotoxic drugs. In this study, the efficacy, safety and tolerance of fluconazole and itraconazole were compared in non-neutropenic cancer patients with oropharyngeal candidiasis. Of 279 patients who were randomised between the two treatment groups, 252 patients were considered to be eligible (126 in each group). The clinical cure rate was 74% for fluconazole and 62% for itraconazole (P=0.04, 95% Confidence Interval (CI): 0.5-23.3%). The mycological cure rate was 80% for fluconazole and 68% for itraconazole (P=0.03, 95% CI: 1.2-22.6%). The safety and tolerance profile of both drugs were comparable. This study has shown that in patients with cancer and oropharyngeal candidiasis, fluconazole has a significantly better clinical and mycological cure rate compared with itraconazole.
Asunto(s)
Antifúngicos/uso terapéutico , Candidiasis Bucal/tratamiento farmacológico , Fluconazol/uso terapéutico , Huésped Inmunocomprometido , Neoplasias/microbiología , Adolescente , Adulto , Anciano , Candida albicans , Candida glabrata , Candidiasis Bucal/complicaciones , Candidiasis Bucal/mortalidad , Femenino , Fluconazol/efectos adversos , Humanos , Itraconazol/efectos adversos , Itraconazol/uso terapéutico , Hígado/fisiopatología , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/fisiopatologíaRESUMEN
UNLABELLED: Between April 1994 and May 1997 103 breast cancer patients (pts), pT1c-3a, pN0-1, M0, were randomised after surgery to adjuvant tamoxifen (20 mg per day) or to tamoxifen plus CMF (C 500 mg/m2, M 40 mg/m2 and F 600 mg/m2 on days 1st and 8th q 28 day) in 6 cycles. The median age (49-72 years, median 58), tumour size, number of involved lymphnodes (0-3), estrogens receptor status, grade (I-III) and type of operation were well balanced among the 50 pts on tamoxifen and the 53 pts on tamoxifen plus CMF pts, preferably postmenopausal. RESULTS: Grade of toxicity according to WHO criteria was not higher then two in both arms. Toxicity both haematological and non-haematological was higher in the group treated with chemotherapy (0 vs 32 resp. 20%) except weight gain (52% in both group). After median follow-up of 42 mos five recurrences in tamoxifen and seven in tamoxifen plus CMF pts were observed (p = NS). The projected 3-y DFS is 92% for tamoxifen and 88% for tamoxifen plus CMF (p = NS). The 3-y OS is 88% for tamoxifen and 80% for tamoxifen plus CMF pts (p = NS). CONCLUSIONS: Both regimens are equally effective with higher toxicity in the group with combined chemo- and hormonal therapy.
Asunto(s)
Antineoplásicos Hormonales/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/radioterapia , Tamoxifeno/uso terapéutico , Anciano , Antineoplásicos Hormonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/mortalidad , Quimioterapia Adyuvante , Femenino , Humanos , Persona de Mediana Edad , Tasa de Supervivencia , Tamoxifeno/efectos adversosRESUMEN
The aim of this multicentric, prospective randomized trial is to evaluate and to compare, effects and toxicities of two chemotherapeutic combinations (AC and CMF) in adjuvant treatment of breast cancer. Both combinations were given in equitoxic doses and number of cycles was only four. There are 106 women treated for breast cancer T1c-3a, N0-1, M0 in the study. After surgery the patients were randomized, 54 for AC combination and 52 for CMF. We evaluate toxicity of this treatment in all patients in the study. Hematological and nonhematological side effects were comparable in both groups except alopecia (in the group AC was 100%). The study is not finished yet. Preliminary analysis does not show any difference between these two groups.