PubMed Health⌕ Search

Biomedical subjects

P T Ang

Publications and source records attributed to P T Ang.

51 records · Page 3Linked to original sources
PubMed1993

Common toxicities of cancer chemotherapy.

Sixty cancer patients who were receiving chemotherapy at an outpatient Oncology Centre were surveyed for their views on a list of treatment-related toxicities. The severity of each toxicity was assessed using a visual analogue scale. Sixty percent of patients felt that the overall toxicity was acceptable. Ten percent felt like giving up. Problem with venous access was named the worst toxicity by 37% of patients, followed by nausea and vomiting (19%), and long waiting time (11%). Male patients tended to tolerate chemotherapy better. The female patients were significantly more affected by hair loss than their male counterpart. Better understanding of the toxicities of chemotherapy as perceived by the patients themselves allows them to take appropriate measures in improving their quality of life.

Alopecia↗
PubMed1993

Management of chemotherapy-induced neutropenic sepsis--combination of cephalosporin and aminoglycoside.

In cancer patients undergoing combination chemotherapy, neutropenic febrile episode (NFE) is a life-threatening condition. Prompt initiation of empirical antibiotics is essential to limit morbidity and mortality. To understand the effectiveness of combination antibiotics consisting of a third-generation cephalosporin and an aminoglycoside, a retrospective review of all patients admitted for NFEs was conducted. Between August 1990 and December 1991, there were 34 NFEs in 26 cancer patients which were treated with a combination of aminoglycoside (gentamicin or amikacin) and a cephalosporin (ceftriaxone or ceftazidime). Initial antibiotic therapy included aminoglycoside plus ceftriaxone in 23 NFEs and ceftazidime in 11 NFEs. A change of antibiotics was required in 11 NFEs because of deteriorating clinical status or culture-proven drug resistance. Bacteria were isolated in 12 (35%) NFEs (blood 7, respiratory tract 2, skin 2, urine 1). Of these, eight (62%) were gram-negative bacteria and five were gram-positive bacteria. One blood specimen grew both gram-positive and gram-negative organisms. Broad spectrum antibiotics were effective in almost all NFEs. Thirty-one (91%) NFEs resolved with antibiotics. Three patients succumbed to their infection despite combination antibiotics. Aminoglycoside and cephalosporin is an effective antibiotic combination in the management of fever in neutropenic hosts. Randomised trials comparing this combination with newer antibiotics like monobactams and quinolones are needed in the search for more effective therapy.

Adolescent↗
PubMed1992

Fulminant hepatic failure in non-Hodgkin lymphoma patients treated with chemotherapy.

Chemotherapy is the mainstay of therapy for patients with non-Hodgkin lymphoma. Among side-effects associated with the use of chemotherapy, immunosuppression is one which can be potentially fatal. In hepatitis B carriers, immunosuppression permits widespread infection of the hepatocytes and its subsequent withdrawal causes an "immunological rebound" leading to massive necrosis of hepatocytes. 4 patients who died of fulminant hepatitis following chemotherapy are reported. These were patients with positive hepatitis B serology. Caution is advised when treating non-Hodgkin lymphoma in patients from hepatitis B endemic regions.

Adult↗
PubMed1992

The Stanford experience with combined procarbazine, Alkeran and vinblastine (PAVe) and radiotherapy for locally extensive and advanced stage Hodgkin's disease.

This report describes the efficacy and toxicity of PAVe (procarbazine, Alkeran, vinblastine) and irradiation (RT) in the management of 159 patients with locally extensive or advanced stage Hodgkin's disease (HD) at Stanford University. Patients received six courses of chemotherapy alternating with RT. The extent of RT and the schedule of treatment varied according to the stage of disease. About 2/3 of patients received PAVe/RT in the setting of prospective, randomized clinical trials. The rate of complete response was 93%. With a median follow-up of seven years (range 2-17), the 15 year actuarial freedom from progression (FFP) is 78% and overall survival is 75%. Ten-year FFP by stage is: 80% for locally extensive stage II, 90% for stage IIIA and 70% for stage IIIB. Excellent and equal results were attained with PAVe/RT vs. MOP(P) (mustard, Oncovin, procarbazine with or without prednisone)/RT in the randomized combined modality studies. Progression or recurrence was documented in 30 patients and was more common in irradiated sites. PAVe was well tolerated acutely. There were no treatment related fatalities. Twenty-three (14%) patients were admitted to the hospital for neutropenic fever. Five second malignancies have occurred after PAVe/RT only: one myelodysplastic syndrome, one acute myelogenous leukemia, one non-Hodgkin's lymphoma and two solid tumors including a case of non-small cell lung cancer and an in situ carcinoma of the cervix. Three patients died from myocardial infarction several years after the completion of treatment. These mature data show that PAVe/RT is effective and well-tolerated therapy for locally extensive stage II and IIIA/B HD.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Combined chemotherapy using cisplatin, ifosfamide and bleomycin (PIB) in the treatment of advanced and recurrent cervical carcinoma.

Combined cisplatin, ifosfamide and bleomycin (PIB) chemotherapy was given to 14 (11 recurrent and 3 advanced and metastatic) cervical carcinoma patients. At least 2 cycles of chemotherapy were given before assessment of tumour response. The overall response rate was 28.6%; the complete response rate was 14.3%. Sites of response included cervical lymph nodes and the lung. Toxicity was common. Alopecia was universal. Other toxicity included suppression of haematopoiesis (73%), leucopenia (71%) and nausea and vomiting. Two patients died from sepsis during the myelosuppressive phase. The role of PIB in the management of advanced and recurrent carcinoma of the cervix should be evaluated in a randomized-controlled trial.

Adenocarcinoma↗
PubMed1992

Embryonal carcinoma arising in Turner's syndrome.

Risk of malignant transformation in a dysgenetic gonad is high. This is a report of a 23 year-old female who presented with symptoms and signs of ovarian neoplasm which was histologically confirmed as embryonal carcinoma. She had features of Turner's syndrome and was found to have XO chromosomal constitution. Embryonal carcinoma arising in a dysgenetic gonad is uncommon. It is even rarer when it arises in a patient with pure 45 XO. The following is a case report which highlights the role of chemotherapy and surgery in the management. It includes a literature review on the clinical features, genetic variants and malignant transformation in dysgenetic gonad. The role of prophylactic removal of dysgenetic gonad is discussed.

Adult↗
PubMed1992

Adult parameningeal rhabdomyosarcoma--a case report and literature review.

Although rhabdomyosarcoma is predominantly a malignant disease of children, it is also seen in adults. Since adults account for only 15% of rhabdomyosarcomas, the experience gathered for the treatment of the malignancy has been derived from treating children. The treatment of a case of adult extensive parameningeal rhabdomyosarcoma with CyVADlC chemotherapy and radiotherapy is described, together with a review of the literature.

Adult↗
PubMed1989

Analysis of dose intensity in doxorubicin-containing adjuvant chemotherapy in stage II and III breast carcinoma.

Three hundred thirty-six patients with stage II or stage III breast cancer were treated on an adjuvant protocol containing fluorouracil, doxorubicin, cyclophosphamide, vincristine, and prednisone (FACVP). Depending on the estrogen-receptor (ER) status, the patients were subdivided to receive maintenance chemotherapy with or without tamoxifen. The administered dose intensity of fluorouracil, doxorubicin, and cyclophosphamide (FAC) (mg/m2/wk) relative to the projected dose intensity (based on planned dose) was computed for each patient. The relative dose intensity of the first six cycles of chemotherapy (RDI6) was compared with disease-free survival (DFS). Of the 299 patients who completed at least six cycles of therapy, 83% received dose intensities within 20% of standard intensity (.8 less than or equal to RDI6 less than or equal to 1.2). The group with the highest dose intensity (RDI6 greater than or equal to 1.13) had the longest DFS, though there was not a clear trend of linear association between dose intensity and DFS after adjustment for prognostic factors (P = .16). The patients who received at least standard dose intensity (RDI6 greater than or equal to 1.0) had longer DFS than those whose therapy did not reach standard intensity (RDI6 less than 1.0). This difference was significant in patients with stage III disease (P = .01). The 37 patients who completed fewer than six cycles of chemotherapy had the shortest DFS (5-year DFS of 48% v 65% in the others). This retrospective analysis, in a heterogeneously treated group of patients, did not show the differences in outcome associated with dose intensity as demonstrated in the earlier studies comparing projected dose intensity of various cyclophosphamide, methotrexate-, and fluorouracil (CMF)-containing adjuvant trials. Improved DFS was noted in the stage III patients receiving higher dose intensity. Our failure to demonstrate the differences in stage II patients may be due to the narrow range of dose intensity in this study or to a difference in the dose-response curves depending on the stage of disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Abdominal tuberculosis revisited.

Four patients with abdominal tuberculosis (ATB) managed in the University Department of Medicine, Singapore General Hospital, are presented to highlight problems encountered in the diagnosis of this condition. Three patients had intestinal tuberculosis, one of whom had peritoneal involvement and another had possible hepatic disease. The fourth patient presented with peritoneal disease alone. Ages at presentation ranged from 25 years to 71 years. There were three females and one male. Two patients presented with symptoms of chronic illness for 10 months before the disease was diagnosed. Two other patients had acute presentations. Fever, abdominal pain, vomiting and diarrhoea were the main symptoms encountered. Three patients had abdominal masses at diagnosis. Radiological investigations were the most useful diagnostic aid. Bacteriological confirmation was made in only one patient. Histology helped in the diagnosis in two others. Recent literature on this condition was reviewed and the possible role of impaired immunity in the pathogenesis of this condition was discussed.

Adult↗