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PubMed2005

Variation in modes of chemotherapy administration for breast carcinoma and association with hospitalization for chemotherapy-related toxicity.

BACKGROUND: To the authors' knowledge, few studies to date have addressed the patterns of how chemotherapy was administered (administration modes) over time. In the current study, the goal of the authors was to describe how chemotherapy for breast carcinoma was administered and to determine whether chemotherapy administration modes were associated with toxicity in a community-based large cohort. METHODS: The authors studied 5256 women who were diagnosed with breast carcinoma at age 65 years or older between 1992-1999 and received chemotherapy. The patients were identified from the Surveillance, Epidemiology, and End Results (SEER)Program-Medicare linked databases. Chemotherapy drugs and modes of administration were determined through procedure codes in Medicare claims. RESULTS: Of the 5256 patients who received chemotherapy, 33% received it through an intravenous infusion for less than 1 hour; 39% through an intravenous infusion lasting 1-8 hours; 15% through an intravenous infusion lasting longer than 8 hours and requiring a pump; 12% through an intravenous push technique; and 1% through a subcutaneous, intramuscular, or intralesional injection. These modes varied substantially across the 11 SEER areas. The risks of hospitalization for chemotherapy-related toxicities (neutropenia, fever, thrombocytopenia, and adverse effects of systemic therapy) were not found to be significantly associated with different modes of chemotherapy after adjusting for other factors. Compared with patients receiving 5-flurouracil using an intravenous infusion for longer than 8 hours, the risk of toxicity was determined to be 0.96 (95% confidence interval [95% CI], 0.63-1.47) for patients treated with an intravenous infusion lasting 1-8 hours; 0.94 (95% CI, 0.62-1.41) for patients treated with an intravenous infusion lasting less than 1 hour; and 0.66 (95% CI, 0.38-1.08) for patients treated with subcutaneous, intramuscular, or intralesional injection or an intravenous push technique. CONCLUSIONS: There were substantial geographic variations noted in the modes of administering chemotherapy; however, these variations did not appear to be associated with the risk of toxicities (neutropenia, fever, thrombocytopenia, and adverse effects of systemic therapy).

Aged↗
PubMed1975

Efficacy of intralesional BCG therapy in guinea pigs with disseminated tumor.

It has been previously demonstrated that transplanted syngeneic tumors established in the skin of inbred (strain-2) guinea pigs regressed and regional lymph node metastases were eliminated after intralesional injection of viable Mycobacterium bovis (BCG). During the course of this reaction there is the development of tumor-specific immunity. This experimental model was further manipulated in order that it would more closely approximate a clinical reality. In the present study an evaluation was made of the effectiveness of the developing tumor-specific immunity in this BCG therapy model, to abrogate artifically induced distant tumor deposits and to assess the requirement for tumor-specific immunity in the local BCG-mediated tumor regression. During BCG-mediated regression of established intradermal tumor, the developing tumor-specific immunity inhibited the growth of artificially induced vascular metastases in animals receiving a 10(4) or 10(5) tumor cell dose. However, there is a direct causal relationship between the distant tumor burden and the escape of skin tumor and regional lymph node metastases from BCG-mediated regression. Thus, multiple tumor deposits as low as 10(4) cells are capable of competing for or preempting tumor-specific immune reactivity, which must be a requirement during some phase of the intralesional BCG-mediated therapy of established tumor and regional lymph node metastases. Thus, a significant therapeutic effect could be achieved in guinea pigs with established skin tumors and limited vascular metastases when the modality of therapy included BCG intralesional injection, followed 6 weeks later by surgery of the treated skin tumor and regional lymph node.

Animals↗
PubMed1996

Ultrasound-guided injection of ganglia with coricosteroids.

OBJECTIVE: The aim of this study was to demonstrate the use of ultrasound guidance in confirming intralesional injection of corticosteroids and local anesthetic into symptomatic ganglia, and to propose potential advantages of this technique. DESIGN AND PATIENTS: Ten patients (five men, five women) underwent ultrasound-guided injection of a ganglion. Seven ganglia were near the wrist, one was adjacent to a finger interphalangeal joint and two were adjacent to the talus. All were injected with a 1:1 mixture of long-acting corticosteroid and local anesthetic, the actual volume being dependent on the size of the ganglion. Three patients had a second injection 9-18 months following the initial injection. RESULTS: In four patients the ganglia resolved completely. In five patients there was significant improvement, with a reduction in size of the ganglion and symptomatic relief. CONCLUSION: Ultrasound-guided injection insures intralesional deposition of corticosteroids and may provide an alternative to surgery in the management of ganglia.

Adult↗
PubMed1997

Intralesional Ethibloc Injections in Bone Cysts.

Benign bone cysts (aneurysmal and unicameral) often require treatment to prevent pathological fractures. Percutaneous injections are less invasive than surgery. We describe the different percutaneous treatments available: local injection of steroids, calcitonin, or bone marrow in unicameral bone cysts, and Ethibloc(R)(Ethicon, Ethnor Laboratories, Nevilly Sur Seine, France) injection in both unicameral or aneurysmal bone cysts. Within the tumor, histologic modifications usually occur after these injections, due to the fibrogenic properties of the agent. Therefore, we emphasize the necessity of obtaining an histologic proof before any injection, especially in aneurysmal bone cysts.

Journal Article↗
PubMedDate not supplied

Intralesional steroid injection therapy.

Recently, a different therapeutic option for patients with benign esophageal strictures was introduced in our gastroenterology unit. Causes of these strictures, preliminary treatment, pathophysiology, the actual procedure, and possible complications of the procedure are discussed.

Anti-Inflammatory Agents↗
PubMed1990

Perilymphatic subcutaneous atrophy in adnexal hemangioma: a complication of intralesional corticosteroid injection.

We report a case of atrophy of the perilymphatic, subcutaneous tissue following local steroid injection of an eyelid capillary hemangioma. Unlike such cases that have been previously reported, the atrophy in our case occurred after a single injection of triamcinolone. It spontaneously resolved over a period of 1 year. Although many cases of atrophy following local corticosteroid injections for other lesions elsewhere in the body have been reported, the entity we describe is a rare complication in capillary hemangioma therapy.

Atrophy↗
PubMed1986

Perilymphatic atrophy of skin. An adverse side effect of intralesional steroid injections.

A less frequently reported adverse side effect of local steroid injections has been described. Perilymphatic atrophy results in atrophy of the dermal structures and depigmentation along the course of the lymphatic vessels draining the site of injection. The five cases reported here all occurred in dark-skinned patients. Three of the five cases (Cases Three to Five) resolved spontaneously, the longest taking 9 months from the time of injection. The outcome of two of the patients (Cases One and Two) remain unknown since the patients were lost to follow-up. This report did not form any conclusions from the material reported here, but simply sought to make practitioners aware of the occurrence of this adverse side effect.

Adult↗
PubMed1985

[Augmentation of cytotoxicity of tumor infiltrating lymphocytes by interleukin-2 in gastric cancer patients].

Lymphocyte infiltration into tumor has been regarded as an expression of host reaction against tumor, but the natural cytotoxicity of tumor infiltrating lymphocytes (TLL) is often very low. In order to augment this low cytotoxicity, TIL of gastric cancer patients were cultured with interleukin-2 (IL-2) in vitro. On the other hand, immunopotentiators (OK432, PSK) were injected into gastric cancer intralesionally under endoscopy. By the in-vitro culture with IL-2, the cytotoxicity of TIL was augmented against both targets of K562 and MNN28 (gastric carcinoma cell line). In particular, the augmentation of cytotoxicity against MKN28 was more obvious in TLL than PBL (peripheral blood lymphocytes). In the ascitic lymphocytes, the in-vitro culture with IL-2 induced autologous tumor cell killing. Intralesional injection of OK432 or PSK augmented the natural cytotoxicity of TIL, and the ratio of OKT8 and Leu7 cells increased in the TIL of OK432-injected group.

Cell Line↗