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At least 811 records · Page 45Linked to original sources

PubMed2004

Randomised controlled trial comparing single agent paclitaxel vs epidoxorubicin plus paclitaxel in patients with advanced ovarian cancer in early progression after platinum-based chemotherapy: an Italian Collaborative Study from the Mario Negri Institute, Milan, G.O.N.O. (Gruppo Oncologico Nord Ovest) group and I.O.R. (Istituto Oncologico Romagnolo) group.

The aim of the study was to evaluate the role of epidoxorubicin plus paclitaxel combination (ET) vs single agent paclitaxel (T), as second-line chemotherapy treatment in advanced ovarian cancer patients in early progression within 12 months after platinum-based chemotherapy. From October 1994 up to June 1999, 234 patients from 34 Italian hospitals were randomised to receive: (A) epidoxorubicin (E) 80 mg m(-2) + paclitaxel (T) 175 mg m(-2) (3 h infusion), every 21 days for 4-6 cycles. (B) Paclitaxel 175 mg m(-2) (3 h infusion) every 21 days for 4-6 cycles. Evaluable for survival analysis were 106 and 106 patients in ET and T arm, respectively. Platinum-based monochemotherapy was the first-line treatment in 43% patients, while polichemotherapy containing anthracyclines was the preferred first-line therapy in 22% patients. The median time from the end of first-line therapy to randomisation was 3 months. Treatment was completed in 87 and 85% of T and ET arm, respectively. Haematological toxicity was significantly more common in ET group (ECOG grade 3-4 neutropenia: 37.4% in ET vs 18.2% in T arm). Neuropathies were similar in both arms (sensory: ECOG grade 2-3: 12.1% in ET vs 14.7% in T arm, motor: 6.1% in ET vs 5.3% in T arm). Objective response was achieved in 37.4% of patients in ET group and in 46.9% of patients in T arm. At a median follow-up of time of 48 months, a total of 180 patients progressed and 163 patients died. Survival analysis showed no difference between ET and T (median time to progression: 6 months for both regimens, median survival: 12 and 14 months for ET and T, respectively; hazard ratio for mortality of ET vs T: 1.17 (95% CI 0.86-1.59; P=0.33). The ET regimen does not seem to be more effective than T in refractory advanced ovarian cancer patients in early progression after platinum-based chemotherapy. Despite an acceptable response rate, the control of disease progression remains poor.

Adult↗

PubMed2005

Salvage chemotherapy with irinotecan, 5-fluorouracil and leucovorin for taxane- and cisplatin-refractory, metastatic gastric cancer.

We performed a phase II study of combination chemotherapy with irinotecan, 5-fluorouracil (5-FU) and leucovorin in metastatic gastric cancer patients who were previously treated with taxane and cisplatin, to evaluate the antitumour activity and toxicity of the combination chemotherapy. The metastatic gastric adenocarcinoma patients who were previously treated with taxane and cisplatin combination as first line, and had at least one measurable lesion, 0-2 ECOG performance status and adequate organ functions, were considered eligible. They received irinotecan (150 mg m(-2), day 1) and leucovorin (100 mg m(-2), day 1), followed by continuous infusion of 5-FU (1000 mg m(-2) day(-1), days 1 and 2) every 2 weeks. Treatment was continued until progression of disease was observed. In all, 64 patients were treated with this combination chemotherapy. The median age of the patients was 55 years (range, 33-74 years), and the median ECOG performance status was 1 (0-1, 61 (95%)). Out of 64 patients, 57 were assessable for response. Among 57 assessable patients, no complete response and 12 partial responses were observed (overall response rate, 21%; 95% confidence interval (CI), 10-32%). Stable disease was observed in 14 patients (25%) and progressive disease in 31 patients (54%). The median time to progression was 2.5 months (95% CI, 1.6-3.4) and the median overall survival since the start of the second-line modified FOLFIRI was 7.6 months (95% CI, 6.5-8.7). Grade 3-4 haematologic toxicities included neutropenia in seven patients (11%) and thrombocytopenia in five patients (8%). Grade 3-4 nonhaematologic toxicities included diarrhoea in two patients (3%) and vomiting in two patients (3%). There were no treatment-related deaths. The combination of irinotecan, 5-FU and leucovorin showed moderate activity and favourable toxicity profile as a second-line treatment in metastatic gastric cancer patients, who were previously treated with taxane and cisplatin.

Adenocarcinoma↗

PubMed2005

Gefitinib is more effective in never-smokers with non-small-cell lung cancer: experience among Asian patients.

We retrospectively analysed the results of patients with advanced non-small-cell lung cancer treated with gefitinib to derive clinical factors predictive of response and a favourable survival outcome. Patients were treated with gefitinib 250 mg per day and re-evaluated 4-8 weeks later with repeat CT scan and every 8 weeks thereafter to assess response and the duration of response. Pathology review by a histopathologist was conducted, in particular to confirm a recently published result of bronchioloalveolar carcinoma histology or its components as predictive of response to gefitinib. Logistic regression and Cox regression analytical methods were applied to determine factors that could predict for response and improved overall survival. A total of 110 patients were treated. The overall response rate was 32% partial responses (PRs). Only never-smoking status was predictive of response in the logistic regression analysis, adjusted OR=6.1, 95% CI=1.7, 21.5. The presence of a PR and good performance status were predictive of a favourable survival outcome from the Cox regression modelling. Responders had an adjusted HR of 3.0, 95% CI=1.5-5.8 compared to nonresponders, while patients with ECOG status 0-1 had an adjusted HR of 0.42, 95% CI=0.25-0.72, compared with patients with ECOG status 2-4. Bronchioloalveolar carcinoma or its components were distinctly absent on pathology review. In conclusions, Never-smoking status is an important clinical predictor of a favourable response to gefitinib.

Adult↗

PubMed1999

Evaluating the quality of life of cancer patients: assessments by patients, significant others, physicians and nurses.

This study examined the usefulness of caregiver ratings of cancer patients' quality of life (QOL), an issue of relevance to both adequate patient care and to the possible use of proxy QOL raters in clinical studies. We compared QOL ratings of 90 cancer patients receiving inpatient chemotherapy with those provided by their significant others (most often the spouse), physicians and nurses. During patients' scheduled appointment for receiving chemotherapy on a clinical ward, all raters completed independently the Dartmouth COOP Functional Health Assessment charts/WONCA, an instrument developed by a cooperative group of primary care physicians to briefly assess a core set of seven QOL domains (physical fitness, feelings, daily and social activities, overall health, pain and quality of life) by single items with five response options. With few exceptions, mean scores of the proxy raters were equivalent or similar to those of the patients. Most patient-proxy correlations varied between 0.40 and 0.60, indicating a moderate level of agreement at the individual level. Of all comparisons made, 41% were in exact agreement and 43% agreed within one response category, leaving 17% more profound patient-proxy discrepancies. Disagreement was not dependent on the type of proxy rater, or on raters' background characteristics, but was influenced by the QOL dimension under consideration and the clinical status of the patient. Better patient-proxy agreement was observed for more concrete questions (daily activities, pain) and for patients with either a very good (ECOG 0) or poor (ECOG 3) performance status. The results indicate that both significant others and health care providers can be useful sources of information about cancer patients' QOL.

Adult↗

PubMed1999

Rituximab (anti-CD20 monoclonal antibody) therapy for progressive intermediate-grade non-Hodgkin's lymphoma after high-dose therapy and autologous peripheral stem cell transplantation.

We evaluated the response and toxicity of rituximab in the setting of progressive intermediate grade non-Hodgkin's lymphoma (NHL) after autologous peripheral stem cell transplantation (PSCT). Seven patients with a median age of 59 years (45-62), ECOG performance status 0-1, and CD20-positive diffuse large cell lymphoma with progression after PSCT were treated. All patients initially received 4-weekly infusions of rituximab (375 mg/m2). The maximum response was three CR and four PR. Median progression-free survival was 197 days (range 60-282). With a median follow-up of 204 (115-299) days, the patients' disease status is classified as two CR, one PR, and four PD. Four of five patients with ECOG performance status of 1 prior to treatment showed improvement to status 0 after treatment with rituximab. While follow-up is short, these results suggest that rituximab has significant activity in intermediate-grade non-Hodgkin's lymphoma that has relapsed after PSCT.

Antibodies, Monoclonal↗

PubMed2006

Childhood obesity: a pandemic of the twenty-first century.

BACKGROUND: The researchers and clinicians need to gain a better understanding of the social and environmental contexts by which childhood obesity is becoming a growing problem of twenty-first century and develop more efficacious methods of prevention and treatment. METHODS: Summary of the actions and achievements of the European Childhood Obesity Group (ECOG) since its foundation in 1991 until the 16th anniversary. Review of the sessions of the 16th ECOG workshop devoted to epidemiology, prevention, risk factors, comorbidities and treatment of childhood and adolescent obesity. RESULTS: Meta-analysis of epidemiological data on childhood obesity in Europe underscores an urgent need of preventive actions in which general practitioners may play an important role. Media should get actively involved in promotion of healthy lifestyle. Metabolic syndrome, non-alcoholic steatohepatitis, diabetes type 2 and sleep apnoea syndrome are becoming more common in obese adolescents. In morbid obesity with severe comorbidities, more aggressive ways of treatment may be considered. CONCLUSIONS: European Childhood Obesity Group members should get actively involved into targeted prevention and intervention project to promote healthy lifestyle and successful weight control.

Adolescent↗

PubMed2005

Dynamic changes in brain glucose and lactate in pericontusional areas of the human cerebral cortex, monitored with rapid sampling on-line microdialysis: relationship with depolarisation-like events.

The pathophysiology of peri-lesion boundary zones in acute brain injury is highly dynamic, and it is now clear that spreading-depression-like events occur frequently in areas of cerebral cortex adjacent to contusions in the injured human brain. An automated method to assay microdialysate from peri-lesion cerebral cortex in 11 patients with intracranial haematomas requiring surgery was used. Perfusate (2 microL/min) flowed directly into a flow-injection system for assay of glucose and lactate at intervals typically of 30 secs each. Four channels of electrocorticogram (ECoG) were recorded from a subdural strip adjacent to the catheter. Several patterns of change in metabolites were identified in different time domains. Overall, the number of transient lactate events was significantly correlated with the number of glucose events (r2=0.48, P=0.027, n=10). Progressive reduction in dialysate glucose was very closely correlated with the aggregate number of ECoG events (r2=0.76, P=0.0004, n=11). It is proposed that the recently documented adverse impact of low dialysate glucose on clinical outcome may be because of recurrent, spontaneous spreading-depression-like events in the perilesion cortex.

Adult↗

PubMed1998

Primary cutaneous large-cell lymphoma: analysis of 49 patients included in the LNH87 prospective trial of polychemotherapy for high-grade lymphomas. Groupe d'Etude des Lymphomes de l'Adulte.

The objectives of this study were to evaluate the outcome after polychemotherapy for patients with primary cutaneous large-cell lymphomas (PCLL) and to validate the recently proposed immunohistologic classification of cutaneous lymphomas. Among 140 patients with positive skin biopsies included in the LNH87 protocol (for treatment of aggressive lymphomas), 49 patients met the criteria of PCLL. Characteristics were: sex ratio M/F, 2.3; age 18 to 83 years (median, 52), peripheral lymph nodes, n=22; diffuse disease, n=12; median tumor size, 4.5 cm; elevated lactate dehydrogenase, n=9; ECOG: 0/1, n=49. Histology was: follicular center B cell, n=23; B-lymphoblastic, n=1; anaplastic large-cell lymphoma, n=14 (T cell phenotype n=8); CD30- T cell lymphoma, n=11. All patients received polychemotherapy: under 70 years, ACVBP (three to four cycles and consolidation for 6 months) n=25; mBACOD (eight cycles) n=16; over 70 years, C(T)VP (six cycles) n=8. Radiation therapy was not included in the protocol. With a median follow-up of 5 years, 24/49 patients had relapsed, with 20 skin relapses. Event-free (EFS) and overall survival (OS) at 5 years were, respectively, 50 and 77%. Significant adverse prognostic factors were: histology (CD30- T cell lymphoma) and diffuse cutaneous disease (>10% of skin). The presence of nodal involvement was only significant for EFS. When compared to 140 non-cutaneous lymphoma patients included in the same trial and fully matched for the main clinical characteristics, OS was similar. In conclusion, PCLL behaves like other localized B or T cell extranodal lymphomas with the same prognostic factors (LDH, ECOG, age) except for CD30+ PCLL which have a very good prognosis.

Adolescent↗

PubMed1999

Refinement of the basic treatment equivalent model to reflect radiotherapy treatment throughput using Australasian data.

A model of radiotherapy linear accelerator throughput has been developed and shown to be a more sensitive measure of throughput than current measures of throughput. The present study aims to develop a more sensitive basic treatment equivalent (BTE) model that still measures linear accelerator throughput and considers some of the shortcomings of the previous model. All radiation oncology departments in Australia and New Zealand were invited to participate. Departments were asked to time with a stopwatch all episodes of radiotherapy treatment over a 4-week period. Data collected for each treatment fraction included treatment intent, tumour site, patient age, Eastern Cooperative Oncology Group (ECOG) performance status, number of fields used, number of wedges used, number of junctions, number of shielding blocks used, whether the treatment was the first fraction, the use of general anaesthesia and whether port films or electronic portal imaging was used. Twenty-six departments of radiation oncology (70%) participated in this trial. A total of 7929 fractions of treatment, administered to 2424 patients, were timed. The factors found to most significantly impact on treatment duration on multivariate analysis were the type of fraction (first fraction was longer than subsequent fractions), type of beam (electrons were quicker than photons, which were quicker than mixed), number of fields, number of shields, number of junctions, number of port films and performance status (ECOG < 2 vs > 2). The age of the patient, number of compensators and the sex of the patient were not significant. The relationships between factors were assessed, and models of measuring linear accelerator throughput which consider complexity corrections were derived. It is possible to show that linear accelerator throughput is poorly measured by just considering numbers of patients or fields treated per unit time; and that other factors that impact on treatment duration must be considered. A more sensitive model of patient throughput is suggested; but even when a large number of factors are considered, some insensitivity still remains in the model.

Australia↗

PubMed2003

Epileptogenicity of focal malformations due to abnormal cortical development: direct electrocorticographic-histopathologic correlations.

PURPOSE: Malformations due to abnormal cortical development (MCDs) are common pathologic substrates of medically intractable epilepsy. The in situ epileptogenicity of these lesions as well as its relation to histopathologic changes remains unknown. The purpose of this study was to correlate the cellular patterns of MCDs with the expression of focal cortical epileptogenicity as assessed by direct extraoperative electrocorticographic (ECoG) recordings by using subdural grids. METHODS: Fifteen patients with drug-resistant focal epilepsy due to pathologically confirmed MCD who underwent subdural electrode placement for extraoperative seizure localization and cortical mapping between 1997 and 2000 were included in the study. Areas of interictal spiking and ictal-onset patterns were identified and separated during surgery for further pathologic characterization (cellular and architectural). Three pathologic groups were identified: type I; architectural disorganization with/without giant neurons, type IIA; architectural disorganization with dysmorphic neurons, and type IIB; architectural disorganization, dysmorphic neurons, and balloon cells (BCs). The focal histopathologic subtypes of MCDs in cortical tissue resected were then retrospectively correlated with in situ extraoperative ECoG patterns. RESULTS: Cortical areas with histopathologic subtype IIA showed significantly higher numbers of slow repetitive spike pattern in comparison with histopathologic type I (p = 0.007) and normal pathology (p = 0.002). The ictal onset came mainly from cortical areas with histopathologic type IIA (nine of 15 patients). None of the seizures originated from neocortical areas that showed BC-containing MCD (type IIB). CONCLUSIONS: This study shows that areas containing BCs are less epileptogenic than are closely located dysplastic regions. These results suggest a possible protective effect of BCs or a severe disruption in the neuronal networks in BCs containing dysplastic lesions. Further studies are needed to elucidate the nature and the potential role(s) of balloon cells in MCD-induced epileptogenicity.

Adolescent↗

PubMed1990

Electrocorticogram and sensory evoked potentials in the young hydrocephalic H-Tx rat.

The ECoG and the sensory evoked potential in response to stimulation of the contralateral forelimb were studied in control and hydrocephalic H-Tx rats between 21 and 35 days of age by recording in several positions from the dura overlying the somatosensory cortex. All hydrocephalics showed longer periods of low amplitude, high frequency ECoG activity than the controls. For the evoked potentials the hydrocephalic rats were divided into two groups: those that gave an evoked potential in at least one electrode position and those that did not give any evoked potentials. In the hydrocephalic rats that gave an evoked response the latency of the fourth phase of the evoked potential (the N2 component) was significantly longer than in the control rats suggesting that the processing of the signal within the cortex was affected by the hydrocephalus. The absence of an evoked potential in some hydrocephalic rats suggests there may be a disruption of the thalamo-cortical pathway preventing the response from reaching the cortex.

Animals↗

PubMed2006

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer.

BACKGROUND: Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has been shown to benefit patients with a variety of cancers. METHODS: Between July 2001 and April 2004, the Eastern Cooperative Oncology Group (ECOG) conducted a randomized study in which 878 patients with recurrent or advanced non-small-cell lung cancer (stage IIIB or IV) were assigned to chemotherapy with paclitaxel and carboplatin alone (444) or paclitaxel and carboplatin plus bevacizumab (434). Chemotherapy was administered every 3 weeks for six cycles, and bevacizumab was administered every 3 weeks until disease progression was evident or toxic effects were intolerable. Patients with squamous-cell tumors, brain metastases, clinically significant hemoptysis, or inadequate organ function or performance status (ECOG performance status, >1) were excluded. The primary end point was overall survival. RESULTS: The median survival was 12.3 months in the group assigned to chemotherapy plus bevacizumab, as compared with 10.3 months in the chemotherapy-alone group (hazard ratio for death, 0.79; P=0.003). The median progression-free survival in the two groups was 6.2 and 4.5 months, respectively (hazard ratio for disease progression, 0.66; P<0.001), with corresponding response rates of 35% and 15% (P<0.001). Rates of clinically significant bleeding were 4.4% and 0.7%, respectively (P<0.001). There were 15 treatment-related deaths in the chemotherapy-plus-bevacizumab group, including 5 from pulmonary hemorrhage. CONCLUSIONS: The addition of bevacizumab to paclitaxel plus carboplatin in the treatment of selected patients with non-small-cell lung cancer has a significant survival benefit with the risk of increased treatment-related deaths. (ClinicalTrials.gov number, NCT00021060.)

Aged↗

PubMed1995

Flow and velocity waveform indices in the ovine fetal abdominal aorta with changes in behavioural state.

The purpose of this study was to determine the extent to which flow and velocity waveform indices are comparable as measured from the ovine fetal abdominal aorta and reflect downstream vascular resistance with changes in electrocortical activity. Nine chronically catheterized fetal sheep were studied near term with continuous measurement of electrocortical activity, perfusion pressure, and fetal heart rate. A cuffed Doppler crystal and a Transonic flow probe on the descending abdominal aorta were used for the simultaneous measurement of velocity waveforms and flow waveforms, with the Resistance Index (RI), calculated for each. Mean blood flow was also obtained from the Transonic flow probe. Whereas the change in cardiovascular parameters between the low- and high-voltage electrocortical activity (ECOG) states was small, with little relationship to the change in RI measurements, across all animals there was an inverse correlation between the RI measurements and fetal heart rate, perfusion pressure and aortic blood flow during both low- and high-voltage ECOG states. The RI as measured from the velocity waveforms showed only a modest correlation to those measured from the flow waveforms. It is concluded that over the range of circulatory change generated with spontaneous change in behavioural state, the RI as measured in the abdominal aorta of the ovine fetus is primarily determined by pulsatile cardiovascular variables rather than lower body vascular resistance.

Animals↗

PubMed2000

Transtympanic versus tympanic membrane electrocochleography in examining cochleovestibular disorders.

The use of electrocochleography (EcoG) is considered to be of clinical value in otological diagnosis. Non-invasive ear canal (EC) and tympanic membrane (TM) EcoG recording techniques, and invasive transtympanic (TT) technique are the methods used for objective assessment of cochlear function. In this study, eight adults (16 ears) with suspected Meniere's disease were examined using a newly designed, disposable tympanic electrode and a traditional, thin transtympanic needle. The amplitudes of the TT electrode responses were 4-6-fold larger than those produced by the TM electrode. The morphology of the waveforms for the two recording techniques was nearly identical. The mean amplitudes of the action potential (AP) obtained with the TM electrode were 2.39-3.73 microV, and with the TT electrode 14.08-19.60 microV, depending on the stimulus intensity. For the summating potential (SP), the TM and TT electrodes had mean amplitudes of 0.82-1.60 microV and 3.53-5.81 microV respectively. The SP/AP ratios were larger with the TM electrode than with the TT electrode. They were inconsistent in four ears (25%) when measured with the TM and TT electrodes. All patients were more satisfied with the TT examination, since it was quite painless, unlike the TM examination. The authors recommend the use of the TT recording technique as a painless examination in which the electrode is close to the inner ear, allowing a good signal-to-noise ratio and large amplitudes. Diagnostic interpretations are easier and more reliable with the TT electrode than with the TM electrode.

Adult↗

PubMed2000

Electrocochleography in the diagnosis of Meniere's disease.

This study prospectively analyses electrocochleography (ECoG) recordings obtained from ears demonstrating symptoms highly suggestive of Meniere's disease. Comparison is made with ECoG recording from ears in which the diagnosis of Meniere's is considered unlikely (control ears). Electrocochleograph recordings were made through a transtympanic recording needle, situated in the round window niche. Analysis was made of the 1 kHz tone burst summation potential (SP) and the summation potential:action potential (SP/AP) ratio response to a 90 dB click. All patients were prospectively awarded a Meniere's score based on a 10-point scale, and comparison was made between ears awarded a score of 7 or greater (Meniere's ears; n > 500), and ears awarded a score 3 or less (control ears; n > 900). Results demonstrate a significant difference in the 1 kHz SP response, and the SP/AP ratio, between "control" and "Meniere's" ears. Furthermore, we show that SP negativity is proportional to the amplitude of the AP click response, and in patients producing an AP click amplitude exceeding 10 V, sensitivity of the tone burst test approaches 85%. This study provides further evidence suggesting the useful role of electrocochleography in determining a diagnosis of endolymphatic hydrops. and demonstrates improved sensitivity of the 1 kHz SP response, compared with SP/AP click ratio, in the diagnosis of Meniere's disease.

Action Potentials↗

PubMed2005

Sacculo-collic pathway dysfunction accompanying auditory neuropathy.

CONCLUSIONS: In a patient with bilateral auditory neuropathy (AN), the vestibular-evoked myogenic potential (VEMP) was probably absent because of a neuropathy involving the inferior vestibular nerve and/or its end organ, the saccule. Our result can therefore be interpreted as a concomitant unilateral sacculo-collic neuropathy. We suggest the use of more precise terms to characterize AN patients with involvement of different parts of the inner ear and its innervations. We encourage detailed vestibular assessment in patients with AN in order to assess the co-existence of any symptomatic or asymptomatic vestibular disorder. Information such as that provided in this report will be valuable for clinicians caring for this group of patients. OBJECTIVE: AN is a disorder characterized by the absence or severe impairment of auditory brainstem responses in the presence of normal cochlear outer hair cell function as revealed by otoacoustic emissions (OAEs) and/or electrocochleography (ECoG). A variety of processes and etiologies are thought to be involved in its pathophysiology. In most literature reports the auditory profile of patients with AN is discussed. However, the extent of vestibular involvement, especially that involving the saccule, is not known. We performed vestibular tests to assess the status of the saccule in a patient with AN. MATERIAL AND METHODS: One patient with AN was studied. The patient was a right-handed 21-year-old female with chief complaints of hearing loss and speech perception difficulty. RESULTS: The auditory test results were consistent with the diagnosis of AN, i.e. absent auditory brainstem responses, moderate hearing loss, an inappropriately profound speech discrimination score and the presence of OAEs and measurable cochlear microphonics on ECoG. On neurological examination, gait and balance tests were normal. Ice-water caloric testing induced a sensation of dizziness in both ears. Short tone-burst VEMPs showed no response on left-ear stimulation and a biphasic response with normal latency and amplitude on right-ear stimulation.

Adult↗

PubMed2001

Moderate dose diethylstilbestrol diphosphate therapy in hormone refractory prostate cancer.

OBJECTIVE: To examine the efficacy and toxicity of a moderate dose (250 mg/day) of diethylstilbestrol diphosphate (DES-DP) intravenously administered to patients with hormone refractory prostate cancer (HRPC) as well as the influence of this agent on the endocrine system. PATIENTS AND METHODS: Sixteen patients with HRPC were treated with a daily intravenous injection of 250 mg of DES-DP for 28 days. Eastern Cooperation Oncology Group (ECOG) performance status and pain score were used for subjective evaluation and PSA was used for objective evaluation. Testosterone, free testosterone, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were used for hormonal parameters. RESULTS: Fourteen patients were eligible. The mean patient age was 75.2 years. With respect to the ECOG pain score, 5 patients scored 1 or higher, in 4 patients, the pain completely disappeared, and in 1 patient, the pain score improved from 4 to 1. The PSA level decreased significantly from 528 +/- 556 ng/ml (mean +/- SD) to 154 +/- 197 ng/ml. The DHEA level was not changed during DES-DP administration. The DHEA-S level decreased significantly from 882 +/- 430 ng/ml to 480 +/- 236 ng/ml. Testosterone and free testosterone were in the castration level before and during the treatment. Toxicity was minimal. None of the patients developed cardiovascular disorder. CONCLUSION: A moderate dose (250 mg/day) of DES-DP decreased PSA levels and relieved pain without causing serious toxicity in patients with HRPC. It is suggested that the mechanism of the DES-DP effect on the decrease in PSA and pain relief involves a decrease in DHEA-S.

Adenocarcinoma↗

PubMed2000

Surgical management of intractable epilepsy associated with cerebral neurocytoma.

Neuronal neoplasms of the CNS constitute a rarely encountered group of tumors. This report concerns the surgical management of seizures encountered in four cases (ranging from 2 to 10 years-of-age at onset; consisting of two males and two females) of a recently recognized morphologically unique tumor, called 'cerebral neurocytoma'. All patients were associated solely with intractable complex partial seizures. The tumor involved the temporal lobe in two cases, and the frontal in two. Magnetoencephalography (MEG) clearly demonstrated an accumulation of equivalent current dipoles originating from the interictal spikes on the cortex around the tumor. On intra-operative electrocorticography (ECoG), the epileptogenic zone was topographically distinct from the region of the tumor. No definite ECoG activities were observed at the tumor site, although this tumor did consist of small mature neuronal cells. Either a complete or a subtotal resection of the tumor and the epileptogenic cortex was performed and, post-operatively, universal freedom from seizures was demonstrated in all patients. A histological examination of the epileptogenic cortex revealed the presence of minute cortical dysplasia or tumor involvement in the hippocampus. A resection of the epileptogenic cortex along with the tumor was thus found to improve the seizure outcome in patients with neurocytoma-associated epilepsy without inducing any identifiable neurological deficits attributable to the incremental resection.

Adult↗