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- Bergenfeldt, Magnus, et al.
(författare)
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Current state of adjuvant therapy in resected pancreatic adenocarcinoma
- 2006
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 45:2, s. 124-135
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Forskningsöversikt (refereegranskat)abstract
- Pancreatic carcinoma cannot generally be cured by surgery alone. This review summarizes the development of adjuvant therapy over the past two decades. Four randomized controlled trials compare long-term survival of different treatments. The small GITSG-study supports combined chemoradiation, but the EORTC-study found no significant effect. A Norwegian study of adjuvant chemotherapy found an increased median survival, but no effect beyond two years. The large ESPAC-1 study shows a benefit for 5-FU based chemotherapy, while chemoradiation had a negative effect. Thus, evidence favours adjuvant therapy, but 5-FU may not be the ultimate drug. Support for gemcitabine is given by preliminary data from a German randomized trial, and further American and European studies are upcoming. However, postoperative therapy is problematic, as 20-30% of resected patients never undergo treatment because of slow recovery or other reasons. Preoperative therapy has some theoretical advantages, and moreover, patients with rapidly progressive disease may be spared surgery. Randomized controlled trials are lacking, but published results compare well with postoperative, adjuvant therapy. The value of locally targeted therapy is difficult to assess. Reasonable results have been obtained with regional chemotherapy, whereas intraoperative radiotherapy does not seem to increase survival despite reducing reducing local recurrences.
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| 3. |
- Leek, Håkan, et al.
(författare)
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Pilocarpine treatment of xerostomia in head and neck patients
- 2002
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Ingår i: Micron. - 0968-4328. ; 33:2, s. 153-155
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Forskningsöversikt (refereegranskat)abstract
- We studied the effect of pilocarpine hydrochloride, a parasympathicomimewtic agent, on major salivary gland output and subjective responses in 40 patients with salivary hypofunction. Pilocarpine increased salivary output or gave significant symptomatic relief in 21 of the 40 patients. The women fared better than the men. Side effects were uncommon, were generally mild, and caused no treatment interruption. These results indicate that pilocarpine is effective in relieving the signs and symptoms of postradiation xerostomia. (C) 2001 Elsevier Science Ltd. All rights reserved.
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| 4. |
- Tham, J, et al.
(författare)
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Upper extremity deep venous thrombosis in patients with 5-fluorouracil-containing adjuvant chemotherapy - Three case reports and a review
- 2004
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 43:1, s. 108-112
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Forskningsöversikt (refereegranskat)abstract
- Catheter-related deep venous thrombosis is a complication that can occur in patients receiving chemotherapy. Three such cases are described and a review of the literature is made, focusing on recent results regarding possible thrombogenic mechanisms and the high prevalence of non-symptomatic thrombosis as well as the high morbidity and mortality associated with upper extremity deep venous thrombosis. Special emphasis is given to the cytotoxic effects of 5-fluorouracil on vascular endothelium and the likely link to thrombotic complications. The possible differences between two different methods of administering chemotherapy, continuous infusion and bolus dose administration, in this regard are briefly discussed. It is concluded that the first steps towards an understanding of the mechanisms behind the vascular effects of 5-fluorouracil have been taken. Much remains to be done before active interaction with the pathogenic processes leading to vascular and cardiac complications can be realized, yet various forms of anticoagulant therapy could well be an efficient form of prophylaxis.
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