ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Chemotherapy drugs have been reported to cause cardiac side effects including cardiomyopathy, ischemia, arrhythmias, and myocardial necrosis. Most important in terms of daily practice is anthracycline-induced cardiomyopathy. The bisdioxopiperazine compound, dexrazoxane (ICRF-187, ADR-529), has been shown to prevent this cumulative side effect of the anthracyclines. Recent randomized trials performed in breast cancer and in pediatric sarcoma patients have demonstrated the efficacy of this approach, which permits the administration of anthracyclines to greater cumulative doses and thus leads to a substantial reduction in the incidence of decreased left-ventricular ejection fraction or congestive heart failure. Response rates were not significantly different with the use of dexrazoxane in these trials. The risk ratio for a cardiac event was decreased by two to threefold in randomized breast studies involving more than 700 women. Paclitaxel also has been reported to cause arrhythmias and possibly ischemia. In a large data base, National Cancer Institute investigators found a 0.29% incidence of grade 4 or 5 cardiac toxicities, including heart block, ventricular tachycardia, and ischemic events. Other important chemotherapy-related cardiac toxicities discussed include fluorouracil-induced angina and arrhythmias, interleukin-4 induced-cardiomyopathy, and cardiotoxicity associated with autologous bone marrow transplantation procedures.

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Nephrotoxicity is a relatively common and potentially serious adverse effect of treatment with certain cytotoxic drugs (especially ifosfamide). The patient may develop severe chronic proximal tubular toxicity. It is therefore very important to attempt to reduce the frequency and severity of acute and chronic nephrotoxicity resulting from chemotherapy. A logical approach is described, with particular reference to ifosfamide and cisplatin, involving improved evaluation of the important clinical features of nephrotoxicity and a greater understanding of its pathogenesis. This approach will facilitate the development of logical preventive strategies, or less toxic analogues, or both. The methods used may also enable prediction of the potential nephrotoxicity of newly developed cytotoxic agents.

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Chronic anemia associated with cancer often causes poor quality of life and is often exacerbated by intensive treatment. In recent controlled trials, recombinant human erythropoietin (rhEpo) proved to be well tolerated and effective in amelioration and reduction of transfusion requirements of cancer-associated anemia. Double-blind placebo-controlled trials of rhEpo in patients undergoing allogenic, but not autologous, bone marrow transplantation showed significant acceleration of the reconstitution of erythropoiesis. Multivariate analysis revealed that serum erythropoietin levels of 100 mU/mL or greater and an increase in hemoglobin by at least 0.5 g/dL was a probable response; conversely, a serum ferritin level of 400 ng/mL or greater after 2 weeks indicated a poor response to rhEpo therapy. Further studies are needed to define patient populations in whom cost-effective rhEpo therapy is justified.

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Acute and chronic complications of oral tissues and changes in physiologic processes frequently accompany cancer therapies. Mucositis is a common dose-limiting complication in patients receiving systemic cancer chemotherapy, bone marrow transplantation, and local irradiation for tumors in the head and neck area. In addition, mucosal ulcerations may become portals for the invasion of pathogens that in turn may be life threatening. Oral environment changes and salivary gland dysfunction cause an increase in dental caries and periodontal disease in dentulous patients who receive radiation therapy in and around the oral cavity. Some of these therapy-related oral complications can be controlled by pretherapy modification of the oral environment, such as elimination of acute and potential dental and periodontal foci of pathoses, patient participation in oral care, and awareness by dentists and oncologists that cancer patients require specific oral care. Prevention and management of oral mucositis, as well as prevention and control of dental pathoses, are still problems that need further investigation.

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Diarrhea is a common event in the clinical history of cancer patients. It can be caused by the presence of tumor or it can be a side effect of treatment. The latter problem is occurring more often because new drugs (CPT-11) or drug combinations (fluorouracil plus interferon or leucovorin) have diarrhea as the dose-limiting toxicity. The clinical use of octreotide, a long-acting somatostatin analogue, seemed to demonstrate an improvement in most diarrheal states induced by tumors (endocrine tumors) or by treatments (short bowel syndrome; chemotherapy-induced diarrhea).

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Bone and soft tissue sarcomas are diagnostically challenging. Recognition of specific cytogenetic abnormalities in these neoplasms has significantly reduced some of the associated difficulties and has provided valuable information on histopathogenesis. Commonly, translocations involving an exchange of chromosomal material and creation of novel chimeric genes are detected. These fusion genes frequently function as aberrant transcription factors that contribute to sarcomagenesis. New studies indicate that less commonly occurring variant fusion genes are also present in some tumors,eg, Ewing's sarcoma and alveolar rhabdomyosarcoma. The clinical consequences, if any, of these variant hybrids are not yet known. Reverse transcriptase polymerase chain reaction and are useful approaches in detecting these transcripts. In addition to translocations, supernumerary ring chromosomes are often encountered in sarcomas, particularly those of intermediate or borderline malignancy. Traditional fluorescencein situhybridization, and recently, comparative genomic hybridization have uncovered the chromosomal composition of these rings as well as some associated gene amplifications in well-differentiated liposarcoma and dermatofibrosarcoma protuberans.

ISSN:1040-8746    

出版商:OVID    

年代:1995

数据来源: OVID