Bibliothek

X
feed icon rss

Ihre E-Mail wurde erfolgreich gesendet. Bitte prüfen Sie Ihren Maileingang.

Leider ist ein Fehler beim E-Mail-Versand aufgetreten. Bitte versuchen Sie es erneut.

Vorgang fortführen?

Exportieren
Filter
  • 1995-1999  (3)
  • cyclophosphamide  (2)
  • adverse effects  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Cardiac effects of high-dose epirubicin and cyclophosphamide in women with poor prognosis breast cancer (1999)
    Springer
    Annals of oncology 10 (1999), S. 53-58 
    Details
    ISSN: 1569-8041
    Schlagwort(e): breast cancer ; cardiotoxicity ; cyclophosphamide ; epirubicin ; high dose
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Purpose: To prospectively evaluate the long term cardiac effects of high-dose epirubicin and cyclophosphamide given to women with early stage, poor prognosis breast cancer. Patients and methods: Women with stage 2 breast cancer and 10+ nodes or 4+ nodes and estrogen receptor negative tumor, or stage 3 breast cancer received three cycles of epirubicin 200 mg/m2 and cyclophosphamide 4 gm/m2 with peripheral blood progenitor cell and filgrastim support. Treatment was given every 28 days (n = 79) or 21 days (n = 20). Fifty patients received radiotherapy to the chest wall or breast, 25 of to the left side. Patients were assessed clinically regularly during chemotherapy and at least three times yearly after completion of treatment. Cardiac left ventricular ejection fraction (LVEF) was assessed by radionuclide scan before therapy, after each cycle of chemotherapy, three months and six months after completion of chemotherapy, and yearly thereafter until relapse. Results: Ninety-nine women were treated, and 92 completed all three cycles of chemotherapy. The median age was 43 years (range 24 to 60 years). All patients were included in this analysis. The median relapse-free survival was 39 months (11 to 68 months). There was a significant fall in LVEF during chemotherapy. In general, there was no further deterioration in cardiac function from the third month after cessation of treatment, however there was substantial variation between individuals. 35 patients had at least one LVEF measure less than normal (〈50%), but the LVEF returned to normal in 20 of these with further follow-up. Cardiac dysfunction was not increased in women who received radiotherapy and was not different between cohorts given chemotherapy every three or every four weeks. One patient died of acute myocardial necrosis following the third cycle of chemotherapy. Two patients developed clinical evidence of cardiac failure, and another had radiological signs but was asymptomatic. One woman died of progressive cardiac failure, one recovered clinically but also developed recurrent breast cancer, while the third recovered after commencement of medical therapy. Conclusions: During follow-up after high-dose epirubicin and cyclophosphamide as delivered in this study, the LVEF fell to below normal in approximately one third of patients. However, in over half of these patients the LVEF subsequently recovered to the normal range, and the incidence of clinically evident chronic cardiac failure was low. Further follow-up is required to assess the long- term safety. A randomized comparison with standard-dose anthracycline-based chemotherapy is needed to determine whether this regimen is associated with an increased risk of clinical cardiac toxicity.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008390203340
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Artikel (Nationallizenzen)
    Volltext
  • 2
    Digitale Medien
    Digitale Medien
    Inzidenz des Postmyelographiesyndroms (PMS) und postmyelographischer Beschwerden nach lumbaler Punktion mit der bleistiftförmigen Nadel nach Sprotte im Vergleich zur Nadel nach Quincke (1996)
    Springer
    Der Radiologe 36 (1996), S. 921-927 
    Details
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Myelographie ; Postpunktionelles Syndrom ; Nadelspitze ; Iotrolan ; Key words Myelography ; adverse effects ; Iotrolan ; Spinal puncture instrumentation ; Needle-stick injuries
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Purpose: Myelography in combination with a postmyelography CT is an important presurgical examination because of its excellent visualisation of the disc, the bone and the contrast-filled dura. Side effects after myelography can be observed in up to 50 % of patients. The pathophysiological mechanism is thought to be increased cerebrospinal fluid leakage at the puncture site. Since the introduction by Sprotte in 1979 of the pencil-point needle, a modification of Whitacre's needle, fewer complaints after lumbar puncture have been reported. The aim of the study was to examine the influence of two types of needle points and the temperature (37 °C vs 21 °C) of the contrast medium (CM; iotrolan, Isovist) on the incidence of side effects of lumbar puncture for myelography. Material and methods: In a prospective randomized trial the incidence of complaints after lumbar puncture with intrathecal CM application was evaluated by the use of a 21-G pencil-point needle as modified by Sprotte compared to our usual 22-G needle with a Quincke bevel. Some 412 patients (201 female, 211 male; mean age 54.05 ± 7.4 years) were investigated. Directly after examination and 1, 3 and 5 days later the patients were questioned about complaints (headache, neck stiffness nausea, vomiting, buzzing in the ear and dizziness). The results were tested by the chi square test. Results: A significantly lower incidence of complaints was seen after lumbar puncture with the pencil-point needle/Quincke needle (headache: 6.3 %/18.9 %, P 〈 0.0001; headache lasting 3 days: 0.5 %/7.8 %, P 〈 0.0001; headache lasting 5 days: 0 %/2.4 %, P = 0.0305; nausea: 0 %/4.9 %, P = 0.0009; vomiting: 0 %/4.9 %, P = 0.0009; dizziness: 0 %/3.4 %, P = 0.0074; neck stiffness: 0 %/3.4 %, P = 0.0074). The temperature of the CM had no influence on the complaints. No influence was seen on the quality of the myelogram. No relation to sex and age was found. Conclusion: Complaints after lumbar puncture and myelography are caused by the cerebrospinal fluid leakage at the puncture site. The incidence of side effects related to this leakage can be reduced by using a pencil-point needle. The temperature of the CM has no influence on the complaints.
    Notizen: Zusammenfassung Die Myelographie zusammen mit der Postmyelographie-CT ist eine wichtige Untersuchungsmethode in der präoperativen Diagnostik. Bei nahezu der Hälfte der Patienten können postpunktionelle Beschwerden bis zu einem Postmyelographie-Syndrom (PMS) auftreten. Pathophysiologisch kann dies durch ein Punktionsleck mit anschließendem Liquorverlust erklärt werden. Ziel der Studie ist es, den Einfluß zweier Nadeltypen (21 G Nadel nach Sprotte vs 22 G Nadel nach Quincke) auf die Inzidenz postpunktioneller Beschwerden zu überprüfen. In einer prospektiven randomisierten Studie wurden bei 412 Patienten nach lumbaler intrathekaler Kontrastmittelapplikation (Iotrolan, Fa. Schering) die Häufigkeit des PMS und postpunktioneller Nebenwirkungen in Abhängigkeit vom verwendeten Nadeltyp untersucht. Die Häufigkeit postpunktioneller Beschwerden nach lumbaler Punktion mit der bleistiftförmigen Nadel nach Sprotte im Vergleich zur geschliffenen Nadel nach Quincke lag deutlich niedriger (Kopfschmerzen: 6,3 % vs 18,9 %, p 〈 0,0001; Kofschmerzen für mindestens drei Tage: 0,5 % vs 7,8 %, p 〈 0,0001; Kopfschmerzen für mindestens 5 Tage: 0 % vs 2,4 %, p = 0,0305; Übelkeit: 0 % vs 4,9 %, p = 0,0009; Erbrechen: 0 % vs 4,9 %, p = 0,0009; Schwindel: 0 % vs 3,4 %, p = 0,0074; Nackensteife: 0 % vs 3,4 %, p = 0,0074; PMS: 0 % vs 3,4 %, p = 0,0074). Die Temperatur des Kontrastmittels beeinflußte die postmyelographischen Beschwerden nicht. Schlußfolgerung: Die Inzidenz des PMS und postpunktioneller Beschwerden kann durch den Einsatz einer „atraumatischen“Nadel nach Sprotte deutlich gesenkt werden.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001170050159
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Artikel (Nationallizenzen)
    Volltext
  • 3
    Digitale Medien
    Digitale Medien
    Phase I and subsequent phase II study of filgrastim (r-met-HuG-CSF) and dose intensified cyclophosphamide plus epirubicin in patients with non-Hodgkin's lymphoma and advanced solid tumors (1999)
    Springer
    Annals of oncology 10 (1999), S. 907-914 
    Details
    ISSN: 1569-8041
    Schlagwort(e): cyclophosphamide ; dose-escalation ; epirubicin ; filgrastim ; G-CSF ; non-Hodgkin's lymphoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: To define a maximum tolerated dose (MTD) for the combination of epirubicin and cyclophosphamide with filgrastim (r-met-HuG-CSF) in patients with advanced solid tumors and non-Hodgkin's lymphoma (NHL). Patients and methods: Thirty-five patients with advanced solid tumors were enrolled in stages I and II. Twenty-one patients were treated in stage I in sequential cohorts of at least three patients at increasing dosage levels of cyclophosphamide and epirubicin, for up to six cycles every 21 days. At the completion of stage I, a MTD for epirubicin was established. Fourteen patients were treated in stage II, in cohorts of three or more. The epirubicin dose remained constant at the MTD dosage from stage I. Cyclophosphamide was further dose-escalated to establish its MTD. Twenty-one patients with previously untreated non-Hodgkin's lymphoma were treated in stage III with the MTD established in the prior stages. Results: The MTD in stage I was epirubicin 150 mg/m2 and cyclophosphamide 1500 mg/m2 with cumulative neutropenia as the dose-limiting toxicity (DLT). Cumulative thrombocytopenia prevented further dose-escalation of cyclophosphamide in stage II. The stage III regimen consisted of six, 21-day cycles of epirubicin 150 mg/m2, cyclophosphamide 1500 mg/m2, vincristine 2 mg, and prednisolone 100 mg for five days with filgrastim support. Nineteen of twenty-one patients (90%) completed six cycles of treatment, eight (38%) without dose reduction. Common toxicity criteria (CTC) grade 4 neutropenia (neutrophil nadir 〈0.5 × 109/l) was documented in 85 of 118 cycles (72%). Neutropenic fever was documented in 17 of 21 patients (81%) on at least one occasion. Severe thrombocytopenia (〈25 × 109/l) was seen in fourteen of 118 cycles (12%) and increased with cycle number. There was no significant non-hematological toxicity. Conclusion: Significant dose-escalation of epirubicin and cyclophosphamide was possible with filgrastim support. The MTD achieved was approximately double that of standard-dose therapy. This study forms the basis of an ongoing randomized study evaluating dose-intensification in intermediate grade NHL.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1023/A:1008353522601
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Artikel (Nationallizenzen)
    Volltext
Schließen ⊗
Diese Webseite nutzt Cookies und das Analyse-Tool Matomo. Weitere Informationen finden Sie hier...