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  • 1
    Electronic Resource
    Electronic Resource
    Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience (1997)
    Springer
    European radiology 7 (1997), S. 514-519 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Alcohol ; Liver neoplasms ; Therapy ; Interventional procedure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The objective of our work was to evaluate the long-term results of percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in patients with liver cirrhosis. A total of 184 cirrhotic patients with HCC underwent PEI as the only anticancer treatment over an 8-year period. Patients were followed after therapy by means of clinical examinations, laboratory tests, and US and CT studies performed at regular time intervals. Survival rates were determined according to the Kaplan-Meier method. The overall survival was 67 % at 3 years, 41 % at 5 years, and 19 % at 7 years. The 3-, 5-, and 7-year survival rates of patients with single HCC ≤ 3 cm (78, 54, and 28 %, respectively) were significantly higher (p 〈 0.01) than those of patients with single HCC of 3.1–5 cm (61, 32, and 16, respectively) or multiple HCCs (51, 21, and 0 %, respectively). Survival of Child-Pugh A patients (79 % at 3 years, 53 % at 5 years, and 32 % at 7 years) was significantly longer (p 〈 0.01) than that of Child-Pugh B patients (50 % at 3 years, 28 % at 5 years, and 8 % at 7 years). A selected group of 70 patients with Child-Pugh A cirrhosis and single HCC ≤ 3 cm had a 7-year survival of 42 %. Long-term survival of cirrhotic patients with HCC treated with PEI is comparable to that reported in published series of matched patients submitted to surgical resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050194
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Maximum tolerable doses of intravenous zidovudine in combination with 5-fluorouracil and leucovorin in metastatic colorectal cancer patients (1997)
    Springer
    Annals of oncology 8 (1997), S. 539-545 
    Details
    ISSN: 1569-8041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Experimental studies have demonstrated that 5-fluorouracil(5-FU) enhances zidovudine (AZT)-induced DNA strand breaks and cytotoxicity.Phase I studies have demonstrated that the maximum tolerable dose (MTD) of AZTis 8000 mg/sqm when administered i.v. over two hours after weekly 5-FU +l-leucovorin (LV), and that this combination has promising antitumor activity.The purpose of this study was therefore to evaluate the antitumor activity ofweekly bolus 5-FU + LV + AZT, administered at its MTD, and to determinewhether 5-FU enhances AZT-induced DNA strand breaks in blood nuclear cells. Patients and methods: Twenty-nine chemotherapy-naïve metastaticcolorectalcancer patients with measurable disease entered the study to evaluate theactivity of a weekly 5-FU 500 mg/m2 i.v. bolus + LV 250mg/m2 i.v. two-hour infusion + AZT 8000mg/m2 i.v. two-hour infusion. In 10 different patients, whoduring three different weeks received 5-FU + LV, AZT and 5-FU + LV + AZT, DNAstrand breaks in blood nuclear cells were determined by a fluorescent analysisof DNA unwinding. Results: Treatment was generally well tolerated and WHO grades III–IVtoxicities, consisting mostly of diarrhea (17%), were uncommon. Onepatient died of severe diarrhea with consequent hypokalemia and cardiacarrhythmia. All patients were considered evaluable for response, and 3(10%) complete and 10 (35%) partial responses were observed, foran objective response rate of 45% (95% confidence limit interval26%–64%). Both 5-FU + LV and AZT decreased the percentageof double stranded DNA in nuclear blood cells. The greatest effect wasobserved with 5-FU + LV + AZT, which reduced the percentage of double strandedDNA to 50% and 36% after 24 and 48 hours, respectively, and thisinteraction between 5-FU + LV and AZT was found to be cumulative. Conclusions: These studies demonstrate that the present dose and scheduleof AZT in combination with 5-FU + LV has significant activity in metastaticcolorectal cancer and that the combination of 5-FU + LV with AZT increases theamount of DNA damage. Therefore, AZT in combination with 5-FU + LV warrantsfurther study in colorectal cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008249803523
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    Paper (German National Licenses)
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  • 3
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    Patient reported outcome measures for cardiac ablation procedures: a multicentre pilot to develop a new questionnaire (2014)
    Oxford University Press
    In: Europace
    Details
    Publication Date: 2014-10-26
    Description: Aim To assess the feasibility of administering Patient Reported Outcomes Measures (PROMs) in patients treated with ablation for cardiac arrhythmias, and to conduct the first stage of development and testing of a new PROM tool. Methods and results A new tool was developed by a multidisciplinary team and tested alongside an adaptation of the patient perception of arrhythmia questionnaire (PPAQ) and EQ-5D-5L in a multicentre retrospective audit involving 791 consecutive cardiac arrhythmia patients treated with catheter ablation at three UK centres over 13 months. Data were recorded in the National Cardiac Rhythm Management Database, part of the National Institute for Cardiovascular Outcomes Research. The response rate was 71.9% ( n = 569). Patients reported significant improvements across all outcomes and impacts, with reductions in symptoms of 51.7% (heart racing), 33.9% (fatigue) 31.8% (heart flutters), 43.5% (dizziness), 38.6% (breathlessness), 44.2% (chest pressure), 33.1% (trouble concentrating), 15.9% (headache), 28.3% (neck pressure), and 23.4% (fainting) ( P 〈 0.001). The mean number of social days affected reduced by 7.49 days/month ( P 〈 0.001); mean work/school days affected/month reduced by 6.26 ( P 〈 0.001); mean GP/hospital visits reduced by 1.36 days/month ( P 〈 0.001). The procedure met patient expectations in 72% of responders. Conclusions The high response rate suggests that the use of PROMs in this patient group is feasible, with rates equalling those of the National PROMs Programme. The results showed that patients experienced significant improvements in their quality of life following ablation, while feedback allowed the tools to be improved. Further work is required to validate these tools; however, the findings suggest that PROMs could be useful in the audit of ablation techniques.
    Print ISSN: 1099-5129
    Electronic ISSN: 1532-2092
    Topics: Medicine
    Published by Oxford University Press
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  • 4
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    Haemodynamic effects of cardiac resynchronization therapy using single-vein, three-pole, multipoint left ventricular pacing in patients with ischaemic cardiomyopathy and a left ventricular free wall scar: the MAESTRO study (2016)
    Oxford University Press
    In: Europace
    Details
    Publication Date: 2016-08-06
    Description: Aims The clinical response to cardiac resynchronization therapy (CRT) is variable. Multipoint left ventricular (LV) pacing could achieve more effective haemodynamic response than single-point LV pacing. Deployment of an LV lead over myocardial scar is associated with a poor haemodynamic response to and clinical outcome of CRT. We sought to determine whether the acute haemodynamic response to CRT using three-pole LV multipoint pacing (CRT 3P-MPP ) is superior to that to conventional CRT using single-site LV pacing (CRT SP ) in patients with ischaemic cardiomyopathy and an LV free wall scar. Methods and results Sixteen patients with ischaemic cardiomyopathy [aged 72.6 ± 7.7 years (mean ± SD), 81.3% male, QRS: 146.0 ± 14.2 ms, LBBB in 14 (87.5%)] in whom the LV lead was intentionally deployed straddling an LV free wall scar (assessed using cardiac magnetic resonance), underwent assessment of LV + dP/dt max during CRT 3P-MPP and CRT SP . Interindividually, the LV + dP/dt max in relation to AAI pacing with CRT 3P-MPP (6.2 ± 13.3%) was higher than with basal and mid CRT SP (both P 〈 0.001), but similar to apical CRT SP . Intraindividually, significant differences in the LV + dP/dt max to optimal and worst pacing configurations were observed in 10 (62.5%) patients. Of the 8 patients who responded to at least one configuration, CRT 3P-MPP was optimal in 5 (62.5%) and apical CRT SP was optimal in 3 (37.5%) ( P = 0.0047). Conclusions In terms of acute haemodynamic response, CRT 3P-MPP was comparable an apical CRT SP and superior to basal and distal CRT SP . In the absence of within-device haemodynamic optimization, CRT 3P-MPP may offer a haemodynamic advantage over a fixed CRT SP configuration.
    Print ISSN: 1099-5129
    Electronic ISSN: 1532-2092
    Topics: Medicine
    Published by Oxford University Press
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  • 5
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    Not only chemotherapy in the second-line treatment of metastatic gastric cancer (2014)
    Oxford University Press
    Details
    Publication Date: 2014-01-30
    Print ISSN: 0923-7534
    Electronic ISSN: 1569-8041
    Topics: Medicine
    Published by Oxford University Press
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