ifosfamide

异环磷酰胺
  • 文章类型: Journal Article
    背景:尤文肉瘤的多药化疗可导致严重的骨髓抑制。我们提出了两个临床问题(CQ):CQ#1,“G-CSF的一级预防对尤文肉瘤的化疗有益吗?”和CQ#2,“基于G-CSF的强化化疗是否改善尤文肉瘤的治疗结果?”。
    方法:在PubMed,科克伦图书馆,和Ichushi网络数据库,包括1990年至2019年发表的英语和日语文章。两名审稿人评估了提取的论文,并分析了总体生存(OS),发热性中性粒细胞减少症(FN)的发生率,感染相关死亡率,生活质量(QOL),和痛苦。
    结果:为CQ#1确定了25篇英文文章和5篇日文文章。筛选后,长春新碱的队列研究,异环磷酰胺,阿霉素,选择依托泊苷化疗851例。G-CSF的FN发生率为60.8%,无G-CSF的FN发生率为65.8%;未进行统计测试。操作系统上的数据,感染相关死亡率,QOL,或疼痛不可用。因此,CQ#1被重新定义为未来的研究问题。至于CQ#2,我们发现了两篇英文论文和五篇日文论文,其中包括一项关于在强化化疗中使用G-CSF的高质量随机对照试验。该试验显示,与3周间隔的G-CSF主要预防性使用的2周间隔方案相比,死亡率降低和无事件生存率显着增加的趋势。
    结论:本综述表明G-CSF作为尤文肉瘤的初级预防的疗效,除了儿童,是不确定的,尽管它的普遍使用。这篇综述暂时支持尤文肉瘤的G-CSF初级预防强化化疗。
    BACKGROUND: Multidrug chemotherapy for Ewing sarcoma can lead to severe myelosuppression. We proposed two clinical questions (CQ): CQ #1, \"Does primary prophylaxis with G-CSF benefit chemotherapy for Ewing sarcoma?\" and CQ #2, \"Does G-CSF-based intensified chemotherapy improve Ewing sarcoma treatment outcomes?\".
    METHODS: A comprehensive literature search was conducted in PubMed, Cochrane Library, and Ichushi web databases, including English and Japanese articles published from 1990 to 2019. Two reviewers assessed the extracted papers and analyzed overall survival (OS), febrile neutropenia (FN) incidence, infection-related mortality, quality of life (QOL), and pain.
    RESULTS: Twenty-five English and five Japanese articles were identified for CQ #1. After screening, a cohort study of vincristine, ifosfamide, doxorubicin, and etoposide chemotherapy with 851 patients was selected. Incidence of FN was 60.8% with G-CSF and 65.8% without; statistical tests were not conducted. Data on OS, infection-related mortality, QOL, or pain was unavailable. Consequently, CQ #1 was redefined as a future research question. As for CQ #2, we found two English and five Japanese papers, of which one high-quality randomized controlled trial on G-CSF use in intensified chemotherapy was included. This trial showed trends toward lower mortality and a significant increase in event-free survival for 2-week interval regimen with the G-CSF primary prophylactic use compared with 3-week interval.
    CONCLUSIONS: This review indicated that G-CSF\'s efficacy as primary prophylaxis in Ewing sarcoma, except in children, is uncertain despite its common use. This review tentatively endorses intensified chemotherapy with G-CSF primary prophylaxis for Ewing sarcoma.
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  • 文章类型: Journal Article
    Uterine sarcomas are very rare tumours with different histotypes, molecular features and clinical outcomes; therefore, it is difficult to carry out prospective clinical trials, and this often results in heterogeneous management of patients in the clinical practice.
    We planned to set up an Italian consensus conference on these diseases in order to provide recommendations on treatments and quality of care in our country.
    Early-stage uterine sarcomas are managed by hysterectomy + bilateral salpingo-oophorectomy according to menopausal status and histology; lymphadenectomy is not indicated in patients without bulky nodes, and morcellation must be avoided. The postoperative management is represented by observation, even though chemotherapy can be considered in some high-risk patients. In early-stage low-grade endometrial stromal sarcoma and adenosarcomas without sarcomatous overgrowth, hormonal adjuvant treatment can be offered based on hormone receptor expression. In selected cases, external beam radiotherapy ± brachytherapy can be considered to increase local control only. Patients with advanced disease involving the abdomen can be offered primary chemotherapy (or hormonal therapy in the case of low-grade endometrial stromal sarcoma and adenosarcoma without sarcomatous overgrowth), even if potentially resectable in the absence of residual disease in order to test the chemosensitivity (or hormonosensitivity); debulking surgery can be considered in patients with clinical and radiological response. Chemotherapy is based on anthracyclines ± ifosfamide or dacarbazine. Palliative radiotherapy can be offered for symptom control, and stereotactic radiotherapy can be used for up to five isolated metastatic lesions.
    Treatment of uterine sarcoma should be centralised at referral centres and managed in a multidisciplinary setting.
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    文章类型: Journal Article
    背景:SCAN肉瘤工作组旨在为初步评估制定新加坡癌症网络(SCAN)临床实践指南,诊断,四肢软组织肉瘤和骨肉瘤的治疗。
    方法:工作组利用共识方法创建适合我们当地环境的高质量循证临床实践指南。
    结果:来自放射学领域的各种国际指南,病理学,骨科手术,medical,对放射和儿科肿瘤学进行了审查,包括冯·梅伦金属公司(JNatlComprCancNetw2014)开发的产品,国家癌症合作中心(2006年),欧洲肉瘤网络工作组(2012年)和GrimerRJ等人(肉瘤2008年)。我们针对当地患者的临床实践指南将简化护理并改善四肢软组织和骨肉瘤患者的临床预后。
    结论:这些指南构成了2015年SCAN指南的初步评估,诊断,四肢软组织肉瘤和骨肉瘤的治疗。
    BACKGROUND: The SCAN sarcoma workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma.
    METHODS: The workgroup utilised a consensus approach to create high quality evidence-based clinical practice guidelines suited for our local setting.
    RESULTS: Various international guidelines from the fields of radiology, pathology, orthopaedic surgery, medical, radiation and paediatric oncology were reviewed, including those developed by von Mehren Metal (J Natl Compr Canc Netw 2014), the National Collaborating Centre for Cancer (2006), the European Sarcoma Network Working Group (2012) and Grimer RJ et al (Sarcoma 2008). Our clinical practice guidelines contextualised to the local patient will streamline care and improve clinical outcomes for patients with extremity soft tissue and osteosarcoma.
    CONCLUSIONS: These guidelines form the SCAN Guidelines 2015 for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma.
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    文章类型: Comparative Study
    Cervical cancer is one of the most common cancers in women. The purpose of this article is to analyze the main diagnostic and treatment strategies for all stages and recurrences of cervical cancer. The article reviews the epidemiological situation, clinical features, diagnostic procedures for detection of this tumor and for evaluation of the dissemination of the disease, staging criteria, TNM (Tumor, Nodes, Metastases) and FIGO (Federation Internationale de Gynecologie et d\'Obstetrique) classification, as well as treatment and prognosis. Surgical treatment (radical type II or III hysterectomy and lymphonodectomy) for early stage I and IIA cervical cancer is the main treatment method. Delivery of adjuvant postoperative radiation therapy or concomitant chemoradiation depends on the prognostic factors (tumor penetration to cervical tissues, lymphovascular invasion, tumor invasion to paracervical tissues, and surgical margins). For treatment of more advanced stages of cervical cancer (IIB, IIIA, IIIB, IVA) concomitant chemoradiation: external beam radiotherapy with chemotherapy and brachytherapy is used. Description of the treatment guidelines for each stage of cervical cancer is given in this article. These guidelines are useful for good treatment practice.
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