Over 150 People Per Hour are Diagnosed With Cancer in the U.S.
This year, about 156 people every hour will learn they have cancer, and by
the end of 2004 scientists predict 563,700 people will have died from cancer in
the United States, according to a report from the American Cancer Society.
Evidence from the report shows that obesity and little exercise can cause as
many as one-third of the United States’ cancer cases.
Evidence also shows that lung cancer is down but is still increasing in
women, and African American men have a 40 percent higher chance of dying from
all cancers than white men. Further, African-American women have a lower
incidence of breast cancer but a higher death rate from the disease.
There are many reasons for such disparities, according to one of the study’s
authors, such as a limited access to health care due to poverty.
However, the report reveals that death rates have declined slightly and
five-year survival improved significantly for children, from 56 percent in the
mid-1970s to 78 percent in the 1990s. Additionally, certain steps have been made
to prevent cancer, such as anti-smoking campaigns.
.As far back as 5,000 B.C., Egyptian doctors treated tumors with heat. The Greeks
recognized the value of heat in some medical treatments; indeed, the word
hyperthermia comes from the Greek HYPER ("to raise") and THERME ("to heat").
Even the most ancient texts of the Law of Moses mention hot springs (Genesis
36:24) to therapeutically elevate body temperature.
For many years, scientists have recognized that cancer cells are more
sensitive to heat than normal cells, and that at high temperatures cancer cells
break down. This helps explain why, after the Renaissance, there were reports of
spontaneous tumor regressions in patients with smallpox, influenza, tuberculosis
and malaria, where the common factor was an infectious fever of about 104º. In
the late 19th and early 20th centuries, there were scattered reports of similar
successes.
Yet, it was not until dedicated medical scientist , like Valley Cancer
Institute's: Haim I. Bicher, M.D., a pioneer in the field,
had worked for decades to provide a cohesive body of clinical research and
testing, that hyperthermia was given legal status as an approved medical
procedure, in 1984.
For years, though the principles of tumor heating were widely understood,
the technology to direct the heat in a concentrated area lagged behind the
theory.
In modern day hyperthermia, controlling heating placement is done using
fine sensors and directional applicators, (many designed by Dr. Bicher), that
are now standard in hyperthermic medical treatment worldwide. Using microwaves
and computers with these devices, cancerous tumors are heated from 107º - 113º.
This breaks down the tumor without harming the surrounding tissues, with no
lasting side-effects.
Since 1984, hyperthermic oncology, using concentrated heat to destroy
cancerous tissue, has been regarded as standard and beneficial treatment,
specifically recommended for locally recurrent tumors, and for primary cancer,
where other treatment methods have a poor history of success
Hyperthermia can be used by itself, and results in impressive shrinkage and even
complete eradication (10-15%) of tumors. However, these results usually don’t
last, and the tumors regrow. (In some animal experiments, cures were effected by
hyperthermia. For example, in an animal experiment on transplanted mammary
carcinoma, radiation alone produced no cures, heat alone produced 22% cures, and
combined modality produced 77% cures.)
Hyperthermia is also an immune system enhancer, and very effective in providing
pain relief, controlling bleeding, and useful in other conditions such as
prostatic hypertrophy and psoriasis
Combination Chemotherapy With or Without Whole-Body
Hyperthermia in Treating Patients With
Recurrent Ovarian Epithelial, Fallopian Tube, or Peritoneal
Cancer
Sponsored by
Ludwig Maximillian Universitaet Women's Hospital
Purpose
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from
dividing so they stop growing or die. Hyperthermia therapy kills tumor cells by heating them to
several degrees above body temperature. Combining hyperthermia with
chemotherapy may kill more tumor cells. It is not yet known if chemotherapy is
more effective with or without whole-body hyperthermia therapy
in treating
gynecologic cancer.
PURPOSE: Randomized phase II/III trial to compare the effectiveness of
chemotherapy with or without whole-body hyperthermia in treating patients who have recurrent ovarian epithelial,
fallopian tube, or peritoneal cancer.
Condition
Treatment or Intervention
Phase
Fallopian Tube Cancer peritoneal cavity
cancer recurrent ovarian epithelial cancer
Study Type: Interventional Study Design: Treatment
Official Title: Phase II/III Randomized Study of Carboplatin
and Ifosfamide With or Without Whole Body Hyperthermia in Patients With
Recurrent Ovarian Epithelial, Fallopian Tube, or Extraovarian Peritoneal Cancer
Further Study Details:
OBJECTIVES:
Compare the time to progressive disease in patients with
recurrent ovarian epithelial, fallopian tube, or extraovarian peritoneal cancer
treated with carboplatin and ifosfamide with or without whole body hyperthermia.
Compare the response rate, duration of response, and survival time of
patients treated with these regimens.
Compare the effect on the presence of disseminated tumor cells in bone marrow in patients treated with
these regimens.
Compare the toxicity of these regimens in these patients.
Assess quality of life of patients treated with these regimens.
OUTLINE: This is a phase II safety and efficacy study followed by a phase III
randomized, open-label, multicenter study.
Phase II: Patients receive ifosfamide IV over 1 hour and carboplatin IV over
20 minutes on day 1. Patients also undergo whole body hyperthermia for at least
1 hour on day 1. Treatment repeats every 28 days for 6 courses in the absence of disease
progression or unacceptable toxicity.
Patients are stratified according to disease-free interval (6-12 months vs
more than 12 months), measurable disease (bidimensionally measurable vs
measurable by other clinical means), and disease recurrence (first recurrence vs
second or greater recurrence). Patients are randomized to 1 of 2 treatment arms.
Arm I: Patients receive ifosfamide, carboplatin, and whole body hyperthermia as in phase II.
Arm II: Patients receive ifosfamide and carboplatin as in arm I.
In both arms,
treatment repeats every 28 days for 6 courses in the absence of disease
progression or unacceptable toxicity. Quality of life is assessed before each
course, 4 weeks after the last course, and then every 3 months for 2 years.
Patients are followed at 4 weeks and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 15 patients will be accrued for phase II of
this study. A total of 226 patients (113 per treatment arm) will be accrued for
phase III of this study within 2 years.
Eligibility
Ages Eligible for Study: 18 Years - 65 Years, Genders Eligible for
Study: Both
Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed ovarian epithelial, fallopian tube, or extraovarian
peritoneal cancer
Recurrent disease (any FIGO stage)
Not amenable to curative surgery or radiotherapy alone
Failed prior primary platinum-based therapy at least 6 months after therapy
discontinuation
Measurable lesion by CT scan, MRI, chest x-ray, or sonography
Physical examination allowed for documenting lymph node and skin metastases
Physical gynecological examination allowed for well-defined palpable tumor
lesions
Increase in CA
125 without any measurable tumor is not acceptable as indication of recurrence
No CNS metastases
No tumor of borderline malignancy
PATIENT CHARACTERISTICS: Age
18 to 65
Performance status
ECOG 0-2
Life expectancy
At least 24 weeks
Hematopoietic
Neutrophil count at least 1,500/mm3
Platelet count at least 100,000/mm3
Hepatic
Not specified
Renal
Creatinine clearance at least 60 mL/min
No chronic or acute renal failure
Cardiovascular
Cardiovascular function sufficient for hyperthermia treatment by
stress-ECG
No cardiomyopathy with impaired ventricular function
No New York Heart Association class III or IV heart disease
No cardiac arrhythmias influencing LVEF and requiring medication
No myocardial infarction or angina pectoris within the past 6 months
No uncontrolled arterial hypertension
Pulmonary
Pulmonary function sufficient for hyperthermia treatment by pulmonary function tests
Other
No untreated endocrinological disease (e.g., hyperthyroidism or diabetes
mellitus)
No other primary malignancy except carcinoma in situ of the cervix or
adequately treated basal cell skin cancer
No contraindication against hyperthermia treatment (e.g., photodermatosis, history of malignant
hyperthermia, or
claustrophobia)
No hypersensitivity to carboplatin, ifosfamide, or any other study
medication
Not pregnant or nursing
PRIOR CONCURRENT THERAPY: Biologic therapy
Not specified
Chemotherapy
See Disease Characteristics
No concurrent cytotoxic or other antineoplastic therapy
Endocrine therapy
Concurrent hormone replacement therapy allowed
Concurrent steroid antiemetics allowed
Radiotherapy
See Disease Characteristics
At least 1 year since prior radiotherapy (tumoricidal dose) of the pelvis
Concurrent palliative local radiotherapy for painful (nonprogressive)
existing lesion is allowed if other measurable sites are present
No concurrent radiotherapy to a second existing lesion
Surgery
See Disease Characteristics
Other
No prior form of hyperthermic therapy
At least 3 weeks since other medications as part of another clinical study
At least 3 weeks since prior investigational agents
Investigation Units of the European Malignant Hyperthermia Group Since the first meeting in 1983
the group has met regularly. At present, twenty laboratories in twelve European
countries are performing in vitro contracture tests using the protocol of the
EMHG.
Austria: Prof. H. Gilly Klinik
für Anästhesie und allgemeine Intensivmedizin der Universität
Wien Spitalgasse 23 A-1090 Wien Tel: ++43 222 404 00 25 19 Fax: ++43
222 404 00 45 19 E-Mail: Hermann.Gilly@akh-wien.ac.at
Dr. Werner W. Lingnau Univ. Klinik für Anaesthesie und Allgemeine
Intensivmedizin Anichstrasse 35 A-6020 Innsbruck Tel: ++43
512/504-2465 Fax: ++43 512 /504-4556 E-Mail:
werner.lingnau@uibk.ac.at
Belgium: Dr. L. Heytens Department of
Intensive Care Universitair Ziekenhuis Antwerpen Wilrijkstraat
10 B-2650 Edegem Tel: ++32 03 829 11 11 ext. 1635 Fax: ++32 3 828 48
82 E-Mail:
Denmark: Dr. H. Ørding The Danish Malignant
Hyperthermia
Register Department of Anaesthesia Herlev University Hospital DK-2730
Herlev Tel: ++45 44 53 53 00 ext. 3571 Fax: ++45 44 53 53 32 E-Mail:
ording@inet.uni-c.dk
England: Prof. F.R. Ellis MH Investigation
Unit Clinical Sciences Building St. James's University
Hospital GB-Leeds LS9 7TF Tel: ++44 0113 206 5274 Fax: ++44 0113 206
4140 E-Mail: anapmh@stjames.leeds.ac.uk
France: Prof. P. Stieglitz Département
d'Anesthésie Réanimation 1 CHU de Grenoble BP 217 X F-38043 Grenoble
Cedex 9 Tel: ++33 76 76 54 26 Fax: ++33 76 76 51 83 E-Mail:
Prof. R. Krivosic-Horber Département d'Anesthésie Réanimation Hopital
B Centre Hospitalier Régional Universitaire Bd. du Proffesseur J.
Leclercq F-59037 Lille Tel: ++33 20 44 62 70 Fax: ++33 20 65 02
57 E-Mail: rkrivosic@aol.com
Dr. G. Kozak Ribbens C.R.M.B.M. Faculté de Médecine la Timone 27 Bd.
Jean Moulin F-13005 Marseille Tel: ++33 91 25 50 90 Fax: ++33 91 25 65
39 E-Mail:
Dr. Y. Nivoche Département d'Anesthésie Hopital Robert Debré 48 Bd.
Serurier F-75935 Paris Cedex 19 Tel: ++33 1 40 03 21 82 Fax: ++33 1 40
03 20 20 E-Mail: ynivoche.debre@invivo.edu.internet
Germany: Dr. F. Wappler University Hospital
Eppendorf Department of Anesthesiology (Chairman Prof. Dr. J. Schulte am
Esch) Martinistrasse 52 D-20251 Hamburg Tel: ++49 40 47 17 46
04 Fax: ++49 40 47 17 49 63 E-Mail: wappler@uke.uni-hamburg.de
Dr. I. Tzanova Klinik für Anästhesie Uniklinik
Mainz Langenbeckstrasse 1 D-55131 Mainz Tel: ++49 61 31 17 65
68 Fax: ++49 61 31 17 66 49 E-Mail:
Prof. F. Lehmann-Horn Institut für angewandte Physiologie der Universität
Ulm Albert-Einstein-Allee 11 D-89081 Ulm Tel: ++49 731 502 32
51 Fax: ++49 731 502 32 60 E-Mail:
frank.lehmann-horn@medizin.uni-ulm.de
Dr. E. Hartung Institut für Anästhesiologie der Universität
Würzburg Josef Schneider Strasse 2 D-97080 Würzburg Tel: ++49 931 201
33 59 Fax: ++49 931 201 34 44 E-Mail: hartungej@aol.com
Prof.Dr.med.habil. D. Olthoff Klinik und Poliklinik für Anästhesiologie
und Intensivtherapie der Universität zu Leipzig Liebigstraße
20a D-04103 Leipzig Tel: ++49 341 971 77 00 Fax: ++49 341 971 77
09 E-Mail: olthoff@server3.medizin.uni-leipzig.de
Iceland: Dr. Thorarinn
Olafson Department of Anaesthesia Landspitali IS-101 Reykjavik Tel:
++354 1 60 13 75 Fax: ++354 1 60 15 19 E-Mail: stefsig@rhi.hi.is
Ireland: Prof. J.J.A. Heffron Department of
Biochemistry University College EIR-Cork Tel: ++353 21 27 68 71 ext.
2208 Fax: ++353 21 27 40 34 E-Mail: stbi8006@ucc.ie
Dr. Mary Lehane Dept of Anaesthesia Cork University Hospital Wilton,
Cork Ireland Tel: ++35321546400 Fax:++35321546434 E-Mail:
johnj@indigo.ie
Italy: Dr. V.E. Tegazzin Department of
Anesthesiology Traumatic-Orthopedic Hospital Via Facciolati 71 I-35126
Padova Tel: ++39 49 821 65 22 Fax: ++39 49 821 66 36 E-Mail:
Teg1@ux1.unipd.it
Settore Biofarmacologico A.O. Cardarelli Via S. Giacomo dei Capri,
66 80131 Napoli Italy Tel:++39 81 2549524 Fax:++39 81
5608262 E-Mail: sifo@na.nettuno.it
Netherlands: Dr. Marc M.J. Snoeck Department
of Anaesthesia University Hospital Geert Grooteplein 10 NL-6525 GA
Nijmegen Tel: ++31 24 36 14 406 Fax: ++31 24 35 40 462 E-Mail:
MH_nl@anes.azn.nl
Norway: Dr. T.H. Fagerlund Department of
Anaesthesia Ullevål Sykehus N-0456 Oslo Tel: ++47 2 11 80 80 Fax:
++47 2 85 40 36 E-Mail:
Sweden: Dr. E. Ranklev Department of
Anaesthesia Lasarettet University Hospital S-221 85 Lund Tel: ++46 46
17 19 49 Fax: ++46 46 14 23 13 E-Mail: islander@algonet.se
Switzerland: Dr. A. Urwyler Departement
Anästhesie Universitätskliniken Kantonsspital CH-4031 Basel Tel:
++41 61 265 72 54 Fax: ++49 61 265 73 20 E-Mail:urwyler
Cytoreduction surgery with
intraperitoneal chemotherapy
Jun 2003 - Nationally renowned thought leaders discuss the optimal use of
therapeutics and drug sensitivity testing for the management of gynecologic
malignancies.
Jun 2002 - Questions regarding the best treatment for each stage and for
each individual patient with gynecologic cancers can best be answered by
reviewing the latest findings in the diagnosis, treatment, and prevention of
these diseases.
Apr 2003 - A discussion of recent developments in the treatment of ovarian
cancer, including approaches to improve first-line therapy as well as treatment
of recurrent and relapsed disease.
Mar 1999 - Assess the risk of lung cancer for women previously treated for
breast cancer who smoke. Cyclophosphamide and cisplatin compared with paclitaxel
and cisplatin in patients with stage III and stage IV ovarian cancer. When we
get there, we will be able to fine-tune treatment and decision-making for
individual patients, study new drugs in optimal circumstances, and improve the
outcomes for patients with all stages of breast cancer.
Sep 1999 - After numerous phase I/II trials of carboplatin and paclitaxel
combinations, three large randomized phase III trials were performed comparing
cisplatin-paclitaxel with carboplatin-paclitaxel. [5-7] All three trials
demonstrated equivalence with respect to median progression-free survival for
carboplatin-paclitaxel and cisplatin-paclitaxel. Cyclophosphamide and cisplatin
compared with paclitaxel and cisplatin in patients with stage III and stage IV
ovarian cancer.
Nov 2001 - The current treatment focus for ovarian cancer, the most lethal
gynecologic malignancy, is to minimize drug resistance by optimizing treatment
doses, schedules, and combinations, and properly integrating novel agents. Dr
Paul Vasey presents results of drug treatment trials that may help us better
understand this clinical challenge.
Nov 1999 - After this time, however, the incidence of second primary tumors
in p53-normal patients dropped precipitously, while patients with mutated p53 in
the primary tumor went on to have an increasing rate of development of secondary
malignancies. Dr. Hong next studied successfully treated head and neck cancer
patients given retinoic acid as an adjuvant to prevent second primary tumors
from occurring. Two presentations examined the role of primary radiation therapy
compared with surgery and with ...
Nov 1999 - Dr. Kleinberg[1] from Johns Hopkins Oncology Center presented
long-term survival and local control outcome in 92 patients with esophageal
cancer (65 with adenocarcinoma and 27 with squamous cell carcinoma) who received
preoperative chemoradiation followed by surgical resection of esophageal cancer.
As expected, patients with a pathologic complete response had a better actuarial
survival rate of 73% at 4 years (median not reached), whereas the remainder of
the patients had 4-year actuarial ...
Jan 2002 - A 41-year-old female was diagnosed with stage IV colon cancer
with peritoneal seeding and metastases to the ovaries. Resection of the
transverse colon and left oophorectomy with intraoperative radiotherapy was
performed in 1998, and her postoperative CEA was 11.6. Chemotherapy of
intraperitoneal 5-FU and IV leucovorin followed surgery, and her CEA
dropped to 1.2.
Nov 2002 - Dr. Markman discusses open and settled issues in the
chemotherapeutic management of women with ovarian cancer at various stages of
the disease.
Mar 2001 - As part of a work-up for infertility, a 28-year-old woman
underwent a laparoscopy. Several papillary nodules were found on the pelvic
peritoneal surface, which were identified as papillary adenocarcinoma on biopsy.
During laparotomy, her ovaries appeared normal and some 20 nodules were found,
all of them on the pelvic peritoneal surfaces.
Mar 2002 - Describes the current treatment standards for ovarian cancer,
novel agents under investigation, and new methods to reduce toxicity and adverse
effects associated with ovarian cancer chemotherapy.
Mar 1999 - Enhanced clinician knowledge of pain syndromes, improved pain
assessment, and updated medical information can promote adequate management of
cancer pain.
Oct 2001 - We investigated the effect of surgery plus postoperative
(adjuvant) chemoradiotherapy on the survival of patients with resectable
adenocarcinoma of the stomach or gastroesophageal junction. Patients And Methods
Patients having histologic proof of localized carcinoma (either squamous cell
carcinoma or adenocarcinoma) of the esophagus or gastroesophageal junction
underwent full classification including endoscopic ultrasonography (EUS).
Background: The goals of this study were to assess the
...
Sep 2000 - PP is rare, but frequently misdiagnosed, and requires vigilance
from the clinician, gastroenterologist, or surgeon who conducts the initial
evaluation.
May 2003 - Drs. Edgardo Rivera and Robert Burger review the impact of
metastatic breast or ovarian cancer on quality of life and discuss strategies to
maximize efficacy while minimizing toxicity.
Nov 1999 - In this clinician´s practice, patients who have no
evidence of disease are followed with office visits and physical examination
every 6 months for 5 years; CA-125 levels or order imaging studies are not
routine unless required by protocol.
May 1999 - Two teams agree that carboplatin + paclitaxel is preferred over
cisplatin + paclitaxel for advanced ovarian cancer due to its more favorable
toxicity profile and ease of administration. However, 1 group concludes that
cisplatin-based regimens should be considered the standard chemotherapy
option in patients with high-risk ovarian cancer.
Aug 2001 - The only constant in lung cancer treatment is that patients
diagnosed with earlier-stage disease enjoy 5-year survival rates greater than
50%. Improvements in screening for lung cancer, the best method of detecting
early-stage cancers, as well as strategies to prevent lung cancer, were
discussed at the 2nd International Lung Cancer Congress in Kauai, Hawaii. Dr.
James Mulshine,[19] Head of the Intervention Section for Chemoprevention of Lung
Cancer at the National Cancer Institute in Bethesda...
May 1998 - These two trials demonstrate the clinical benefit of
anti-HER-2/neu antibody therapy in patients with metastatic breast cancer.
Long-term follow-up studies of early stage breast cancer patients treated
without adjuvant therapy have demonstrated that HER-2/neu overexpression by
tumors is associated with worse survival outcomes. Dr. F. A. Holmes of the M.D.
Anderson Cancer Center discussed the results of a related multi-center study
that compared 3-hour versus 96-hour paclitaxel infusion in
...
May 1999 - Shepherd F, Ramlau R, Mattson K, et al: Randomized study of
Taxotere (TAX) versus supportive care (BSC) in non-small cell lung cancer
(NSCLC) patients previously treated with platinum-based chemotherapy
[Abstract 1784]. Investigators from the Cleveland Clinic described a large
series of patients with clinically localized prostate cancer who were treated
with RP (1144 patients) or EBRT (1078 patients) and then randomized to receive
AD therapy or not. Improved survival in patients with locally
...
May 2000 - Discuss the results of clinical trials evaluating first- or
second-line treatment protocols for ovarian cancer. Among patients with at least
2 but not 3 prior regimens for metastatic breast cancer, and who had received
paclitaxel for advanced breast cancer, an objective response rate of 20% was
observed. Clinical course of breast cancer patients with complete pathologic
primary tumor and axillary node response to doxorubicin-based neoadjuvant
chemotherapy.
May 1998 - Because of cisplatin's toxicities, carboplatin will likely
continue to be the platinum compound of choice to use in combination with
paclitaxel as first-line therapy for ovarian cancer. Debate regarding the
benefit of IP therapy in this setting will likely
continue.
May 2000 - Based on a phase I study in which 8 of 14 patients with
relapsed/refractory SCLC responded, the Sarah Cannon Research Network[3] added
topotecan to the paclitaxel-carboplatin combination for treatment-naive
patients. Phase II trial of postoperative adjuvant cisplatin/etoposide (PE) in
patients with completely resected stage I - IIIA small cell lung cancer (SCLC):
the Japan Clinical Oncology Lung Cancer Study Group trial (JCOG9101). [15]
Patients with locally advanced NSCLC in this phase III
...
Jun 2003 - Maurie Markman, MD, and Paul A. Vasey, MD, review key
presentations from ASCO 2003 and offer insight into the latest research in the
treatment of gynecologic malignancies.
Jun 2003 - This report from ASCO 2003 highlights new findings in ovarian
cancer research, particularly in treatment results based on cell type and in
salvage therapy.
Jun 2001 - The MILES (Multicenter Italian Lung Cancer Study) phase 3 trial:
gemcitabine+vinorelbine vs. vinorelbine and vs. gemcitabine in elderly advanced
NSCLC patients. Cisplatin/gemcitabine vs. cisplatin/gemcitabine/vinorelbine vs
sequential doublets of gemcitabine/vinorelbine followed by
ifosfamide/vinorelbine in advanced non-small cell lung cancer: results of a
Spanish Lung Cancer Group phase III trial (GEPC/98-02). Program and abstracts of
the 37th Annual Meeting of the American Society of ...
Jun 2001 - We evaluated the tolerability and toxicity attributed to
pegylated liposomal doxorubicin (PL-DOX) in women with recurrent or refractory
ovarian cancer, and reviewed procedures to prevent or treat toxicity induced by
the agent.
Jun 2000 - Journal Scan Surgery, June 2000 Albert B. Lowenfels, MD,
Contributing Editor Journal Scan is the clinician's guide to the latest clinical
research findings in the Annals of Surgery, Archives of Surgery, JAMA, The
Lancet, and The New England Journal of Medicine. This study suggests that
staging laparoscopy can prevent unnecessary surgery in about a third of patients
considered to be surgical candidates and focus appropriate treatment on patients
with pancreatic cancer who might benefit. ...
Dec 1998 - These CSFs, used to improve outcome in immunosuppressed cancer
patients, may also have an adjunctive role in the treatment of a variety of
infectious diseases.
Dec 2000 - Previous studies attempting to determine an increased risk of
second malignancies in patients with breast cancer treated with radiation
therapy have largely failed. Fowble and colleagues[15] at Fox Chase Cancer
Center reported on the increased risk of contralateral breast cancer in younger
patients and in those with a family history of breast cancer. Postoperative
radiotherapy in high-risk postmenopausal breast cancer patients given adjuvant
tamoxifen: Danish Breast Cancer Cooperative Group ...
Sep 2001 - Patients with recent (within 1 year) endometrial biopsy or large
uterine leiomyomas and patients medically unfit for operative hysteroscopy were
excluded. Adverse effects (abdominal pain, breast tenderness, acne, headache,
mood changes) were reported by 13 patients in the LNG IUD group and by 9
patients in the resection group. This study evaluated the diagnostic accuracy of
4 different diagnostic modalities (magnetic resonance imaging [MRI],
transvaginal sonography [TVS], hysterosonography [...
Feb 2001 - An otherwise healthy 59-year-old man with radiographically
resectable adenocarcinoma of the stomach was found to have minimal peritoneal
implants on laparoscopy.
Purpose 
European Malignant Hyperthermia Group Since the first meeting in 1983
the group has met regularly. At present, twenty laboratories in twelve European
countries are performing in vitro contracture tests using the protocol of the
EMHG. 
