RESUMEN
AIM: This study aimed to evaluate the efficacy and safety of 5-fluorouracil (5-FU), doxorubicin and mitomycin-C (FAM) adjuvant chemotherapy in patients who had undergone curative resection of gastric carcinoma. METHODS: From Nov 1999 to Jan 2002, 291 consecutive patients with stage IB-IIIB gastric adenocarcinoma were given FAM adjuvant chemotherapy. Chemotherapy comprised intravenous 5-FU 600 mg/m(2) (days 1, 8, 29 and 36), doxorubicin 30 mg/m(2) (days 1 and 29) and mitomycin-C 10 mg/m(2) (day 1), every 8 weeks for 6 months. RESULTS: The median follow-up time was 60.6 months, 92 patients died, and 93 patients had recurrent disease. The 5-year overall survival (OS) rates were 85.9% for stage IB, 72.1% for stage II, 58.0% for stage IIIA, and 48.2% for stage IIIB (p=0.002). The 5-year relapse-free survival (RFS) rates were 85.2% for stage IB, 71.2% for stage II, 53.3% for stage IIIA, and 39.2% for stage IIIB (p<0.001). A total of 769 cycles of chemotherapy were delivered, and 15 patients experienced grade 3 or higher leukopenia. The most common grade 3 or higher non-hematologic toxicity was nausea/vomiting (11 patients), followed by stomatitis (3 patients). CONCLUSIONS: Adjuvant chemotherapy with FAM for 6 months for gastric carcinoma indicated comparable RFS and OS with an acceptable toxicity profile.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Gastrectomía/métodos , Neoplasias Gástricas/tratamiento farmacológico , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adulto , Anciano , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Doxorrubicina/uso terapéutico , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Humanos , Incidencia , Corea (Geográfico)/epidemiología , Masculino , Persona de Mediana Edad , Mitomicina/administración & dosificación , Mitomicina/uso terapéutico , Recurrencia Local de Neoplasia/epidemiología , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Tasa de Supervivencia/tendencias , Factores de Tiempo , Resultado del TratamientoRESUMEN
This article examines the use of Chinese medicine in Taiwan. Based on a national sample survey, the authors investigated how Chinese medicine is being used and factors that are associated with its use among the Taiwanese. Results of the study suggest that Chinese medicine use among this population depends on health conditions, and that having a regular source of care for Chinese medicine as well as a preference for Chinese medicine are two predictors for its use. Policies on the integration of Chinese medicine or other traditional medicine into the modern healthcare system are recommended.
Asunto(s)
Medicina Tradicional China , Curación Mental , Adolescente , Adulto , Anciano , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Muestreo , Taiwán/epidemiologíaRESUMEN
This paper examines the practice of Chinese medicine in Taiwan. Using a national sample survey of Chinese medicine physicians, supplemented by another national survey of Chinese medicine hospitals and government records, the authors study the education and training background of Chinese medicine physicians, their mode of practice, their productivity measured by patient visits, and the practice characteristics of Chinese medicine hospitals. Moreover, the authors investigate the relationship between the resource input, the public health insurance contract, and the number of patient visits Chinese medicine physicians provided. Results of this study are used to make several recommendations on the appropriate way of integrating the practice of Chinese medicine into the modern health care system. Many of these recommendations may also be applicable to other countries that are contemplating integrating traditional or alternative medicine into their health care systems.