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Int J Hyperthermia ; 19(4): 402-13, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12850926


INTRODUCTION: The aim of this prospective study was to describe quality of life (QoL) in patients with locally advanced prostate carcinoma treated with conventional radiotherapy and to evaluate the influence of adding regional or interstitial hyperthermia. MATERIALS AND METHODS: All patients were irradiated using a CT-planned conventional three field technique, administering 70 Gy to prostate and vesicles. In two different phase I studies, hyperthermia was added to the radiotherapy. Twelve patients were treated with one interstitial hyperthermia treatment, lasting 60 min. Fourteen patients have been treated with five regional hyperthermia treatments, lasting 75 min each. In both hyperthermia studies, the body, bladder and rectum temperatures remained below safety limits. Patients treated with radiotherapy alone (n = 58) or combined with regional (n = 8) or interstitial hyperthermia (n = 12) completed the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (C30 + 3), the EORTC prostate cancer module (PR25) and the Rand 36 health survey before treatment and 1 and 6 months after completion of treatment. Analysis of Variance (ANOVA) for repeated measurements has been performed to describe the data. RESULTS: All patient groups were comparable concerning patient characteristics. No significant interaction or difference in QoL has been noticed between the two hyperthermia patient groups and the patient group without hyperthermia. Therefore, all groups were analysed together (n = 78) to detect QoL changes in time. A deterioration of QoL has been measured from baseline to 1 month after treatment. Fatigue, pain, urinary symptoms, bowel symptoms and financial difficulties increased significantly. Social, physical and role functioning worsened significantly. No differences in QoL were measured 6 months after treatment compared to the baseline measurement, except for a decrease in sexual activity. CONCLUSIONS: After radiotherapy with or without hyperthermia only a temporary deterioration of QoL occurs, concerning social, psychological and disease related symptoms. Additional hyperthermia does not seem to decrease QoL.

Hipertermia Inducida , Neoplasias de la Próstata/fisiopatología , Neoplasias de la Próstata/terapia , Calidad de Vida , Radioterapia , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/psicología , Encuestas y Cuestionarios
Eur J Cancer ; 39(8): 1081-8, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12736107


The concurrent administration of adjuvant chemotherapy and radiotherapy in breast cancer treatment might lead to an increased incidence of side-effects. In this prospective, non-randomised, comparative study, the acute toxicity of radiotherapy alone (RT) and radiotherapy concurrent with doxorubicin-cyclophosphamide (AC/RT) and radiotherapy concurrent with cyclophosphamide-methotrexate-5-fluorouracil (CMF/RT) was compared. We used the common toxicity criteria (CTC) to score the level of acute toxicity before, during and 6 months after the completion of the period of irradiation. The number of hospital admissions, as well as the compliance of chemotherapy, were noted. We observed that patients treated with AC/RT and CMF/RT had significant higher incidences of (high-grade) skin-toxicity, oesophagitis, dyspnoea, malaise, anorexia, nausea and hospital admission compared with those treated with RT only. The target-volume of radiotherapy was the main predictor of (high-grade) acute skin toxicity and oesophagitis. AC/RT was associated with significant more (high-grade) skin toxicity than CMF/RT. The dose of chemotherapy was reduced to less than 85% of the planned dose in 11% of patients, 17% of patients treated with concurrent chemotherapy and radiotherapy needed admission to hospital. From the results of our study, we conclude that the concurrent administration of adjuvant chemotherapy and radiotherapy leads to an unacceptably high level of acute toxicity.

Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/cirugía , Quimioterapia Adyuvante/efectos adversos , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Hospitalización , Humanos , Mastectomía Radical , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Radioterapia Adyuvante/efectos adversos , Factores de Riesgo
J Clin Epidemiol ; 46(3): 253-9, 1993 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-8455050


Application of sequential analysis may avoid unnecessary experimentation and achieve economical use of available biomaterial stored in biological banks. When, as often happens in cohort case-controls studies, cases are scarce, it may be possible to use multiple control observations per case to increase the power of a test for detecting differences between cases and controls. Samples from a biological data bank were analysed. We compared results of a non-sequential analysis with results of sequential t-tests for 1 to 5 controls matched per case in a cohort nested case-control study. Simulations are performed to get an idea of the unreliability and the power of the sequential test. In general the sequential t-tests are too conservative with respect to the achieved power. Average sample numbers are lower for the sequential tests and decrease with multiple controls. More than 3 or 4 controls per case does not give a meaningful increase in efficiency.

Estudios de Casos y Controles , Estadística como Asunto/métodos , Adulto , Análisis de Varianza , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Persona de Mediana Edad , Uñas/metabolismo , Proyectos de Investigación , Estudios Retrospectivos , Selenio/metabolismo
Breast Cancer Res Treat ; 25(1): 11-9, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8518405


Selenium has been claimed to have chemo-preventive properties. However, data showing that in humans selenium levels are already decreased prior to diagnosis of breast cancer were not available. Such information is mandatory before oral selenium supplementation in the primary prevention of (breast) cancer in humans is acceptable. This question of a 'preventive-potential' of selenium was evaluated in a case-control study nested in a cohort, because this design allows determination of the time-order of preceding selenium levels and subsequent cancer risk. The cohort consisted of 5577 women aged 55-70 years from the DOM project, a population based breast cancer screening program in the Netherlands. Instrumental Neutron Activation Analysis was used to measure the selenium content of toenail clippings. The 69 cases of breast cancer found during follow-up after screening. represent 'recent' tumours since all women had a negative screening mammogram 3-5 years previously. No decreased selenium levels, as measured in nail clippings from the big toes, could be detected in cases-to-be, either when compared to 4 age matched controls per case or when compared with a random control group drawn from the entire cohort. On the contrary, a tendency for slightly higher selenium levels among 'future' cancer cases was observed. As to the sensitivity of detecting differences in selenium by nail clippings, lower selenium could be detected in nails of current smokers. The smoking-related decrease in nail selenium level was of the same order as the differences between breast cancer cases and controls, but was independent of the breast cancer risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Neoplasias de la Mama/metabolismo , Menopausia/metabolismo , Uñas/química , Anciano , Neoplasias de la Mama/prevención & control , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Factores de Riesgo , Selenio/uso terapéutico