Chemotherapy (CAP) for the treatment of advanced ovarian cancer and second-effort surgery in the second look.

Seventy-two patients with advanced ovarian cancer received CAP chemotherapy followed by laparotomy and 'second-effort' surgery. The overall response to CAP therapy was 80%. A complete pathological response (CPR) was obtained in 16 patients and partial microscopic (PMiR) and macroscopic responses in 7 and 33 cases, respectively. The actuarial survival for the entire group was 36% at 50 months with a median survival of 34 months. No significant differences in survival between the CPR and PMiR groups were found. Radical second-effort surgery showed a somewhat beneficial effect. The tumor size before chemotherapy (less than 5 cm) and FIGO stage III had a significantly favorable effect on response rate and survival.

[Cerebral metastasis from breast cancer. Treatment with irradiation. Results]. / Metástasis cerebral por cáncer de mama. Tratamiento con irradiación. Resultados.

The authors describe the results of cranial radiotherapy in 22 patients with brain metastases due to mammary cancer; 77.5% of the patients responded to treatment, 45.5% showing a complete response. The mean survival attained was 6.4 months for all the patients and 18 months for those with complete response. The presence of cerebellar metastases makes worse the prognosis.

[The clinico-mammographic follow-up of breast cancer after conservative treatment]. / Seguimiento clínico-mamográfico del cáncer de mama tras tratamiento conservador.

Clinical and mammographic follow-up of 149 patients diagnosed of stage I and II breast neoplasm and treated with conservative surgery and irradiation between January 1986 and December 1988 was reviewed to determine clinical and radiographic recurrence pattern. Follow-up controls included a clinical examination and a mammogram at 6-9 months, a second at 10-16, a third at 17-22, a fourth at 23-24 and a mammogram yearly and a clinical examination every 6 months thereafter. To December 1991 18 patients recurred. 12 had a metastatic spread, 3 a unique local recurrence and 3 a local recurrence with a metastasis spread. Clinical recurrence was as a carcinomatous mastitis in three patients and a solid nodule in two. Radiologic recurrence was as an augmented skin thickness in three patients. Mammogram was not performed in one patient because an associated poor prognostic metastatic spread. Mammographic skin thickness secondary to irradiation appeared in 93% of the patients at 6-9 first control, 62% at second, 50% at third and 35% at fourth. The number of recurrences is scarce to achieve any clinical, pathological or treatment factor associated with greater risk of recurrence. We suggest that first mammogram should be delayed after 12 months of treatment because we would not obtain any relevant clinical information before, once observed skin thickness persistence at 6 months and most frequent recurrence radiologic pattern.

Randomized trial of tamoxifen versus aminoglutethimide and versus combined tamoxifen and aminoglutethimide in advanced postmenopausal breast cancer.

In a randomized trial, 105 postmenopausal women with advanced carcinoma of the breast received tamoxifen or aminoglutethimide or combined tamoxifen and aminoglutethimide. No differences were found in the rate of responses and duration of responses between the treatment groups. Toxicity was significantly greater (p less than 0.01) in patients who received aminoglutethimide.