ABSTRACT
BACKGROUND: The aim of this study was to determine whether the efficacy of the combination of 5-fluorouracil (5-FU), leucovorin (LV) and radiation therapy (RT) could be improved by the addition of interferon-alpha2b (IFN-alpha) in patients who have had a 'curative' resection, for rectal adenocarcinoma (Dukes' B2/C; T3 N0, T4 N0, N1-3). PATIENTS AND METHODS: A total of 207 eligible patients with a performance status of 0 or 1 were randomized postoperatively between days 21 and 70 to one of the two treatment groups: group A, LV 20 mg/m2 i.v. bolus and 5-FU 425 mg/m2 i.v. days 1-5 and 29-33, LV 20 mg/m2 and 5-FU 400 mg/m2 days 57-60 and 85-88, LV 20 mg/m2 and 5-FU 380 mg/m2 days 1-5 and 29-33 with the second day 1 occurring 28 days after the completion of RT (45 Gy); group B, LV, 5-FU and RT as in group A, and IFN-alpha 5 x 10(6) IU s.c. three times during each week chemotherapy is given. RESULTS: 104 patients were randomized into group A and 103 into group B. There was no statistically significant difference in either disease-free survival or overall survival between the two groups. Toxicity was also the same, except for the flu-like syndrome associated with the IFN-alpha administration. CONCLUSIONS: There was no difference in efficacy between the two combinations. Toxicity was greater with the LV + 5-FU + IFN-alpha regimen because of the flu-like syndrome.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapy , Adenocarcinoma/surgery , Adult , Aged , Chemotherapy, Adjuvant , Disease-Free Survival , Female , Fluorouracil/administration & dosage , Humans , Infusions, Intravenous , Injections, Intravenous , Interferon alpha-2 , Interferon-alpha/administration & dosage , Leucovorin/administration & dosage , Male , Middle Aged , Radiotherapy, Adjuvant , Recombinant Proteins , Rectal Neoplasms/surgery , Treatment OutcomeABSTRACT
Lymphangioleiomyomatosis is a rare disease involving the lung, lymphatic trunk and lymph nodes. Sometimes it appears in the retroperitoneum with or without subsequent development in the lungs. We present a 52-year-old woman with retroperitoneal location of the disease. We discuss the abdominal CT appearance, the cytologic and immunophenotypic features and a preoperative differential diagnosis is attempted.
Subject(s)
Lymphangioleiomyomatosis/diagnostic imaging , Retroperitoneal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Actins/analysis , Biomarkers, Tumor/analysis , Diagnosis, Differential , Factor VIII/analysis , Female , Humans , Immunophenotyping , Leiomyoma/pathology , Lymphangioleiomyomatosis/pathology , Lymphangioleiomyomatosis/surgery , Middle Aged , Neoplasms, Multiple Primary/pathology , Retroperitoneal Neoplasms/pathology , Retroperitoneal Neoplasms/surgery , Uterine Neoplasms/pathology , Vimentin/analysisABSTRACT
BACKGROUND: Many surgical techniques to keep the small intestine out of the pelvis after cancer surgery have been developed. METHODS: We used part of the ileum and its mesentery sutured around the linea terminalis in ten patients who underwent surgery for rectal or gynecologic carcinomas. RESULTS: All imaging studies of our patients on the tenth postoperative day confirmed the position of the bowel above the pelvis. Four of ten patients had radiation treatment postoperatively without any problems. CONCLUSION: Use of the ileum to reconstruct the pelvic floor seems to be a simple and efficacious technique to keep the pelvic area free. We believe this warrants further investigation in a larger number of patients.
