Treatment of high-risk Hodgkin lymphoma with a modified Stanford V regimen in the AHOPCA: Substituting chemotherapy agents and hampered outcomes.

BACKGROUND/OBJECTIVES: High-risk Hodgkin lymphoma (HRHL) in children is curable with combined modality therapy. The Association of Pediatric Hematology-Oncology of Central America (AHOPCA) is a consortium of cancer centers from Central America. In 2004, AHOPCA implemented a guideline with a short course of chemotherapy (mStanfordV), strict diagnostics, and radiation guidelines, aimed at reducing abandonment and improving outcomes. METHODS: Newly diagnosed children less than 18 years of age with high-risk HL (Ann Arbor stages: IIB, IIIB, IV) from AHOPCA centers were staged with chest radiography and ultrasound or computed tomography. Therapy was a modified Stanford V (mStanfordV), substituting cyclophosphamide for mechlorethamine and involved field radiation. RESULTS: Of 219 patients with HRHL, 181 patients were eligible and evaluable; 146 (81%) were boys, 22% being less than 6 years; 43 were stage IIB, 84 IIIB, and 54 IV. Thirty-one (17%) abandoned therapy, 28 (15%) progressed, 30 (17%) relapsed, and eight (4%) died of toxicity. Radiation guidelines were not followed. Five-year abandonment-sensitive event-free survival and overall survival (AS-EFS, AS-OS ± SE) for the cohort were 46% ± 4% and 56% ± 4%; 5-year AS-OS for stages IIB, IIIB, and IV was 76% ± 7%, 59% ± 7%, and 35% ± 7% (p = .0006). CONCLUSION: Despite instituting a short treatment guideline, it did not improve the abandonment rate (17%) and did not achieve the reported outcomes of Stanford V. The cyclophosphamide dose used to replace merchlorethamine was inadequate. Despite strict guidelines, the radiation therapy application was inaccurate. Weekly chemotherapy may have adversely affected abandonment of therapy by increasing the burden of travel time. Based on these results, AHOPCA established a new abandonment strategy and a new guideline.

Chemical composition and physicochemical properties of Phaeodactylum tricornutum microalgal residual biomass.

The production of photosynthetic biofuels using microalgae is a promising strategy to combat the use of non-renewable energy sources. The microalgae residual biomass is a waste by-product of biofuel production; however, it could prove to have utility in the development of sustainable nutraceuticals and functional foods. In this study, a comprehensive characterisation of the under-utilised Phaeodactylum tricornutum microalgae residual biomass is presented. Proximal composition, antioxidant capacity (using three different antioxidant assays; oxygen radical absorbance capacity; radical cation activity, ABTS; and radical scavenging activity, DPPH), and total phenolic content of free and bound polyphenols were determined. Additionally, the physicochemical properties of water activity, pH, water absorption index, water solubility index, and dispersibility were evaluated. Results revealed that P. tricornutum microalgae residual biomass exhibits a relatively high protein and carbohydrate content, with values of 36.67% and 46.78%, respectively; and most carbohydrates were found as total dietary fibre (45.57%), of which insoluble dietary fibre was the most predominant (43.54%). Antioxidant capacity values for total phytochemicals of 106.22, 67.93, 9.54 µM TE g-1 dw were determined by oxygen radical absorbance capacity, ABTS, and DPPH assays, respectively. Total phenolic content was found to be 2.90 mg GAE g-1 dw. Interestingly, antioxidant capacity and total phenolic content were higher in bound than in free phytochemical extracts. The physicochemical analysis showed P. tricornutum microalgae residual biomass to have suitable properties for the generation of a beverage with Aw, pH, water absorption index, water solubility index, and dispersibility values of 0.45, 7.12, 3.40 g gel g-1 dw, 2.5 g solids 100 g-1 dw, and 90%, respectively. Hence, P. tricornutum microalgae residual biomass could be considered a potential source of bioactive compounds suitable for the production of functional food exhibiting antioxidant capacity and high dietary fibre content.

A chemotherapy only therapeutic approach to pediatric Hodgkin lymphoma: AHOPCA LH 1999.

BACKGROUND: AHOPCA is a collaborative group that designs uniform treatment regimens (protocols) for children diagnosed with cancer in Central America. Based on a preliminary report from one of the AHOPCA centers, AHOPCA adopted a treatment regimen to maintain a good event-free survival (EFS) as well as eliminate radiation therapy from the treatment of children with Hodgkin lymphoma. PROCEDURE: Newly diagnosed patients with histologically proven Hodgkin lymphoma were staged according to the Ann Arbor classification and divided into favorable (stage I, stage IIA, and IIIA) and unfavorable (stage IIB, IIIB, and IV) groups. Subjects classified as group 1 (favorable) were treated with six 28-day cycles of chemotherapy (COPP/COPP ± ABV). Subjects classified as group 2 (unfavorable) were treated with eight 28-day cycles of COPP/ABV chemotherapy. RESULTS: Of 269 patients registered, 216 were eligible for evaluation. The mean age at diagnosis was 7.5 years with a male to female ratio of 3.7-1. The predominant histology was nodular sclerosis (44%) but with a relatively high proportion of mixed cellularity (35.2%) The EFS at 5 and 10 years was 71% and 68%, respectively. There was a 14% rate of abandonment of therapy. CONCLUSION: This treatment regimen for children with Hodgkin lymphoma, when applied as a multi-institutional regimen, had poorer outcome than our previously reported preliminary data and was inferior to the EFS reported in high-income countries. The major contributor adversely affecting EFS in this report is abandonment of therapy. Given these results, AHOPCA initiated a concerted effort to decrease abandonment of therapy.

Evaluation of in vitro serial antibiotic elution from meropenem-impregnated polymethylmethacrylate beads after ethylene oxide gas and autoclave sterilization.

OBJECTIVES: To determine the elution properties of meropenem and to compare the elutions of meropenem-impregnated polymethylmethacrylate (PMMA) beads without sterilization (P-M-C) to those sterilized with steam (P-M-A) and ethylene oxide gas (P-M-EO). METHODS: A commercial bead mould was used to produce four groups of beads: one group without antibiotic (negative control), and three groups of meropenem-impregnated beads: P-M-C, P-M-A, and P-M-EO. The beads were placed in a phosphate buffered solution and eluent samples were collected. Concentrations of the antibiotic in eluent samples from the two sterilized groups and the control beads were determined using a microbiological assay at 1, 3, 6 and 12 hours and at 1, 2, 3, 6, 9, 12, 15, 18, 22, 26, and 30 days. RESULTS: The microbiological assay resulted in no zone of inhibition at all time periods for the P-M-A samples and the samples of PMMA without antimicrobial. The meropenem concentration on the eluent remained above 4 mcg/ml for 15 days in the P-M-C group and until day 18 for P-M-EO group. There was no statistical difference in AUC0-∞ (p<0.318), however significance did occur for MRT (p<0.005) when comparing P-M-C and P-M-EO with the later being higher. DISCUSSION: The meropenem incorporated in the PMMA beads eluted effectively and gradually decreased after the 24 hour peak, but remained above the concentration level of 4 mcg/ml for 15 days in the P-M-C group and until day 18 for P-M-EO group. Ethylene oxide does not adversely affect meropenem's elution from PMMA beads.

Perfiles de personalidad de estudiantes de psicología de universidad privada comparados em similitud y congruencia / Personality profiles of psychology students from a privateuniversity compared by similarity and congruence

En continuidad con los estudios del área de Perfiles de la Cátedra de Psicología Experimental I y II, se llevó a cabo un análisis comparativo de Perfiles de Personalidad en estudiantes de psicología. La muestra fue intencional y autoseleccionada, quedó conformada por 153 estudiantes de Psicología. Se ha utilizado un diseño Descriptivo y Comparado. El instrumento utilizado fue el Inventario Multifásico de la Personalidad Minnesota-2 (MMPI-2). Los resultados reportan que existe un patrón de personalidad con similitudes muy acentuadas en los estudiantes de la carrera de psicología, independiente del curso al que pertenecen, y en comparación a los perfiles de años anteriores (n = 152, muestra 2001: n=168, muestra 2007: y n= 101 muestra 2008).

In continuity with the studies of the area of Profiles of the Professorship of Experimental Psychology I and II, a comparative analysis of Profiles of Personality in students of psychology was carried out. The sample was intentional and autoseleccionada, remained conformed by 153 (166) students of Psychology. A Descriptive design has been utilized and Compared. The instrument utilized was the Polyphase Inventory of the Personality Minnesota-2 (MMPI-2). The results report that a boss of personality with similarities exists very accentuated in the students of the career of psychology, independent of the course to which they belong, and in comparison to the profiles of previous years (n = 152 sample 2001; n = 168, sample 2007 and n = 101 sample 2008).

Programa "Educación Alimentaria en Acción" / Nutritional education in Action Program

¶Educación Alimentaria en Acción÷ es un Programa en desarrollo que alcanza a 240000 alumnos, 15000 maestros y 1200 escuelas de Corrientes. Para el diagnóstico se realizó un Taller convocado por los Ministerios correntinos de Educación, Salud y Desarrollo Social y Nutritia, en el que participaron representantes de organismos de gobierno,instituciones asistenciales de toda la provincia, la Comisión de Lactancia Materna, la Dirección de Maternidad e Infancia, el Instituto Nacional de Tecnología Agropecuaria, Organizaciones no Gubernamentales, la Universidad Nacional del Noreste, la Federación de Odontólogos, el Colegio de Nutricionistas local y los presidentes de la Sociedad Argentina de Nutrición y de la Asociación Argentina de Dietistas y Nutricionistas Dietistas. Se realizó un análisis causal y priorización de los problemas nutricionales, identificando componentes educativos y Consensuando 6 ejes pedagógicos, incluyendo las Guías Alimentarias para la Población Argentina. Se aplicó encuestas de conocimientos, actitudes y prácticas iniciales a una muestra de 1309 niños y de necesidades de capacitación sobre alimentación y nutrición a maestros como línea de base para evaluaciones posteriores. El equipo constituido por Licenciadas en Nutrición, pedagoga, comunicadores y médicos elabora cuadernillos y CDs trimestrales que incluyen láminas, fichas y experiencias de aprendizaje que articulan la currícula escolar con la Educación Alimentaria involucrando a las familias. Además se ha diseñado una página web de acceso público con Intranet para que maestros y directivos compartan inquietudes y experiencias. Conclusiones : La sinergia entre organismos oficiales, no gubernamentales, profesionales de la Salud, la Educación y la empresa privada favorece la concreción de un Programa de Educación Alimentaria de amplia cobertura (AU)

Programa "Educación Alimentaria en Acción" / Nutritional education in Action Program

“Educación Alimentaria en Acción” es un Programa en desarrollo que alcanza a 240000 alumnos, 15000 maestros y 1200 escuelas de Corrientes. Para el diagnóstico se realizó un Taller convocado por los Ministerios correntinos de Educación, Salud y Desarrollo Social y Nutritia, en el que participaron representantes de organismos de gobierno,instituciones asistenciales de toda la provincia, la Comisión de Lactancia Materna, la Dirección de Maternidad e Infancia, el Instituto Nacional de Tecnología Agropecuaria, Organizaciones no Gubernamentales, la Universidad Nacional del Noreste, la Federación de Odontólogos, el Colegio de Nutricionistas local y los presidentes de la Sociedad Argentina de Nutrición y de la Asociación Argentina de Dietistas y Nutricionistas Dietistas. Se realizó un análisis causal y priorización de los problemas nutricionales, identificando componentes educativos y Consensuando 6 ejes pedagógicos, incluyendo las Guías Alimentarias para la Población Argentina. Se aplicó encuestas de conocimientos, actitudes y prácticas iniciales a una muestra de 1309 niños y de necesidades de capacitación sobre alimentación y nutrición a maestros como línea de base para evaluaciones posteriores. El equipo constituido por Licenciadas en Nutrición, pedagoga, comunicadores y médicos elabora cuadernillos y CDs trimestrales que incluyen láminas, fichas y experiencias de aprendizaje que articulan la currícula escolar con la Educación Alimentaria involucrando a las familias. Además se ha diseñado una página web de acceso público con Intranet para que maestros y directivos compartan inquietudes y experiencias. Conclusiones : La sinergia entre organismos oficiales, no gubernamentales, profesionales de la Salud, la Educación y la empresa privada favorece la concreción de un Programa de Educación Alimentaria de amplia cobertura

Randomized phase 2 trial of ketoconazole and ketoconazole/doxorubicin in androgen independent prostate cancer.

Eighty-nine patients with progressive prostate cancer despite suppression of testosterone and withdrawal of anti-androgens were studied. This was a relatively advanced population, with 63 of 89 having either osseous metastases (mets) beyond the axial skeleton or visceral mets. Patients were randomly assigned to receive either ketoconazole alone, or ketoconazole with weekly doxorubicin. All patients received replacement hydrocortisone. The primary endpoints were response and survival. Based on PSA reduction criteria (>/= 80% maintained for at least 8 weeks), 14 of 45 patients (31%) in the single-agent ketoconazole arm responded. Sixteen of 44 patients (36%) in the combination ketoconazole/doxorubicin arm responded. There were no important differences between the two treatments in any outcome measure. The median overall survival for all patients was 12.5 months; median time to progression was 3.3 months. Toxicity was significant with both regimens, and more severe in the doxorubicin arm. Fully 20% of patients in each arm discontinued therapy due to intolerable side effects.Each of these regimens is toxic, and produced responses in fewer than half of treated patients. Although the observed median survival does compare favorably with reports from similar cohorts treated in the community, the potential benefit is only modest. In our view, neither of these regimens is sufficiently promising to justify phase 3 evaluation.

Direct acetylation of the estrogen receptor alpha hinge region by p300 regulates transactivation and hormone sensitivity.

Regulation of nuclear receptor gene expression involves dynamic and coordinated interactions with histone acetyl transferase (HAT) and deacetylase complexes. The estrogen receptor (ERalpha) contains two transactivation domains regulating ligand-independent and -dependent gene transcription (AF-1 and AF-2 (activation functions 1 and 2)). ERalpha-regulated gene expression involves interactions with cointegrators (e.g. p300/CBP, P/CAF) that have the capacity to modify core histone acetyl groups. Here we show that the ERalpha is acetylated in vivo. p300, but not P/CAF, selectively and directly acetylated the ERalpha at lysine residues within the ERalpha hinge/ligand binding domain. Substitution of these residues with charged or polar residues dramatically enhanced ERalpha hormone sensitivity without affecting induction by MAPK signaling, suggesting that direct ERalpha acetylation normally suppresses ligand sensitivity. These ERalpha lysine residues also regulated transcriptional activation by histone deacetylase inhibitors and p300. The conservation of the ERalpha acetylation motif in a phylogenetic subset of nuclear receptors suggests that direct acetylation of nuclear receptors may contribute to additional signaling pathways involved in metabolism and development.

p300 and p300/cAMP-response element-binding protein-associated factor acetylate the androgen receptor at sites governing hormone-dependent transactivation.

The androgen receptor (AR) is a sequence-specific DNA-binding protein that plays a key role in prostate cancer cellular proliferation by dihydrotestosterone and the induction of secondary sexual characteristics. In this study we demonstrate that the AR can be modified by acetylation in vitro and in vivo. p300 and p300/cAMP-response element-binding protein acetylated the AR at a highly conserved lysine-rich motif carboxyl-terminal to the zinc finger DNA-binding domain. [(14)C]acetate-labeling experiments demonstrated that AR acetylation by p300 in cultured cells requires the same residues identified in vitro. Point mutation of the AR acetylation site (K632A/K633A) abrogated dihydrotestosterone-dependent transactivation of the AR in cultured cells. Mutation of the p300 CH3 region or the p300/cAMP-response element-binding protein histone acetylase domain reduced ligand-dependent AR function. The identification of the AR as a direct target of histone acetyltransferase co-activators has important implications for targeting inhibitors of AR function.

Treatment of squamous cell esophageal cancer with topotecan: an Eastern Cooperative Oncology Group Study (E2293).

Seventeen patients with enhanced measurable squamous cell carcinoma of the esophagus were treated with topotecan 1.5 mg/m2 daily for 5 days repeated every 21 days. Toxicity was severe, with 1 death from myelotoxicity and 10 patients with life-threatening myelotoxicity. Severe gastrointestinal toxicity consisting of vomiting was also seen in three patients. No response was seen in any of the patients in the study. Topotecan given in this manner has no activity in squamous cell carcinoma of the esophagus.

Randomized trial of 3-hour versus 24-hour infusion of high-dose paclitaxel in patients with metastatic or locally advanced breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-26.

PURPOSE: Paclitaxel is an active drug for the treatment of breast cancer; however, the appropriate duration of administration is unknown. We assessed and compared the response rate, event-free survival, survival, and toxicity of paclitaxel 250 mg/m(2) delivered every 3 weeks as a 3-hour or 24-hour infusion. PATIENTS AND METHODS: A total of 563 women with stage IV or IIIB breast cancer were randomized into one of two groups: 279 received 3-hour paclitaxel and 284 received 24-hour paclitaxel. Patients were stratified by age, stage of disease, and prior therapy. RESULTS: A significantly higher rate of tumor response occurred in the first four cycles of therapy in patients who received the 24-hour infusion of paclitaxel (51% v 41%, respectively; P =.025). Tumor response over all cycles was also significantly higher in the group that received 24-hour infusion (54% v 44%, respectively; P =.023). There were no significant differences in event-free survival or survival between the two arms of the study (P =.9 and.8, respectively). No treatment by stage or by age interactions were observed. During the first four cycles of therapy, at least one episode of >/= grade 3 toxicity (excluding nadir hematologic values, alopecia, and weight change) occurred in 45% of patients who received the 3-hour paclitaxel infusion and in 50% of those who received the 24-hour paclitaxel infusion. Febrile neutropenia, >/= grade 3 infection, and >/= grade 3 stomatitis were less frequent, and severe neurosensory toxicity was more frequent in those who received the 3-hour paclitaxel infusion. Ten treatment-related deaths occurred in the first four cycles. Age, stage, and prior chemotherapy did not influence the effect of treatment. CONCLUSION: When administered as a continuous 24-hour infusion, high-dose paclitaxel results in a higher tumor response rate than when administered as a 3-hour infusion but does not significantly improve event-free survival or survival. Paclitaxel as a 24-hour infusion results in increased hematologic toxicity and decreased neurosensory toxicity.

Spanish language translation and initial validation of the functional assessment of cancer therapy quality-of-life instrument.

OBJECTIVES: There is a need in the United States for culture-equivalent assessment of health-related quality of life, particularly among people who speak different languages and among those with low literacy skills. This report summarizes the adaptation of the Functional Assessment of Cancer Therapy (FACT) Scales for use with Spanish-speaking cancer patients, including those with low literacy. METHODS: The Spanish language version of the general Functional Assessment of Cancer Therapy scale plus five disease-specific subscales (breast, lung, colorectal, head and neck, HIV infection) were translated, reviewed, and revised, then evaluated in interviews with Spanish-speaking patients from the mainland United States and Puerto Rico. An iterative forward-backward-forward sequence of item translation, expert bilingual/bicultural advisor review, pretesting interviews with 92 patients, and further expert advisory input were used to establish semantic, content, and partial technical equivalence. RESULTS: The Functional Assessment of Cancer Therapy-General and five disease-specific subscales were translated successfully into wording that was easily understood and answered, leading to psychometric and scoring data similar to that of the English version. All but one of the 28 Functional Assessment of Cancer Therapy-General items and all of the disease-specific items were seen as culturally relevant. The result is a document that underwent iterative forward-backward translation and evaluation and was pretested successfully with native Spanish-speaking oncology patients living in the Central United States and Puerto Rico. CONCLUSIONS: The Functional Assessment of Cancer Therapy-General and five disease-specific subscales have been translated successfully into Spanish using a thorough translation and initial validation methodology. The methods and data provide a model for preparing a health status questionnaire for cross-cultural validation. The questionnaire is available for use in clinical trials and clinical practice.

Protein and mRNA analysis of myosin heavy chains in the developing avian pectoralis major muscle.

While the existence of post-hatch and adult myosin heavy chain isoforms in the large, avian type IIB pectoralis major muscle has been clearly established, the number and nature of fast myosin heavy chains during in ovo development and the perihatch period have not been resolved. In the present study, developmental fast heavy chain proteins purified by high resolution anion-exchange have been characterized by sequence analysis of a unique CNBr peptide and by complementary mRNA analysis. The four proteins present at 15/16 days in ovo are shown to differ uniquely in primary structure. They correlate with heavy chains II, IV, VI and VII, characterized recently as major or minor species in adult fast muscles using similar methods. These four heavy chains are expressed in a time-dependent fashion from 8 to 16 days in ovo. At the mRNA level, heavy chain VI predominates until 12 days in ovo. Heavy chain IV mRNA is upregulated dramatically at 16 days in ovo preparatory to its protein's predominance in the peri-hatch period. Heavy chains II, IV and V (the post-hatch isoform which replaces heavy chain IV) have major roles in adult fast muscles.

Current role of chemotherapy protectors in cancer treatment

The administration of full doses of chemotherapy according to an established schedule improves the response rate and duration of response in cancer patients. However, frequently there are delays in therapy due to dose-limiting side effects and chemotherapy could affect permanently normal tissues. This has led to the development of chemotherapy protectors and of rescue agents in the past years. We will discuss some of these new agents and their use in cancer treatment. Some of these agents include amifostine (Ethyol), dexrazoxane (Zinecard), mesna (Mesnex), leucovorin, G-CSF, GM CSF, recombinant erythropoietin and thrombopoietin. Oncologists must learn the adequate use of different strategies in reducing chemotherapy toxicity in order to improve both the quality and quantity of life of cancer patients

Recent advances in cancer therapy

The treatment of cancer has developed substantially from its conception in the first years of the 20th century. Since the introduction of alkylating agents during second World War, the oncology specialty has markedly grown. In the recent years, new drugs have been approved for the treatment of cancer. Such examples include the taxanes (Docetaxel and Paclitaxel), Vinorelbine, Irinotecan, Topotecan, Gemcitabine and Gliadel. We will discuss these new chemotherapuetic agents, their pharmacology, indications, toxicity and appropriate dosing. There is no doubt that further clinical research is needed to determine the optimal use of these agents

Characterization of the myosin heavy chains of avian adult fast muscles at the protein and mRNA levels.

High resolution anion-exchange chromatography of myosin subfragment-1 in avian fast muscles revealed five fast heavy chains (I-V) expressed in muscle-specific patterns. Sequence analysis of a unique peptide established that the proteins differed in primary structure and suggested correlation with heavy chain genes identified independently by Robbins and coworkers. The identities of the isoforms and their expression patterns were confirmed at the mRNA level by a reverse-transcription, 5'-anchored PCR procedure. The fast white pectoralis major muscle possessed heavy chain I, the posterior latissimus dorsi muscle, of similar fibre type, expressed heavy chains I, III and IV. The fast red adductor superficialis muscle expressed either, or both, of heavy chains II and IV. The lateral gastocnemius muscle, of mixed fibre type, expressed heavy chains II-V. In general, heavy chains I, III and V appeared to be favoured in fast white fibres, while heavy chains II and IV were characteristic of fast red fibres. These results imply a greater subtlety of fast muscle function than has previously been appreciated.

Recent advances in cancer therapy.

The treatment of cancer has developed substantially from its conception in the first years of the 20th century. Since the introduction of alkylating agents during second World War, the oncology specialty has markedly grown. In the recent years, new drugs have been approved for the treatment of cancer. Such examples include the taxanes (Docetaxel and Paclitaxel), Vinorelbine, Irinotecan, Topotecan, Gemcitabine and Gliadel. We will discuss these new chemotherapuetic agents, their pharmacology, indications, toxicity and appropriate dosing. There is no doubt that further clinical research is needed to determine the optimal use of these agents.

Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study.

BACKGROUND: Clinics that primarily see members of ethnic minority groups have been found to provide inadequate treatment of cancer-related pain. The extent of undertreatment of pain in these patients and the factors that contribute to undertreatment are not known. OBJECTIVES: To evaluate the severity of cancer-related pain and the adequacy of prescribed analgesics in minority outpatients with cancer. DESIGN: Prospective clinical study. SETTING: Eastern Cooperative Oncology Group. PATIENTS: 281 minority outpatients with recurrent or metastatic cancer. MEASUREMENTS: Patients and physicians independently rated severity of pain, pain-related functional impairment, and pain relief obtained by taking analgesic drugs. Analgesic adequacy was determined on the basis of accepted guidelines. RESULTS: 77% of patients reported disease-related pain or took analgesics; 41% of patients reporting pain had severe pain. Sixty-five percent of minority patients did not receive guideline-recommended analgesic prescriptions compared with 50% of non-minority patients (P < 0.001). Hispanic patients in particular reported less pain relief and had less adequate analgesia. CONCLUSIONS: The awareness that minority patients do not receive adequate pain control and that better assessment of pain is needed may improve control of cancer-related pain in this patient population.

Current role of chemotherapy protectors in cancer treatment.

The administration of full doses of chemotherapy according to an established schedule improves the response rate and duration of response in cancer patients. However, frequently there are delays in therapy due to dose-limiting side effects and chemotherapy could affect permanently normal tissues. This has led to the development of chemotherapy protectors and of rescue agents in the past years. We will discuss some of these new agents and their use in cancer treatment. Some of these agents include amifostine (Ethyol), dexrazoxane (Zinecard), mesna (Mesnex), leucovorin, G-CSF, GM CSF, recombinant erythropoietin and thrombopoietin. Oncologists must learn the adequate use of different strategies in reducing chemotherapy toxicity in order to improve both the quality and quantity of life of cancer patients.