A non-comparative phase II study of dose intensive chemotherapy with doxorubicin and ifosfamide followed by high dose ICE consolidation with PBSCT in non-resectable, high grade, adult type soft tissue sarcomas.

The objective was to determine the role of dose intensive induction chemotherapy in patients with soft tissue sarcomas (STS) that were considered unresectable. Treatment consisted of 2-3 cycles of doxorubicin (Dox) and ifosfamide (Ifo) followed by high dose chemotherapy with ifosfamide, carboplatin, etoposide (HD-ICE) plus peripheral blood stem cell transplantation (PBSCT). 30 out of 631 consecutive patients, median age 46 years (21-62), with high grade STS were included. 29 patients completed at least 2 cycles of Dox/Ifo. HD-ICE was withheld because of progressive disease (PD) in 5 patients, neurotoxicity in 6 cases, insufficient peripheral blood stem cell (PBSC) mobilization, complete remission (CR) and refusal in 1 patient each. HD-ICE was associated with non-haematological grade III toxicity including emesis, mucositis, fever, neurotoxicity, and transaminase level elevation. Two additional patients attained a partial response after HD-ICE. Overall, 24 of 30 (80%) patients underwent surgery, with complete tumor resections in 19 patients (63% of all patients, 79% of the operated subgroup); however, 2 of these required amputation. After a median follow up period of 50 months in surviving patients (range, 26-120), 5-year PFS and OS rates were 39% and 48%, respectively. Induction chemotherapy plus consolidation HD-ICE is generally feasible, but is associated with significant neurotoxicity. The advantage of HD-ICE over conventional dose chemotherapy plus external beam radiation therapy (EBRT) in non-resectable disease remains unproven.

[Contrast media-enhanced and B-imaging ultrasound as a diagnostic and follow-up tool of hepatic echinococcosis in a 19-year-old Turkish woman]. / Kontrastmittel- und B-Bild-Ultraschall in der Diagnostik und Therapiekontrolle der hepatischen Echinokokkose bei einer türkischen Patientin.

HISTORY: A 19-year-old Turkish woman was admitted to the emergency room because of the worsening recurrent pain in the right abdomen radiating to the right shoulder and right flank. INVESTIGATIONS: Ultrasound examination showed a polycystic mass in the right lobe of the liver surrounded by a capsule. A contrast-enhanced ultrasound examination was done. It revealed, starting in the arterial phase, marginal enhancement near the capsule of the liver lesion. TREATMENT AND COURSE: The suspected diagnosis of a hydatid liver disease caused by Echinococcus granulosus was confirmed by serology. The patient was treated with oral albendazole (400 mg, twice daily) for eight weeks. Follow-up ultrasound examinations showed significantly reduced "collapsing" cyst membranes. A hydatid cyst weighing 130 g and 8 cm in diameter was resected by open laparatomy nine weeks after diagnosis. Albendazole treatment was continued for six months and well tolerated by the patient. One year after surgical treatment the serology was negative. CONCLUSIONS: Ultrasound examination is the method of choice for the initial diagnosis and follow-up of hepatic echinococcosis. Serology is not always reliable. The treatment depends on the WHO stage of the disease and individual factors.