Feasibility of sequential therapy with FOLFIRI followed by docetaxel/cisplatin in patients with radically resected gastric adenocarcinoma. A randomized phase III trial.

Objective: Combination therapies of fluorouracil (FU) with irinotecan (CPT-11) and docetaxel plus cisplatin have been proven to be active in metastatic gastric cancer. In this paper, we present the results of a phase III trial in which these two combinations given sequentially were compared to mitomycin C (MMC) monochemotherapy in an adjuvant setting.

Methods: 169 patients with radically resected gastric cancer were randomized to receive CPT-11 (180 mg/m2 day 1), leucovorin (100 mg/m2 days 1-2), FU (400-600 mg/m2 days 1-2, q 14; for four cycles; FOLFIRI regimen), followed by docetaxel (85 mg/m2 day 1), cisplatin (75 mg/m2 day 1, q 21; for three cycles; arm A), or MMC (8 mg/m2 days 1-2 as 2-hour infusion, q 42; for four cycles; arm B).

[Alendronate-induced esophagitis. A report of 2 cases].

Two cases of esophagitis associated with the use of alendronate are described. Both patients were women with no past history of heartburn or dyspepsia, who started alendronate for postmenopausal osteoporosis at least one week before the symptoms onset, by taking the drug with half a glass of tap water at bedtime. The first patient suffered from a severe chest pain; endoscopy showed confluent erosions of the lower third of the esophagus.

Pancreatic carcinoma: differences between patients with or without diabetes mellitus.

In order to assess the prevalence and type of diabetes mellitus in patients with pancreatic carcinoma and if the risk factors for the cancer have a different distribution among diabetics and non-diabetics, we reviewed the charts of 127 histologically and/or cytologically proven pancreatic carcinomas consecutively diagnosed from 1977 to 1989 and referred to our Primary Care Hospital from the attending physician. 48 out of 127 (37.7%) subjects were found to be diabetic; 3 had long standing insulin dependent diabetes mellitus, 10 long standing non insulin dependent diabetes mellitus and 35 (73% of all diabetics) new onset diabetes mellitus.

Changes in diagnostic approach and factors affecting treatment and survival of pancreatic carcinoma in a retrospective series over twelve years.

Aims: Identify the following aspects of pancreatic carcinoma: 1) the prevalence of some risk factors, 2) the accuracy of the diagnostic techniques and the pattern of their utilization over the years, 3) the factors affecting the therapeutic choice and mortality.

Methods: Retrospective study on all patients with a final diagnosis of pancreatic carcinoma seen at the Ospedale di Busto Arsizio, from January 1978 to August 1989.

Results: There were 155 patients, 68 +/- 11.

[Digestive hemorrhage secondary to biliary ileus. Endoscopic diagnosis].

A rare case of gastrointestinal hemorrhage is presented. The cause of bleeding was ulcer of the descending duodenum due to erosion of an impacted gallstone. Oral endoscopy made possible a preoperative diagnosis and, pushing the gallstone, made surgery easier.