Improving Cox survival analysis with a neural-Bayesian approach.

In this article we show that traditional Cox survival analysis can be improved upon when supplemented with sensible priors and analysed within a neural Bayesian framework. We demonstrate that the Bayesian method gives more reliable predictions, in particular for relatively small data sets. The obtained posterior (the probability distribution of network parameters given the data) which in itself is intractable, can be made accessible by several approximations.

Phase II study of mitomycin-C and cisplatin in disseminated, squamous cell carcinoma of the uterine cervix. A European Organization for Research and Treatment of Cancer (EORTC) Gynecological Cancer Group study.

The aim of this study was to investigate the tumour response rate and toxicity of a combination chemotherapy consisting of mitomycin-C and cisplatin in patients with disseminated squamous-cell carcinoma of the uterine cervix. Chemotherapy consisted of mitomycin, 6 mg/m(2) intravenously (i.v.

[Diverse expression of multiple endocrine neoplasia type 1].

MEN-1 is an autosomal dominantly inherited disorder, characterised by the occurrence of multiple tumours, particularly in the parathyroid glands, the pancreatic islets, the pituitary gland and the adrenal glands, as well as by neuroendocrine carcinoid tumours. Various clinical manifestations are presented by description of three patients harbouring a MEN1 gene germline mutation. A 44-year-old man had symptoms of hyperparathyroidism and in addition to parathyroid adenomas proved to have tumours in the thymus, adrenal and pituitary glands.

Exploratory phase III study of paclitaxel and cisplatin versus paclitaxel and carboplatin in advanced ovarian cancer.

Purpose: To determine the side effects and feasibility of cisplatin and carboplatin each in combination with paclitaxel as front-line therapy in advanced epithelial ovarian cancer.

Patients And Methods: Patients were randomly allocated to receive paclitaxel 175 mg/m(2) intravenously as a 3-hour infusion followed by either cisplatin 75 mg/m(2) or carboplatin (area under the plasma concentration-time curve of 5), both on day 1. The schedule was repeated every 3 weeks for at least six cycles.

A development protocol for a diagnostic DSS.

A diagnostic decision support system (DSS) in medicine is an expert system that aids the physician in the determination of the diagnosis based on findings and test results. The DSS can be divided into 2 different types of components: the knowledge component and the information system component. Methods from software engineering, knowledge engineering and management are combined into a dynamic development cycle that allows stepwise update and refinement.

[Cytostatic treatment of ovarian carcinoma].

Shortly after treatment with the cytostatic combination of cisplatin and paclitaxel was generally accepted as the standard therapy for patients with epithelial ovarian carcinoma, many have come to regard the combination of carboplatin and paclitaxel as a better choice. The latter combination causes fewer side effects and may be used in the outpatient clinic. Conceivably, the carboplatin-paclitaxel scheme will shortly have to be adjusted again owing to results of current research.

Phase II study of gemcitabine in ovarian cancer.

This phase II study evaluated the response rate and toxicity of single-agent gemcitabine in 40 women with epithelial ovarian cancer, previously treated with platinum-based chemotherapy. Patients had stage III or IV disease and progressive disease 1-12 months after the last treatment. Gemcitabine 1250 mg/m2 was administered on days 1, 8 and 15 of each 28-day cycle as a 30-minute infusion.

Advanced epithelial ovarian cancer: 1998 consensus statements.

Background: During an international workshop held in September 1998, a group of specialists in the field of ovarian cancer reached consensus on a number of issues with implications for standard practice and for research of advanced epithelial ovarian cancer.

Methods: Five groups of experts considered several issues which included: biologic factors, prognostic factors, surgery, initial chemotherapy, second-line treatment, the use of CA 125, investigational drugs, intra-peritoneal treatment and high-dose chemotherapy. The group attempted to arrive at answers to questions such as: Are there prognostic factors, which help to identify patients who will not do well with current therapy? What is the current best therapy for advanced ovarian carcinoma? What directions should research take in advanced ovarian cancer? These issues were discussed in a plenary meeting.

First line chemotherapy with carboplatin plus paclitaxel in advanced ovarian cancer--a new standard of care?

Cisplatin 75 mg/m2 plus paclitaxel 135 mg/m2 administered over 24 hours have been established as the standard treatment for advanced ovarian cancer. This schedule can not be administered in an outpatient setting. A European-Canadian trial confirmed the superiority of cisplatin-paclitaxel, but failed to improve the therapeutic index of this combination by reducing infusion length of paclitaxel from 24 to 3 hours.

Ovarian cancer: should we be managing patients with good and bad prognostic factors in the same manner?

There are only rare circumstances where knowledge of a patient's prognostic features appropriately guides therapy. The last few years a plethora of studies have been published which attempt to refine our understanding of determinants of prognosis in ovarian cancer patients by analysing molecular markers thought to be of relevance in malignant biology. Unfortunately, only a few studies have simultaneously evaluated, in a large patient sample, the relative prognostic importance of traditional clinical pathological variables together with molecular markers through application of multivariate analysis techniques.

Paclitaxel/carboplatin for the initial treatment of advanced ovarian cancer.

In 1996, the combination of cisplatin 75 mg/m2 plus 24-hour infusion of 135 mg/m2 paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) was proved to prolong survival in comparison with cyclophosphamide/cisplatin in women with advanced ovarian cancer. As a result, the paclitaxel/cisplatin combination was recommended to serve as the new standard of care. One year later, a European-Canadian group confirmed the efficacy of paclitaxel/cisplatin in a study in which the infusion period of paclitaxel was reduced from 24 to 3 hours and the dose of paclitaxel escalated to 175 mg/m2.

Four cycles of BEP vs four cycles of VIP in patients with intermediate-prognosis metastatic testicular non-seminoma: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. European Organization for Research and Treatment of Cancer.

We investigated the efficacy and toxicity of induction chemotherapy with cisplatin and etoposide with either bleomycin or ifosfamide in patients with intermediate-prognosis testicular non-seminoma. A total of 84 eligible patients were randomized to receive four cycles of etoposide, ifosfamide, cisplatin (VIP), or four cycles of bleomycin, etoposide, cisplatin (BEP). Intermediate prognosis was defined as any of the following: lymph node metastases 5-10 cm in diameter, lung metastases more than four in number or > 3 cm, HCG 5000-50,000 IU l(-1), AFP > 1000 IU l(-1).

Paclitaxel (175 mg/m2 over 3 hours) with cisplatin or carboplatin in previously untreated ovarian cancer: an interim analysis.

The side effects of cisplatin (75 mg/m2) in combination with paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (175 mg/m2 over 3 hours) are expected to be more severe and frequent than those of carboplatin (area under the concentration-time curve of 5) in combination with the same dose of paclitaxel, but the combinations are expected to be equally effective. A disadvantage of the cisplatin-based regimen is that patients need to be admitted to the hospital. The carboplatin regimen can be administered to outpatients.

Paclitaxel with carboplatin for the treatment of ovarian cancer.

Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (135 mg/m2 over 24 hours) plus cisplatin (75 mg/m2 at a rate of I mg/min) every 3 weeks is widely accepted as the new standard of treatment for women with advanced epithelial ovarian cancer. A higher dose of paclitaxel over a shorter infusion period is under investigation as an alternative because it looks at least as effective and is more convenient to administer. However, in combination with cisplatin this dose-time schedule causes neurotoxicity in an important number of patients that can preclude the delivery of an adequate total dose.

Gemcitabine in cisplatin-resistant ovarian cancer.

Many new drugs have been tested in phase II studies in recent years. With a number of drugs the results vary because of differences in the patients recruited to these studies. A number of factors impact the response to second-line therapy, including the treatment-free interval between the end of previous therapy and the entry into phase II study, the bulk and stage of disease, the histology of the tumor, and hemoglobin level.

Upregulation of B50/GAP-43 protein mRNA in rat dorsal root ganglia during cisplatin intoxication.

Expression of the growth-associated protein B50 (GAP-43) mRNA in dorsal root ganglia (DRG) of rats was studied by in situ hybridization. In response to treatment with the neurotoxic agent cisplatin, B50 mRNA expression was significantly enhanced following a cumulative cisplatin dose of 14 mg/kg. In the untreated age-matched control animals, only half of the ganglion cells exhibited expression of B50 mRNA (mean hybridization signal, 10 times background), whereas at a cumulative cisplatin dose of 14 mg cisplatin every neuron exhibited well above background expression (mean hybridization signal, 34 times background).

Value of quantitative pathological variables as prognostic factors in advanced ovarian carcinoma.

Aims: To evaluate correlations among clinical, pathological, morphometric, stereological, and DNA flow cytometric variables and their prognostic value in advanced ovarian cancer.

Methods: Tissue was collected from 180 patients with advanced ovarian cancer. All 180 had undergone debulking surgery and were being treated with cisplatin.

Phase II study of gemcitabine in previously platinum-treated ovarian cancer patients.

Fifty-one patients with histologically confirmed epithelial stage III or IV ovarian cancer were entered into a study in which gemcitabine 800 mg/m2 was given as a 30 min intravenous infusion in a cycle once a week for 3 weeks followed by a week of rest. Patients were aged 58 years (range 23-70 years) with WHO performance status 0-2, and had received up to two different chemotherapy regimens. Thirty-eight patients had received only one prior platinum-containing chemotherapy regimen whereas 9 had received a first-line regimen on more than one occasion.

[Feasibility of transferring medical-technological aid to the home situation for patients with cancer or a serious infection].

Objective: To describe the feasibility of home care technology for patients with cancer or serious infectious diseases.

Setting: Utrecht.

Methods: One hundred and thirty one patients with cancer or serious infections were treated at home with parenteral administration of fluid, cytostatics, analgetics, blood products or antimicrobial agents.