Two years of tamoxifen or no adjuvant systemic therapy for patients with high-risk breast cancer: long-term follow-up of the Copenhagen breast cancer trial.

Background: The Copenhagen Breast Cancer Trial (CBCT) randomly assigned patients with early breast cancer to two years of tamoxifen or placebo and we evaluated the effect over the following four decades.

Patient And Methods: Between 1975 and 1978, 327 patients with primary breast cancer were randomly assigned to two years of daily placebo or tamoxifen. Survival statistics was collected from the Danish Civil Registration System.

Nationwide quality improvement in lung cancer care: the role of the Danish Lung Cancer Group and Registry.

Introduction: To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry was opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators.

Monitoring renal function during chemotherapy.

Purpose: Renal function is monitored during chemotherapy because chemotherapeutic drugs are excreted by the kidneys and are potentially nephrotoxic. Doses are adjusted according to the glomerular filtration rate (GFR), i.e.

[Pharmaceutical treatment of cancer-associated fatigue--a survey of a Cochrane review].

The data and the conclusions of the Cochrane review of drug therapy for the management of cancer related fatigue (CRF) is analysed and summarized in this report. Overall, data is weakened substantially by a high degree of heterogeneity that stems primarily from the fact that fatigue is a subjective and multidimensional phenomenon Apart from erythropoietin and to some degree methylphenidate, there is no evidence that pharmacologic intervention may reduce CRF. CRF has major impact on quality of life for most patients suffering from a cancer disease.

National quality measurement using clinical indicators: the Danish National Indicator Project.

This article describes the Danish National Indicator Project that aims to document and improve the quality of care at national level. Specific clinical indicators, standards, and prognostic factors have been developed for eight diseases (e.g.

Data from a national lung cancer registry contributes to improve outcome and quality of surgery: Danish results.

Objective: In 1998 The Danish Lung Cancer Group published the first edition of guidelines for diagnosis and treatment of lung cancer. A national registry was implemented in the year 2000 with the primary objective to monitor the implementation of these guidelines and nationwide to secure and improve the quality of the clinical management of lung cancer. The results of this effort are reported with special focus on surgery.

[Monitoring renal function in patients treated with cytostatics].

Introduction: Some cytostatics, used in the treatment of cancer, are excreted by the kidneys and may be nephrotoxic. The glomerular filtration rate (GFR) represents a method for reliable assessement of the 51Cr-EDTA plasma clearance before and during treatment with nephrotoxic drugs. The aim of this retrospective study was to evaluate whether this method could be replaced by a more simplified GFR estimate calculated from the creatinine plasma concentration.

Cisplatin and vinorelbine first-line chemotherapy in non-resectable malignant pleural mesothelioma.

The aim was to evaluate the activity of cisplatin and vinorelbine in previously untreated, inoperable patients having histologically verified malignant pleural mesothelioma (MPM), normal organ function, and performance status 0-2. Treatment was vinorelbine 25 mg m(-2) i.v.

Topotecan and cisplatin in combination with concurrent twice-daily chemoradiation in limited disease small cell lung cancer-a Danish Oncological Lung Cancer Group (DOLG) phase II trial.

Introduction: The longest survival time reported in randomised trials of limited disease (LD) SCLC has been achieved with early twice-daily concurrent chemoradiation. Topotecan is active in recurrent SCLC and in extensive disease as first line treatment.

Aim: To incorporate and assess the effect of topotecan with concurrent twice-daily radiochemotherapy in LD SCLC.

Delay in diagnosis of lung cancer in general practice.

Background: Lung cancer is a common cancer disease; nevertheless, in Denmark a GP only sees one new case of lung cancer per year. The core symptoms of lung cancer, cough and dyspnoea, are on the other hand very common in general practice. This represents a challenge to the diagnostic process and increases the risk of diagnostic delay.

[General practitioners' attitudes towards the diagnosis of lung cancer and the diagnostic organisation].

Introduction: The aim of this study was to determine whether there is a nihilistic attitude towards diagnosing lung cancer among Danish general practitioners (GPs) and to obtain the GPs' evaluation of the present approach to lung cancer diagnosis.

Materials And Methods: A questionnaire was sent to 1,186 randomly selected GPs. Most of the questions addressed the possibilities of improving primary prevention, GPs' attitudes towards diagnosing lung cancer, their opinions about waiting times and their clinical practice.

Randomised controlled trial of a shared care programme for newly referred cancer patients: bridging the gap between general practice and hospital.

Objective: To determine the effect of a shared care programme on the attitudes of newly referred cancer patients towards the healthcare system and their health related quality of life and performance status, and to assess patients' reports on contacts with their general practitioner (GP).

Setting: Department of Oncology at Aarhus University Hospital and general practices.

Design: Randomised controlled trial in which patients completed questionnaires at three time points.

Peripheral blood accessory cells modulate committed colony-forming units but not 5-week cobblestone-area-forming cell outgrowth from CD34+ cells.

While cellular modulation in vitro of committed hematopoietic stem cell (HSC) growth has been known for some time, less is known about the effect of accessory cells (AC) on the growth of more immature HSC. We have examined the effect of peripheral blood (PB) AC on hematopoiesis by coculturing enriched PB CD34+ cells (>96% pure) with different quantities of CD34 cells (<1% contamination) harvested from 10 breast cancer patients. As expected colony growth was predominantly present in the CD34+ fractions, in which colony forming units granulocyte-macrophage (CFU-GM) varied between 89-3289/10(5) (median 1422/10(5) seeded cells) and week 5 cobblestone area forming cells (CAFC) between 64-1330/10(5) (median 427/10(5) seeded cells).

Pretreatment leukaemia cell drug resistance is correlated to clinical outcome in acute myeloid leukaemia.

In 85 adult patients diagnosed with acute myeloid leukaemia (AML) and treated at the same institution during a 5-yr period, the clinical significance of in vitro cellular drug resistance to the anthracyclines aclarubicin (Acla) and daunorubicin (Dau) as well as the nucleoside analogue cytarabine (Ara-C) was investigated using a 4-d MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay. In 59 patients of whom 40 were treated by the combination of Acla and Ara-C we found that leukaemia cell drug resistance towards Acla was higher (by a factor 2.80) in patients who failed to enter complete remission (CR) after the first cycle of induction chemotherapy as compared to patients who entered complete remission.

[Cross-sectorial cooperation regarding cancer patients in a recently started care program. Ideas and themes based on focus group interviews with general practitioners and oncologists].

This study identified ideas for an improved collaboration between general practitioners and oncologists regarding patients with cancer. A qualitative research-method with focused group interviews was chosen. The results demonstrated that both oncologists and general practitioners would like the general practitioners to take more active part in the total care programme for cancer patients.

Relevance of in vitro leukaemia cell survival to short- and long term clinical outcome in AML.

In ninety-three cases of newly diagnosed acute myeloid leukaemia (AML) we investigated the importance to short- and long term clinical outcome of the in vitro short term leukaemia cell survival as measured by a 4-day MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide)-assay. In 67 patients treated by intravenous remission induction therapy we found that patients who after the first induction cycle or after induction therapy overall achieved a complete remission (CR) had leukaemia cells with significantly lower in vitro cell survival ability than cells of non-responders (p = 0.02 and 0.

MDR1 gene expression and drug resistance of AML cells.

We investigated the cellular drug resistance to aclarubicin (Acla), cytosine arabinoside (Ara-C), daunorubicin (Dau), doxorubicin (Dox), etoposide (Etop) and mitoxantrone (Mitox) using the MTT assay at time of disease presentation in 93 cases of acute myeloid leukaemia (AML). In 31 cases we concomitantly investigated MDR1 (multiple drug resistance 1 gene) expression (semi-quantitative competitive RT-PCR) of the leukaemic cells. Drug resistance towards Dau, Dox and Etop was correlated to the MDR1 expression of the AML cells (P<0.

Randomized study of initial versus late chest irradiation combined with chemotherapy in limited-stage small-cell lung cancer. Aarhus Lung Cancer Group.

Purpose: To evaluate if the timing of chest irradiation with respect to chemotherapy would influence survival and local and distant control in patients with limited-stage small-cell lung cancer (LSCLC).

Patients And Methods: From 1981 to 1989, 199 consecutive patients with LSCLC were randomly allocated to receive initial chest irradiation (ICI; n = 99) or late chest irradiation (LCI; n = 100) given 18 weeks delayed. Both groups received the same nine cycles of combination chemotherapy: three cycles of cisplatin and etoposide and six cycles of cyclophosphamide, doxorubicin, and vincristine.