Purpose: To compare a neoadjuvant regimen of cisplatin/5-fluorouracil (5-FU) and concurrent radiation therapy (RT) with paclitaxel-based regimens and RT in the management of operable esophageal (EC)/gastroesophageal junction (GEJ) cancer.
Methods And Materials: All patients receiving neoadjuvant chemotherapy (CT) and RT for EC/GEJ cancer at Duke University between January 1995 and December 2004 were included. Clinical end points were compared for patients receiving paclitaxel-based regimens (TAX) vs. alternative regimens (non-TAX). Local control (LC), disease-free survival (DFS), and overall survival (OS) were estimated using the Kaplan-Meier method. Chi-square analysis was performed to test the effect of TAX on pathologic complete response (pCR) rates and toxicity.
Results: A total of 109 patients received CT-RT followed by esophagectomy (95 M; 14 F). Median RT dose was 45 Gy (range, 36-66 Gy). The TAX and non-TAX groups comprised 47% and 53% of patients, respectively. Most (83%) TAX patients received three drug regimens including platinum and a fluoropyrimidine. In the non-TAX group, 89% of the patients received cisplatin and 5-FU. The remainder received 5-FU or capecitabine alone. Grade 3-4 toxicity occurred in 41% of patients receiving TAX vs. 24% of those receiving non-TAX (p = 0.19). Overall pCR rate was 39% (39% with TAX vs. 40% with non-TAX, p = 0.9). Overall LC, DFS, and OS at 3 years were 80%, 34%, and 37%, respectively. At 3 years, there were no differences in LC (75% vs. 85%, p = 0.33) or OS (37% vs. 37%, p = 0.32) between TAX and non-TAX groups.
Conclusions: In this large experience, paclitaxel-containing regimens did not improve pCR rates or clinical end points compared to non-paclitaxel-containing regimens.
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http://dx.doi.org/10.1016/j.ijrobp.2007.03.035 | DOI Listing |
JMIR Res Protoc
January 2025
Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group, Uppsala University, Uppsala, Sweden.
Background: Digital health interventions have become increasingly popular in recent years, expanding the possibilities for treatment for various patient groups. In clinical research, while the design of the intervention receives close attention, challenges with research participant engagement and retention persist. This may be partially due to the use of digital health platforms, which may lack adequacy for participants.
View Article and Find Full Text PDFJ Neurosurg
January 2025
Departments of1Neurosurgery.
Objective: Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs.
View Article and Find Full Text PDFJ Neurosurg Pediatr
January 2025
1Neurotology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and.
Objective: The objective of this study was to discuss the characteristics of intracranial extension in patients with juvenile nasopharyngeal angiofibroma (JNA) and propose and an algorithm for its management.
Methods: A retrospective chart review of all patients with JNA who underwent operations between January 2013 and January 2023 was done, and those cases with intracranial extension categorized as stage IIIb, IVa, and IVb according to the Andrews modification of the Fisch staging classification were included in the study. Data were collected about age at presentation, symptoms, radiological findings, routes of intracranial extension, therapeutic management, and follow-up.
J Neurosurg
January 2025
1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
Objective: Deep brain stimulation (DBS) is an effective neurosurgical option for patients with treatment-resistant obsessive-compulsive disorder (OCD). Despite being more costly than neuroablative procedures of comparable efficacy, DBS has gained popularity over the years for its reversibility and adjustability. Although the cost-effectiveness of DBS has been investigated extensively in movement disorders, few economic analyses of DBS for psychiatric disorders exist.
View Article and Find Full Text PDFJCO Glob Oncol
January 2025
Auckland Regional Cancer and Blood Service, Te Toka Tumai Auckland, Health New Zealand, Te Whatu Ora, Auckland, New Zealand.
Purpose: In Aotearoa New Zealand, there are inequitable outcomes for Pacific peoples who experience higher rates of preventable cancers and poorer survival compared with other ethnicities. The aim of this study was to explore Pacific peoples lived experience of cancer and its treatment in the Auckland setting.
Methods: Data were collected through semistructured interviews (talanoa) with Pacific patients under the Auckland Regional Cancer and Blood Service.
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