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Importance: Extramammary Paget disease (EMPD), a rare intraepithelial adenocarcinoma, poses a therapeutic challenge with high postoperative recurrence rates and a limited number of effective local treatment options.
Objective: To describe the use and efficacy of a topical combination of fluorouracil and calcipotriene as a palliative therapy for refractory EMPD.
Design, Setting, And Participants: This retrospective case series of 3 women with recurrent, refractory EMPD was conducted at Beth Israel Deaconess Medical Center, Boston, Massachusetts and Washington University School of Medicine, St Louis, Missouri. All patients were treated with a 1:1 mixture of fluorouracil, 5%, cream and calcipotriene, 0.005%, cream or ointment.
Main Outcomes And Measures: Clinical and histopathological findings.
Results: All 3 women (1 in her 50s, 2 in their 70s) presented with recurrent EMPD (vulvar, perianal, and perioral) after surgery and/or irradiation, and their EMPD was refractory to treatment with imiquimod, 5%, cream. Owing to disease progression and/or intolerable adverse effects from imiquimod, the patients began treatment with a 1:1 mixture of fluorouracil, 5%, cream and calcipotriene, 0.005%, cream. This treatment, which was well tolerated, was followed by clinical improvement in symptoms and appearance of the lesions in all 3 cases and histopathological signs of decreased tumor burden in 2 cases. Patients applied the combination topical therapy to affected areas with differing frequencies, ranging from 1 to 2 days per month to 4 consecutive days every 2 weeks.
Conclusions And Relevance: Extramammary Paget disease frequently recurs even after aggressive surgical management and can be refractory to many topical and locoregional therapies. Palliative treatment with a combination of fluorouracil and calcipotriene may be a viable option for patients with recurrent, refractory EMPD.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506893 | PMC |
http://dx.doi.org/10.1001/jamadermatol.2018.4793 | DOI Listing |
PLoS One
December 2024
Department of Colorectal Surgery, The Affiliated Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Background: The optimal second-line systemic treatment for metastatic colorectal cancer (mCRC) is inconclusive.
Methods: We searched PubMed, Web of Science, EMBASE, and Cochrane Library for RCTs comparing second-line systemic treatments for mCRC from the inception of each database up to February 3, 2024. Markov Chain Monte Carlo (MCMC) technique was used in this network meta-analysis (NMA) to generate the direct and indirect comparison results among multiple treatments in progression-free survival (PFS), overall response rate (ORR), overall survival (OS), complete response (CR), partial response (PR), grade 3 and above adverse events (Grade ≥ 3AE), and any adverse events (Any AE).
J Chin Med Assoc
December 2024
Department of Stomatology, The Fourth Hospital of Hebei Medical University, Hebei Tumor Hospital, Hebei, China.
Background: To investigate the effect of nimotuzumab (N) combined with nab-paclitaxel, cisplatin, and fluorouracil (APF) neoadjuvant chemotherapy on the surgical margin.
Methods: 55 patients were divided into three groups: neoadjuvant chemotherapy and surgery group (G1, 15 cases), chemotherapy and surgery group (G2 group, 20 cases), and surgery group (G3 group, 20 cases). Tissue samples of the tumor core zone (P0), adjacent (P1, 3-5mm from tumor), distal adjacent (P2, 7-10mm from tumor), and surgical margin (P3, 15mm from tumor) were collected.
Int J Pharm
December 2024
Department of Chemical Engineering, Osaka Metropolitan University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan.
Combination therapy using multiple drugs has the potential for synergistic therapeutic effects and reduction in the administered dose. Furthermore, when combined with a drug delivery system, the therapeutic agents can effectively be targeted and delivered to the affected area. Therefore, a single carrier capable of encapsulating multiple drugs is of clinical significance.
View Article and Find Full Text PDFJ Cell Mol Med
December 2024
Cancer Pathophysiology and Therapy Lab, Institute of Biomedicine (IB-UCLM) Universidad de Castilla-La Mancha, Albacete, Spain.
Colorectal cancer is the third most commonly diagnosed cancer worldwide and the second most common cause of cancer-related death in both men and women. Although a number of treatments are available to combat this malignancy, the antimetabolite 5-fluorouracil has been the cornerstone of therapy since its synthesis in the 1950s. Unfortunately, the prolonged use of 5-fluorouracil can lead to chemoresistance, which has prompted research into combination regimens to improve efficacy and quality of life and reduce resistance.
View Article and Find Full Text PDFWorld J Surg Oncol
December 2024
Department of Surgery, Keio University School of Medicine, 35 Shinano-Machi Shinjuku-Ku, Tokyo, 160-8582, Japan.
Background/objectives: This study aimed to evaluate the safety, efficacy, and long-term outcomes of S-1-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable or borderline-resectable pancreatic ductal adenocarcinoma (PDAC).
Methods: This retrospective study included patients with PDAC who underwent S-1-based NACRT at our institute between 2010 and 2017.
Results: Forty patients were included in the study, including 15 (37.
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