Bleomycin may be replaced in first-line treatment regimens for advanced germ cell tumours of the testis ???

1991 ◽  
Vol &NA; (780) ◽  
pp. 12-13
Author(s):  
&NA;
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumours ◽  
Line Treatment ◽  
First Line ◽  
Treatment Regimens ◽  
First Line Treatment

Pineal tumours

2019 ◽  
pp. 427-438
Author(s):  
Mueez Waqar ◽  
Samantha Mills ◽  
Conor L Mallucci ◽  
Michael D Jenkinson
Keyword(s):  
Germ Cell ◽  
Adjuvant Radiotherapy ◽  
Residual Disease ◽  
Germ Cell Tumour ◽  
Third Ventriculostomy ◽  
Germ Cell Tumours ◽  
Line Treatment ◽  
Surgical Biopsy ◽  
First Line Treatment

Tumours of the pineal are very rare, tend to be more common in children and while there are a wide variety of pathologies the majority are germ cell tumours and pineal parenchymal tumours. These tumours usually present with hydrocephalus and endoscopic third ventriculostomy is the operation of choice. It is important to test for tumour markers in the blood and cerebrospinal fluid, since the diagnosis of a secreting germ cell tumour precludes the need for surgery. Surgical biopsy can be performed by endoscopy or with frame-based stereotaxy. For germ cell tumours chemotherapy and radiotherapy are the mainstay of treatment, but surgery has a role in the management of residual disease. For primary parenchymal tumours, maximum surgical resection is the first-line treatment and can be curative for pineocytoma. Pineoblastoma require adjuvant radiotherapy and for intermediate grade pineal tumours the role of radiotherapy is still being evaluated.

Treatment of Relapse of Clinical Stage I Nonseminomatous Germ Cell Tumors on Surveillance

2019 ◽  
Vol 37 (22) ◽  
pp. 1919-1926 ◽  
Author(s):  
Robert J. Hamilton ◽  
Madhur Nayan ◽  
Lynn Anson-Cartwright ◽  
Eshetu G. Atenafu ◽  
Philippe L. Bedard ◽  
...  
Keyword(s):  
Germ Cell ◽  
Odds Ratio ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Line Treatment ◽  
First Line ◽  
Factors Associated ◽  
Nonseminomatous Germ Cell Tumors ◽  
First Line Treatment

PURPOSE Active surveillance (AS) for testicular nonseminomatous germ cell tumors (NSGCT) is widely used. Although there is no consensus for optimal treatment at relapse on surveillance, globally patients typically receive chemotherapy. We describe treatment of relapses in our non–risk-adapted NSGCT AS cohort and highlight selective use of primary retroperitoneal lymph node dissection (RPLND). METHODS From December 1980 to December 2015, 580 patients with clinical stage I NSGCT were treated with AS, and 162 subsequently relapsed. First-line treatment was based on relapse site and extent. Logistic regression was used to explore factors associated with need for multimodal therapy on AS relapse. RESULTS Median time to relapse was 7.4 months. The majority of relapses were confined to the retroperitoneum (66%). After relapse, first-line treatment was chemotherapy for 95 (58.6%) and RPLND for 62 (38.3%), and five patients (3.1%) underwent other therapy. In 103 (65.6%), only one modality of treatment was required: chemotherapy only in 58 of 95 (61%) and RPLND only in 45 of 62 (73%). Factors associated with multimodal relapse therapy were larger node size (odds ratio, 2.68; P = .045) in patients undergoing chemotherapy and elevated tumor markers (odds ratio, 6.05; P = .008) in patients undergoing RPLND. When RPLND was performed with normal markers, 82% required no further treatment. Second relapse occurred in 30 of 162 patients (18.5%). With median follow-up of 7.6 years, there were five deaths (3.1% of AS relapses, but 0.8% of whole AS cohort) from NSGCT or treatment complications. CONCLUSION The retroperitoneum is the most common site of relapse in clinical stage I NSGCT on AS. Most are cured by single-modality treatment. RPLND should be considered for relapsed patients, especially those with disease limited to the retroperitoneum and normal markers, as an option to avoid chemotherapy.

A nationwide population-based study comparing survival in unresectable advanced or synchronous metastatic esophageal and gastric adenocarcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 308-308
Author(s):  
Marieke Pape ◽  
Pauline A.J. Vissers ◽  
David Bertwistle ◽  
Laura McDonald ◽  
Hanneke W.M. Van Laarhoven ◽  
...  
Keyword(s):  
Systemic Treatment ◽  
Rank Test ◽  
Tumor Characteristics ◽  
Line Treatment ◽  
First Line ◽  
Treatment Regimens ◽  
Netherlands Cancer Registry ◽  
Number Of Patients ◽  
Significant Difference ◽  
First Line Treatment

308 Background: Similarities between esophageal and gastric adenocarcinomas have been identified in terms of genomic characteristics. There is however no consensus on the combined or stratified inclusion of esophageal adenocarcinoma (EAC) within gastric cancer (GC) clinical trials. The aim of our study was to compare patient and tumor characteristics, first-line treatment regimens and overall survival (OS) of patients with EAC and GC. Methods: We selected patients with unresectable advanced and/or synchronous metastatic EAC (n = 1554) or GC (including junction tumors; n = 2095) diagnosed in the period 2015-2017 from the nationwide Netherlands Cancer Registry. Patients with a positive HER2 test result and/or receiving trastuzumab as a first-line treatment were excluded. Data on OS were analyzed using Kaplan-Meier curves with Log-Rank test. Results: The EAC patient population had significantly more male patients (83% vs 66%), lower median age (68 vs 71 years) and higher median BMI (25.4 vs 24.5). Significant differences in location of metastases were identified, with higher percentages in non-regional lymph nodes (48% vs 28%), liver (50% vs 35%), lung (21% vs 9%) and bone (19% vs 7%) and lower in peritoneum (5% vs 42%), in EAC versus GC patients respectively. EAC patients more often received any type (supportive or active systemic) of treatment (76% vs 60%). Median OS was longer in EAC than GC patients (EAC: 4.8 vs GC: 4.1 months; p < 0.01). The percentages of patients receiving first-line systemic treatment were equal in both groups (43%). The number of patients receiving CapOx or FOLFOX was not significantly different (43% vs 47%). Carboplatin+paclitaxel was more frequently given in EAC versus GC (34% vs 3%), while EOX or ECC was given less frequently (12% vs 30%). No significant difference was observed in median OS between EAC and GC patients receiving first-line active systemic treatment (8.0 vs 7.6 months; p = 0.28). Conclusions: Patient characteristics, tumor characteristics, treatment regimens and OS differ between EAC and GC patients. Despite these differences, in patients receiving first-line active systemic treatment no significant differences in OS were found.

scholarly journals In VitroAntimicrobial Susceptibility Patterns of Blastocystis

2015 ◽  
Vol 59 (8) ◽  
pp. 4417-4423 ◽  
Author(s):  
Tamalee Roberts ◽  
Stephen Bush ◽  
John Ellis ◽  
John Harkness ◽  
Damien Stark
Keyword(s):  
Current Treatment ◽  
Line Treatment ◽  
First Line ◽  
Content Type ◽  
Treatment Regimens ◽  
Drug Treatments ◽  
Resistant Strains ◽  
Susceptibility Patterns ◽  
First Line Treatment

ABSTRACTBlastocystisis the most common human enteric protist with controversial clinical significance. Metronidazole is considered a first-line treatment forBlastocystisinfection; however, there has been increasing evidence for the lack of efficacy of this treatment. Treatment failure has been reported in several clinical cases, and recentin vitrostudies have suggested the occurrence of metronidazole-resistant strains. In this study, we tested 12Blastocystisisolates from 4 commonBlastocystissubtypes (ST1, ST3, ST4, and ST8) against 12 commonly used antimicrobials (metronidazole, paromomycin, ornidazole, albendazole, ivermectin, trimethoprim-sulfamethoxazole [TMP-SMX], furazolidone, nitazoxanide, secnidazole, fluconazole, nystatin, and itraconazole) at 10 different concentrationsin vitro. It was found that each subtype showed little sensitivity to the commonly used metronidazole, paromomycin, and triple therapy (furazolidone, nitazoxanide, and secnidazole). This study highlights the efficacy of other potential drug treatments, including trimethoprim-sulfamethoxazole and ivermectin, and suggests that current treatment regimens be revised.

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