Onkologie
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We wanted to determine the factors influencing survival in a retrospective review of patients with melanoma brain metastases to permit more specific recommendations regarding therapy. ⋯ Radiotherapy, chemotherapy and especially surgery and stereotactic radiosurgery seem to significantly prolong survival, as shown by multivariate analysis. Treatment with temozolomide will possibly play an important role in the future management of patients with brain metastases from cutaneous melanoma, but further prospective studies to verify this assumption are urgently needed.
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Oncological management of pediatric cancer patients belonging to Jehovah's Witnesses: a two-institutional experience report.
Aim of this study was to analyze the feasibility of oncological treatment in pediatric patients belonging to Jehovah's Witnesses and to describe the changing policy in performing transfusions and supportive care measures at two German pediatric cancer institutions. ⋯ Pediatric cancer patients belonging to Jehovah's Witnesses can be treated similarly to other patients. A restrictive transfusion policy and the broad application of hematopoietic supportive care measures may reduce transfusions. This treatment policy and a continuous collaboration with the Hospital Liaison Committee for Jehovah's Witnesses appears to create an oncological treatment situation with a high compliance of patients and parents where court orders may not be necessary.
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The results of the standard therapy of upper gastrointestinal tract cancer remain unsatisfactory, mainly because still the majority of cases are diagnosed at a late stage of disease, which implicates a poor prognosis. Innovative strategies focus on neoadjuvant chemotherapy in locally advanced gastric cancer and chemo- or radiochemotherapy in advanced oesophageal cancer. ⋯ There is rising evidence that adjuvant radiochemotherapy in gastric cancer may be of benefit for curatively resected patients, whereas the results of trials including a systematic lymphadenectomy have to be awaited. New substances like the taxanes or irinotecan in the palliative setting did not prove to be superior to platinum-based standard chemotherapy protocols so far.