Medical and pediatric oncology
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Med. Pediatr. Oncol. · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialRandomized comparison of cefepime versus ceftazidime monotherapy for fever and neutropenia in children with solid tumors.
With the availability of new broad-spectrum antibiotics, initial therapy with a single agent has become an alternative to classic combinations, especially beta-lactam antibiotics plus aminoglycosides, in the management of febrile neutropenic cancer patients. ⋯ CFP is as effective and safe as CFZ for the empirical treatment of febrile episodes in neutropenic patients with solid tumors.
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Med. Pediatr. Oncol. · Mar 2001
Randomized Controlled Trial Clinical TrialLumbar puncture in pediatric oncology: conscious sedation vs. general anesthesia.
Lumbar punctures (LP) generally have been performed with conscious sedation (CS) but are increasingly performed using general anesthesia (GA) owing to the belief that this is less distressing. The aim of this study was to compare these two methods concerning distress, discomfort, pain, well-being and security after the LP, and problems with the LP. ⋯ Outcomes for CS and GA in LP were similar. Although there were failures with the CS model, most preferred it to GA. LP in CS also saved time and medical resources. An alternative approach would be to have a pediatric anesthesiologist available at the oncology ward for these elective LPs to provide the sedation or anesthesia required by each individual.
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Med. Pediatr. Oncol. · Mar 2001
Letter Randomized Controlled Trial Clinical TrialNeoadjuvant chemotherapy in osteosarcoma: the experience at the Hospital Infantil de Mexico from August 1996 to August 1999.
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Med. Pediatr. Oncol. · Mar 2000
Randomized Controlled Trial Multicenter Study Clinical TrialComplete necrosis induced by preoperative chemotherapy in Wilms tumor as an indicator of low risk: report of the international society of paediatric oncology (SIOP) nephroblastoma trial and study 9.
The SIOP Nephroblastoma therapeutic protocols include a period of preoperative chemotherapy followed by nephrectomy and a period of postoperative chemotherapy. From the outset, identification of low-risk groups has been an aim of the SIOP Nephroblastoma Trials and Studies. Now that 90% of children with Wilms tumor can be cured, attention is even more focused on the identification of patients who could benefit from less aggressive postoperative therapy, thus minimizing the morbidity and late effects associated with treatment. The prognostic implications of total necrosis in nephroblastoma after chemotherapy have not been investigated hitherto. ⋯ Patients with unilateral nonanaplastic WT that showed total necrosis following preoperative chemotherapy had excellent outcome and should benefit from less aggressive postoperative treatment in further trials. Other very responsive tumors, such as Wilms with <10% viable tumor, should also be assessed.
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Med. Pediatr. Oncol. · Feb 2000
Randomized Controlled Trial Comparative Study Clinical TrialOral ciprofloxacin vs. intravenous ceftriaxone administered in an outpatient setting for fever and neutropenia in low-risk pediatric oncology patients: randomized prospective trial.
Infections are one of the major complications in children undergoing chemotherapy. Monotherapy with either ciprofloxacin or ceftriaxone is safe and efficient in low-risk patients (solid tumors and stage I/II lymphomas). The same drugs may be used in an outpatient setting, decreasing costs and the risk of nosocomial infections. ⋯ Outpatient therapy with either oral ciprofloxacin or intravenous ceftriaxone for fever and neutropenia is effective and safe in pediatric patients with solid tumors and stage I/II non-Hodgkin lymphoma (low-risk patients).