Tumori
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Several pediatric tumors require mutilating procedures in order to be treated effectively. Although the pain caused by the surgery is usually of a transient nature, the perception of pain in the amputated limb may persist. This prolonged pain, which is often refractory to pain-killing medication, may severely affect the patient's quality of life. The phenomenon of phantom limb pain (or phantom limb syndrome) has been investigated using neurological, neurophysiological and psychopathological approaches. Here we discuss the advantages of an unconventional rehabilitation technique, the recently reported mirror therapy, whose positive effects might be due, according to some researchers, to neuronal plasticity mechanisms. ⋯ The reported case highlights the value of an integrated multidisciplinary approach including neurological/physiatric assessment, clinical psychological support, physiotherapy and other, unconventional treatment modalities. This report should guide future studies towards the application of mirror therapy in order to elucidate its effects and efficacy.
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Lapatinib in combination with capecitabine is feasible in patients with HER2-positive metastatic breast cancer pretreated with anthracyclines, taxanes and trastuzumab, but inferior results were reported in the global lapatinib expanded access program in comparison with the phase III registration trial. ⋯ Our data confirm that lapatinib plus capecitabine is an active regimen even in heavily pretreated patients with visceral and brain metastases and is feasible and active also in selected elderly patients.
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The purpose of the study was to identify predictive factors of tumor response to preoperative chemoradiotherapy for rectal adenocarcinoma. ⋯ Pretreatment carcinoembryonic antigen level, tumor mobility and circumferential extent of tumor may be helpful in predicting responsiveness in rectal adenocarcinoma to preoperative chemoradiotherapy, although the results should be confirmed in larger, more homogeneous studies.
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When there is little hope of a clinical benefit, too delayed a withdrawal from chemotherapy might be detrimental for a patient's quality of life. We evaluated appropriately timed cessation of chemotherapy in our Oncology Department after integration of a Supportive and Palliative Care Unit. ⋯ Supportive and Palliative Care Unit integration decreased chemotherapy use in the last 30 days of life. A careful evaluation of prognostic factors of advanced cancer patients and provision of appropriate supportive and palliative cares can reduce the use of futile anticancer chemotherapy and preserve a patient's qualify of life.
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Although pituitary adenoma is a primary brain tumor that occasionally accompanies intratumoral hemorrhage, there are little reports about the molecular mechanism of intratumoral bleeding in pituitary adenoma. Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis and vascular permeability of various brain tumors. The authors studied the relationship between intratumoral hemorrhage and the expression of VEGF in human pituitary adenomas. ⋯ This study suggests that VEGF expression may be responsible for intratumoral hemorrhage of pituitary adenomas. Therefore, VEGF can be a novel target to prevent a catastrophic apoplexy in pituitary adenomas and to establish roles in angiogenesis-based therapeutics of pituitary adenomas.