PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.
Antineoplastic Combined Chemotherapy Protocols ; Clinical Protocols ; Cytarabine ; Etoposide ; Eye ; Humans ; Intensive Care Units ; Methotrexate

OBJECTIVETo observe treatment response, survival, safety and the improvement of ECOG in patients with refractory multiple myeloma (MM) with serious heart failure after the administration of continuous low-dose of cyclophosphamide combined with prednisone (CP).

METHODSFrom January 2005 to September 2013, a total of 75 patients were treated by metronomic chemotherapy with continuous low-dose cyclophosphamide (50 mg/d) and prednisone (15 mg/d).

RESULTSAmong the 75 patients, 2 were lost for follow-up. In the 73 available patients, the overall response was 64.4%, including 2 patients (2.7%) with complete remission (CR), 4 cases (5.5%) very good partial remission (VGPR), and 24 patients (32.9%) partial remission (PR). The median survival was 12 months (1-70 months) with a median onset time of 90 days (16-120) and a median progressive freedom survival of 12 months (1-60). The level of B-type natriuretic peptide in responders declined significantly, as compared to no responders [(336.6 ± 30.3) ng/L vs (906.4 ± 104.8) ng/L, P<0.01]. Common adverse events were as follows: 32 (43.8%) cases of bone marrow suppression, 26 (35.6%) cases of infection, 8 cases of dizzy as well as sleepiness (11.0%), 7(9.6%) cases of Cushing syndrome, 4 (5.5%) cases of secondary diabetes mellitus, and 3 (4.1%) cases of edema respectively.

CONCLUSIONThe metronomic chemotherapy of cyclophosphamide combined with prednisone had satisfactory impact on the treatment outcome, including the improvement of cardiac functions and physical capacities, better survival and safety in refractory MM with serious heart failure. It provides a novel regimen for such patients.

Antineoplastic Combined Chemotherapy Protocols ; Clinical Protocols ; Cyclophosphamide ; Heart Failure ; Humans ; Multiple Myeloma ; Prednisone ; Remission Induction ; Treatment Outcome

OBJECTIVETo investigate the clinical manifestations, diagnosis, and treatment of peripheral primitive neuroectodermal tumor (pPNET) in children and the survival of patients treated with the CCG7942/POG9354 protocol.

METHODSA retrospective analysis was performed on the clinical data of 10 patients with pPNET admitted from October 2008 to October 2013. Of the 10 patients, 3 had metastasis, while others had no metastasis. The 7 patients without metastasis were treated with the Children's Cancer Study Group 7942 (CCG7942) protocol, and the other 3 patients with metastasis with the Pediatric Oncology Group 9354 (POG9354) protocol. The therapeutic response and chemotherapy-related toxicities were evaluated by WHO criteria and Common Terminology Criteria for Adverse Events (version 4.0).

RESULTSIn the 7 patients treated with the CCG7942 protocol, 4 achieved a complete remission (CR), 1 had stable disease, 2 developed progressive disease (PD), and 2 had recurrence. In the 3 patients treated with the POG9354 protocol, 1 achieved a CR, 2 developed PD, 2 had recurrence, and 2 died. For the 7 patients without metastasis, the survival time was 5-60 months, and the event-free survival rate was 71%. For the 3 patients with metastasis, the survival time was 13-25 months, and the event-free survival rate was 33%. All patients developed grade 4 bone marrow suppression, and other grade 1-2 toxicities, including gastrointestinal reactions, liver function impairment, and renal function impairment, were also seen.

CONCLUSIONSCCG7942 protocol is effective and safe for children with non-metastatic pPNET. However, POG9354 protocol has unsatisfactory efficacy in children with metastatic pPNET, so further studies are needed to improve the therapy for this disease.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Clinical Protocols ; Female ; Humans ; Infant ; Male ; Neuroectodermal Tumors, Primitive, Peripheral ; drug therapy ; Retrospective Studies

OBJECTIVETo study the long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia (ALL).

METHODSThree hundred and eighteen children who were newly diagnosed with ALL between January 1999 and December 2007 were enrolled in this study. Among the 318 children, 83 children who hospitalized before December 2002 were treated with CAMSBDH-ALL99 protocol, including 48 patients of standard risk and 35 patients of high risk. The patients (n=235; 131 in standard risk and 104 in high risk) who hospitalized after December 2002 were treated with CAMSBDH-ALL03 protocol. Patients in the CAMSBDH-ALL99 protocol group were treated with conventional chemotherapy. CAMSBDH-ALL03 protocol was modified based on the CAMSBDH-ALL99 protocol.

RESULTSThe long-term overall survival (OS) and event-free-survival (EFS) in the CAMSBDH-ALL03 group was significantly higher than in the CAMSBDH-ALL99 (P<0.01). The long-term OS and EFS of standard risk and high risk patients in the CAMSBDH-ALL03 protocol group were significantly higher than in the CAMSBDH-ALL99 protocol group (P<0.01). The CAMSBDH-ALL03 protocol group showed a significantly lower recurrence rate (28.9%) than in the CAMSBDH-ALL99 protocol group (50.6%) (P<0.05). The mortality rate in the CAMSBDH-ALL03 protocol group was 28.5% vs 56.6% in the CAMSBDH-ALL99 protocol group (P<0.05).

CONCLUSIONSThe therapeutic effect of the CAMSBDH-ALL03 protocol is supior to the CAMSBDH-ALL99 protocol group for childhood ALL, with a higher long-term survival rate.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Clinical Protocols ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; mortality ; Recurrence

BACKGROUND: Combination treatment with all-trans-retinoic acid (ATRA) and anthracycline-based chemotherapy has led to major advances in the treatment of acute promyelocytic leukemia (APL). METHODS: In this study, we reviewed the outcome of pediatric APL patients treated using a modified AIDA protocol at our institution. RESULTS: Between May 1999 and December 2007, 23 patients were diagnosed with APL at the Department of Pediatrics, Saint Mary's Hospital, The Catholic University of Korea. Eleven patients were male (48%) (median age at diagnosis, 11 (range, 2-14) years). The treatment protocol consisted of remission induction (achieved by coadministration of ATRA and idarubicin), 3 courses of consolidation treatment, and 2 years of maintenance treatment during which ATRA was also administered. Three patients died early during remission induction due to CNS hemorrhage. The remaining 20 patients achieved complete remission (CR), with an overall CR rate of 87%. Two patients relapsed and died, and another patient died of pneumonia unrelated to APL. Four patients (17%) were diagnosed with ATRA syndrome, and all patients showed resolution of symptoms. The event-free survival (EFS) and overall survival (OS) of the cohort were 78.3+/-8.6% and 76.3+/-9.5%, respectively. Initial WBC count at diagnosis was the only significant prognostic factor for the rate of CR (P=0.039) and OS (P=0.039). CONCLUSION: A modified AIDA protocol for the treatment of childhood APL leads to improved EFS and OS, with limited ATRA syndrome-associated toxicity. Active monitoring and treatment of patients with high initial WBC counts may help in reducing mortality.
Antineoplastic Combined Chemotherapy Protocols ; Child ; Clinical Protocols ; Cohort Studies ; Disease-Free Survival ; Hemorrhage ; Humans ; Idarubicin ; Korea ; Leukemia, Promyelocytic, Acute ; Male ; Pediatrics ; Pneumonia ; Remission Induction ; Saints ; Tretinoin

Currently there is considerable interest among oncologists to find anticancer drugs in Chinese herbal medicine (CHM). In the past, clinical data showed that some herbs possessed anticancer properties, but western scientists have doubted the scientific validity of CHM due to the lack of scientific evidence from their perspective. Recently there have been encouraging results, from a western perspective, in the cancer research field regarding the anticancer effects of CHM. Experiments showed that CHM played its anticancer role by inducing apoptosis and differentiation, enhancing the immune system, inhibiting angiogenesis, reversing multidrug resistance (MDR), etc. Clinical trials demonstrated that CHM could improve survival, increase tumor response, improve quality of life, or reduce chemotherapy toxicity, although much remained to be determined regarding the objective effects of CHM in human in the context of clinical trials. Interestingly, both laboratory experiments and clinical trials have demonstrated that when combined with chemotherapy, CHM could raise the efficacy level and lower toxic reactions. These facts raised the feasibility of the combination of herbal medicines and chemotherapy, although much remained to be investigated in this area.
Antineoplastic Agents, Phytogenic ; pharmacology ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Clinical Trials as Topic ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; methods ; Clinical Trials as Topic ; Disease-Free Survival ; Humans ; Neoadjuvant Therapy ; methods ; Neoplasm Staging ; Stomach Neoplasms ; drug therapy ; pathology ; surgery ; Survival Rate

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Disease-Free Survival ; Dose Fractionation ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Staging ; Radiotherapy, Intensity-Modulated ; Randomized Controlled Trials as Topic ; Survival Rate

OBJECTIVETo compare the efficacy of gemcitabine (GEM) alone and gemcitabine based combination chemotherapy (GEMCOM) on advanced pancreatic cancer.

METHODSKeywords Phase III, gemcitabine and pancreatic cancer were used to search and collect Phase III-randomized references about gemcitabine and gemcitabine-based combination chemotherapy applied on advanced pancreatic cancer. A references-based meta-analysis was made to compare the efficacy between GEM and GEMCOM. Before that, test for heterogeneity was committed. Fixed effect model was used if the I(2) ≤ 50%, and random effect model was used if not. The evaluating indicators were overall response rate and 1-year survival rate.

RESULTSThere were 14 randomized controlled trial (RCT) and 10 RCT enrolled in overall response rate analysis and 1-year survival rate analysis, respectively. Results of meta-analysis showed that, arm GEMCOM's overall response rate and 1-year survival rate were higher than arm GEM's (z = 2.190, P = 0.028 vs. z = 4.400, P = 0.000). The differences were significant. The biases of the results were tested by Egger-test. The tests showed that no bias exists in both of two meta-analysis (t = 0.070, P = 0.946 and t = -0.740, P = 0.483) respectively.

CONCLUSIONThere is a possibility that the gemcitabine-combination is more effective than the gemcitabine on overall response rate and 1-year survival rate.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Clinical Trials, Phase III as Topic ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; therapeutic use ; Humans ; Pancreatic Neoplasms ; drug therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

OBJECTIVE: To retrospectively analyze clinical characteristics and survival time of patients with diffuse large B-cell lymphoma (DLBCL), detect prognosis-related markers, and establish a nomogram prognostic model of clinical factors combined with biomarkers. METHODS: One hundred and thirty-seven patients with DLBCL were included in this study from January 2014 to March 2019 in the First Affiliated Hospital of Nanchang University. The expression of GCET1, LMO2, BCL-6, BCL-2 and MYC protein were detected by immunohistochemistry (IHC), then the influences of these proteins on the survival and prognosis of the patients were analyzed. Univariate and multivariate Cox regression analysis were used to gradually screen the prognostic factors in nomogram model. Finally, nomogram model was established according to the result of multivariate analysis. RESULTS: The positive expression of GCET1 protein was more common in patients with Ann Arbor staging I/II (P =0.011). Compared with negative patients, patients with positive expression of LMO2 protein did not often show B symptoms (P =0.042), and could achieve better short-term curative effect (P =0.005). The overall survival (OS) time of patients with positive expression of LMO2 protein was significantly longer than those with negative expression of LMO2 protein (P =0.018), though the expression of LMO2 protein did not correlate with progression-free survival (PFS) (P >0.05). However, the expression of GCET1 protein had no significant correlation with OS and PFS. Multivariate Cox regression analysis showed that nomogram model consisted of 5 prognostic factors, including international prognostic index (IPI), LMO2 protein, BCL-2 protein, MYC protein and rituximab. The C-index applied to the nomogram model for predicting 4-year OS rate was 0.847. Moreover, the calibrated curve of 4-year OS showed that nomogram prediction had good agreement with actual prognosis. CONCLUSION The nomogram model incorporating clinical characteristics and IHC biomarkers has good discrimination and calibration, which provides a useful tool for the risk stratification of DLBCL.
Humans ; Prognosis ; Nomograms ; Immunohistochemistry ; Retrospective Studies ; Clinical Relevance ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Rituximab/therapeutic use* ; Proto-Oncogene Proteins c-bcl-2 ; Transcription Factors ; Antineoplastic Combined Chemotherapy Protocols