Objectives: Glioblastoma(GBM) is one of the worst cancers in terms of prognosis.Standard therapy consists of resection with concomitant chemoradiotherapy.Resistance to nimustine hydrochloride(ACNU),an alkylating agent...Objectives: Glioblastoma(GBM) is one of the worst cancers in terms of prognosis.Standard therapy consists of resection with concomitant chemoradiotherapy.Resistance to nimustine hydrochloride(ACNU),an alkylating agent,has been linked to methylguanine DNA methyltransferase(MGMT).Daily administration of procarbazine(PCZ) has been reported to decrease MGMT activity.This study investigated the efficacy of ACNU + PCZ compared to ACNU alone for GBM and anaplastic astrocytoma(AA).Methods: Patients(20-69 years) who had newly diagnosed AA and GBM were randomly assigned to receive radiotherapy with ACNU alone or with ACNU + PCZ.The primary endpoint was overall survival(OS).This was designed as a phase Ⅱ/Ⅲ trial with a total sample size of 310 patients and was registered as UMIN-CTR C000000108.Results: After 111 patients from 19 centers in Japan were enrolled,this study was terminated early because temozolomide was newly approved in Japan.The median OS and median progression-free survival(PFS) with ACNU alone(n = 55) or ACNU + PCZ(n = 56) in the intention-to-treat population were 27.4 and 22.4 months(P = 0.75),and 8.6 and 6.9 months,respectively.The median OS and median PFS of the GBM subgroup treated with ACNU alone(n = 40) or ACNU + PCZ(n = 41) were 19.0 and 19.5 months,and 6.2 and 6.3 months,respectively.Grade 3/4 hematologic adverse events occurred in more than 40% of patients in both arms,and 27% of patients discontinued treatment because of adverse events.Conclusions: The addition of PCZ to ACNU was not beneficial,in comparison with ACNU alone,for patients with newly diagnosed AA and GBM.展开更多
Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
文摘Objectives: Glioblastoma(GBM) is one of the worst cancers in terms of prognosis.Standard therapy consists of resection with concomitant chemoradiotherapy.Resistance to nimustine hydrochloride(ACNU),an alkylating agent,has been linked to methylguanine DNA methyltransferase(MGMT).Daily administration of procarbazine(PCZ) has been reported to decrease MGMT activity.This study investigated the efficacy of ACNU + PCZ compared to ACNU alone for GBM and anaplastic astrocytoma(AA).Methods: Patients(20-69 years) who had newly diagnosed AA and GBM were randomly assigned to receive radiotherapy with ACNU alone or with ACNU + PCZ.The primary endpoint was overall survival(OS).This was designed as a phase Ⅱ/Ⅲ trial with a total sample size of 310 patients and was registered as UMIN-CTR C000000108.Results: After 111 patients from 19 centers in Japan were enrolled,this study was terminated early because temozolomide was newly approved in Japan.The median OS and median progression-free survival(PFS) with ACNU alone(n = 55) or ACNU + PCZ(n = 56) in the intention-to-treat population were 27.4 and 22.4 months(P = 0.75),and 8.6 and 6.9 months,respectively.The median OS and median PFS of the GBM subgroup treated with ACNU alone(n = 40) or ACNU + PCZ(n = 41) were 19.0 and 19.5 months,and 6.2 and 6.3 months,respectively.Grade 3/4 hematologic adverse events occurred in more than 40% of patients in both arms,and 27% of patients discontinued treatment because of adverse events.Conclusions: The addition of PCZ to ACNU was not beneficial,in comparison with ACNU alone,for patients with newly diagnosed AA and GBM.
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
