Passive Trust or Active Application: Changes in the Management of Difficult Childbirth and the Edinburgh Royal Maternity Hospital, 1850–1890
نویسنده
چکیده
Forty-six patients with recurrent ovarian cancer were reoperated, and cancer samples for the subrenal capsule assay (SRCA) were collected from 23 of them, whereas this test was not done in the remaining 23 control patients. The SRCA was evaluable in 22 cases (96%). Taken together, no significant difference appeared in the 3 years' survival figures between the groups: seven of 22 patients (32%) with the evaluable SRCA and six of 23 control patients (26%) were alive. However, a further analysis of the data revealed that the SRCA guided the selection of chemotherapy only in 15 patients, whereas tumour samples were resistant to all cytostatics tested in six cases and toxic side-effects limited the clinical application of the test results in the remaining one case. Four of the 11 patients (36%) whose further chemotherapy was strictly chosen based on the SRCA and seven of the 24 patients (29%) whose treatment was based on physician's choice survived at least 3 years. Our conclusion is that the SRCA is of limited value in the selection of second-line chemotherapy in recurrent ovarian cancer. The subrenal capsule assay (SRCA) (Bogden et al., 1981) correctly predicts the response to cytostatic chemotherapy in 63-85% of patients with previously untreated ovarian cancer The situation may differ in cases with recurrent cancer, when cell populations resistant to first-line chemotherapy have become selected out to form clinically detectable tumours (Maenpaa, 1985c). There are some data to suggest that the SRCA could be useful in the selection of the second-line chemotherapy (Griffin et al., 1983; Maenpaa, 1985c), but so far no data exist on improved survival rates in patients whose second-line chemotherapy has been guided by the use of the SRCA. We therefore assessed the value of the SRCA in patients with recurrent ovarian cancer that were followed up to death or for a minimum of 3 years.
منابع مشابه
Report of the Royal Maternity and Simpson Memorial Hospital, for the Quarter Ending 31st January 1890
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عنوان ژورنال:
- Medical History
دوره 50 شماره
صفحات -
تاریخ انتشار 2006