Grade Update

BIO 202
EXW 325 A-
HHS 302
HHS 405 A+
JAC 1
NTR 348

Motherfucking minuses.

Leave Them, We Gotta Go

So in my efforts to be there for people, I sometimes fail. I do this mental triage thing that basically says, "Okay, so who needs the most right at this moment? Who needs the second most? Ok, go." Should the triage instead be "Who matters the most to you at this moment"? It's hard, I guess. It's hard to look at three people, decide that you only have time for two, and just hope the other one understands. Combine this with my abstract concept of time (you'll notice, if you speak to me on the phone, how rarely I can actually say what day something happened on). I find that a week passes by before I realize even a day is gone. I hope that my friends grasp this about me, and that they will grant me their patience.

I hadn't spoken to Erin for a while (relatively), and I thought that she was mad at me, because every time we DID talk, she said very little:

Me: "So how was your day?"
Erin: "Fine."
Me: "...What did you do?"
Erin: "Work."
Me: "Anything happen at work?"
Erin: "No, just work stuff."
Me: "NOTHING happened today?" (this is the point at which my sensibility demands you to recognize at least ONE positive aspect of the day, so learn to identify this question)
Erin: "NO, just work. What do you want me to say?"
Me: "I don't know, SOMETHING"
Erin: "Ok, fine, I woke up, felt like shit, drove to work, got bitched at by my boss, did everyone's work like I always do, then I left work and now I'm talking to you."
Me: "Sounds like fun"
Erin: "Yeah, it was a blast"
Me: "..."
Erin:
Me: "..."
Erin:
Me: "You alright?"
Erin: "..."
Me: "Hello??? Are you alright?"
Erin: "What? Yeah! I'm fine!"
Me: "..."
Erin: "..."

So then I was supposed to go to this Christmas Party with her, but she told me that day that I wasn't going, and that she wasn't mad at me, and that she felt like shit. I felt bad, because I knew what she was doing (thinking that she was doing me a favor by not making me go, even though I actually did want to go), and I knew that there was no way around it. I intended to call her the next day, but some shit went down with Heather, and frankly, I forgot about it. And now it's Wednesday, and I was going to call her before I did anything with Duffy, but she called me first and was pissed off that I hadn't called her. Then she either hang up on me or her phone died (her phone always dies) after I told her about the week.

I wonder if it's better to spread it out or concentrate. It's not quite the 99 vs 1 conundrum that I thought it was (100 sheep, 1 runs away, shepherd leaves the 99 to find the 1, etc etc). I'm okay with that problem, but I find this is distinctly different. This is more like I have 100 sheep on a mountain rim and 3 of them run away. Two of them run straight at a cliff that's still about a mile away, and the other one starts walking down a path into the dark valley below us. Now, do I stop the one that is easiest to stop and then hope that I still have enough time to catch up to the other two? Or do I take off after the other two knowing that it'll be hard, but ultimately possible, to eventually get the third? The choice seems obvious, but the obvious answer is not always the right one.

"But I can't do this all on my own
No, I know I'm no Superman
I'm no Superman"

Superman by Lazlo Bane

Girl for Tonight

So tonight should be really the first test of my assumption regarding Duffy (the assumption being that she is interested). She is going to call me after a little while, and we are going to do something. I have no idea what, but I'm about to clean my room/part of the house in case we end up just chilling out here. She is JUST getting over being sick, so she might not want to go anywhere that requires her to be outside (we tend to walk around shopping centers and the such), so I should probably be ready for just chillin out here. In fact, I should be cleaning now. I was going to quote Mest (hence the title of this entry), but I hate Mest. So here is one of the more hilarious lyrics ever written:

"Whitney, don't you understand that what I say is true?
I just want you to know I have a major crush on you.
I'd drive you to Las Vegas and do the things you wanna do
I'd even have Wayne Newton dedicate a song to you."

San Dimas High School Football Rules by The Ataris

Born to be a Lawyer

http://www.sullivanandcromwell.com/lawyers/detail.aspx?attorney=140

credits to barzelay.net

Johnny Five ALIVE

Took my last final. Finale ultimo. 50 questions. 8 minutes. I'm the bomb.

Here are my reported grades:

HHS405 - A+

No one else has posted any yet. Damn them.

Poor poor Pat Smear

So in working on this final homework for Bio, I wikipediaed "pap smear" and got this helpful suggestion:

"For the similarly named guitar player and actor see Pat Smear"

change your name already

Cervies pt II

Cochrane Library search terms: antioxidant AND cancer

Bioavailability and antioxidant activity of tea flavanols after consumption of green tea, black tea, or a green tea extract supplement.
Author(s) Henning SM, Niu Y, Lee NH, Thames GD, Minutti RR, Wang H, Go VL, Heber D
Source The American journal of clinical nutrition
Date of Publication 2004 Dec
Volume 80
Issue 6
Pages 1558-64
Abstract BACKGROUND: Green and black tea polyphenols have been extensively studied as cancer chemopreventive agents. Many in vitro experiments have supported their strong antioxidant activity. Additional in vivo studies are needed to examine the pharmacokinetic relation of absorption and antioxidant activity of tea polyphenols administered in the form of green or black tea or tea extract supplements. OBJECTIVE: The purpose of this study was to compare the pharmacokinetic disposition of tea polyphenols and their effect on the antioxidant capacity in plasma 8 h after a bolus consumption of either green tea, black tea, or a green tea extract supplement. DESIGN: Thirty healthy subjects were randomly assigned to 3 different sequences of green tea, black tea, or a green tea extract supplement in a 3 x 3 crossover design with a 1-wk washout period in between treatments. RESULTS: Flavanol absorption was enhanced when tea polyphenols were administered as a green tea supplement in capsule form and led to a small but significant increase in plasma antioxidant activity compared with when tea polyphenols were consumed as black tea or green tea. All 3 interventions provided similar amounts of (-)-epigallocatechin-3-gallate. CONCLUSIONS: Our observations suggest that green tea extract supplements retain the beneficial effects of green and black tea and may be used in future chemoprevention studies to provide a large dose of tea polyphenols without the side effects of caffeine associated with green and black tea beverages.

-------------------------------------------

[Enhancement of antioxidant capability of cancer patients during chemotherapy by reduced glutathione]
Author(s) Zhu BD, Li X, Zhao QC, Huang XL
Source Ai zheng = Aizheng = Chinese journal of cancer
Date of Publication 2004 Apr
Volume 23
Issue 4
Pages 452-5
Abstract BACKGROUND & OBJECTIVE: It is unknown how administration of reduced glutathione (GSH) affects chemotherapy of cancer patients. This study was designed to investigate the effect of GSH on lipid peroxidation, and activities of antioxidant enzyme among cancer patients with chemotherapy. METHODS: Sixty-two cancer patients with chemotherapy were enrolled randomly into AB or BA group in cross-over pattern. In AB group, combination of chemotherapy and GSH was administrated first, then following chemotherapy alone was given 21 or 28 days later. In group BA, chemotherapy alone was administrated first, then the combination therapy was given. Duration of chemotherapy was 2-5 days, 21-28 days for a cycle, depended on chemotherapy strategies. GSH was given as a 15 minute intravenous infusion at the dose of 1 500 mgx(m(2)xd)(-1) for 7 days from day 1. Serum samples were collected from the patients on the day just before the chemotherapy, the 7(th) day, and the 21(st) (if 21 days per cycle of the chemotherapy) or 28(th) day of treatment. Concentration of malondialdehyde (MDA), activity of glutathione peroxidase (GSH-Px), and total superoxide dismutase (T-SOD) of serum samples were analyzed biochemically. RESULTS:(1)Administration of chemotherapy significantly increased serum MDA level on the 7(th) day compared with that before chemotherapy (mean+/-SD,6.12+/-1.94 micromol/L versus 4.63+/-1.87 micromol/L,P< 0.01). The increased serum MDA level was restored partially (5.05+/-2.07)micromol/L on the 21(th) or 28(th) day, but still higher than that before chemotherapy (P< 0.05). (2)Serum activity of T-SOD and GSH-Px decreased on the 7(th) day (P< 0.01) and restored partially on the 21(th) or 28th day, but still lower than that before chemotherapy (T-SOD, P< 0.05;GSH-Px,P< 0.01).(3)Co-treatment of GSH prevents lipid peroxidation and depletion of antioxidant enzymes by chemotherapy partially but significantly (P< 0.01). (4)Similar results were obtained in both AB group and BA group. CONCLUSION: Chemotherapy depletes antioxidant capability of cancer patients and co- treatment of GSH might prevent such depletion.

-------------------------------------------

Ganoderma lucidum ("Lingzhi"), a Chinese medicinal mushroom: biomarker responses in a controlled human supplementation study.
Comments Comment in: Br J Nutr. 2004 Feb;91(2):171-3. PMID: 14756900.
Author(s) Wachtel-Galor S, Tomlinson B, Benzie IF
Source The British journal of nutrition
Date of Publication 2004 Feb
Volume 91
Issue 2
Pages 263-9
Abstract Lingzhi (Ganoderma lucidum) is a woody mushroom highly regarded in traditional medicine and is widely consumed in the belief that it promotes health and longevity, lowers the risk of cancer and heart disease and boosts the immune system. However, objective scientific validation of the putative health benefits of Lingzhi in human subjects is lacking, and issues of possible toxicity must be addressed. The present double-blinded, placebo-controlled, cross-over intervention study investigated the effects of 4 weeks Lingzhi supplementation on a range of biomarkers for antioxidant status, CHD risk, DNA damage, immune status, and inflammation, as well as markers of liver and renal toxicity. It was performed as a follow-up to a study that showed that antioxidant power in plasma increased after Lingzhi ingestion, and that 10 d supplementation was associated with a trend towards an improved CHD biomarker profile. In the present study, fasting blood and urine from healthy, consenting adults (n 18; aged 22-52 years) was collected before and after 4 weeks supplementation with a commercially available encapsulated Lingzhi preparation (1.44 g Lingzhi/d; equivalent to 13.2 g fresh mushroom/d) or placebo. No significant change in any of the variables was found, although a slight trend toward lower lipids was again seen, and antioxidant capacity in urine increased. The results showed no evidence of liver, renal or DNA toxicity with Lingzhi intake, and this is reassuring. The present study of the effects in healthy, well-nourished subjects provides useful, new scientific data that will support controlled intervention trials using at-risk subjects in order to assess the therapeutic effect of Lingzhi in the promotion of healthy ageing.

------------------------------------------

A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients.
Comments Comment in: J Natl Cancer Inst. 2005 Apr 6;97(7):468-70. PMID: 15812064.
Author(s) Bairati I, Meyer F, Gélinas M, Fortin A, Nabid A, Brochet F, Mercier JP, Têtu B, Harel F, Mâsse B, Vigneault E, Vass S, del Vecchio P, Roy J
Source Journal of the National Cancer Institute
Date of Publication 2005 Apr
Volume 97
Issue 7
Pages 481-8
Abstract BACKGROUND: Although low dietary intakes of antioxidant vitamins and minerals have been associated with higher risks of cancer, results of trials testing antioxidant supplementation for cancer chemoprevention have been equivocal. We assessed whether supplementation with antioxidant vitamins could reduce the incidence of second primary cancers among patients with head and neck cancer. METHODS: We conducted a multicenter, double-blind, placebo-controlled, randomized chemoprevention trial among 540 patients with stage I or II head and neck cancer treated by radiation therapy between October 1, 1994, and June 6, 2000. Supplementation with alpha-tocopherol (400 IU/day) and beta-carotene (30 mg/day) or placebo began on the first day of radiation therapy and continued for 3 years after the end of radiation therapy. In the course of the trial, beta-carotene supplementation was discontinued after 156 patients had enrolled because of ethical concerns. The remaining patients received alpha-tocopherol or placebo only. Survival was evaluated by Kaplan-Meier analysis. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS: After a median follow-up of 52 months, second primary cancers and recurrences of the first tumor were diagnosed in 113 and 119 participants, respectively. The effect of supplementation on the incidence of second primary cancers varied over time. Compared with patients receiving placebo, patients receiving alpha-tocopherol supplements had a higher rate of second primary cancers during the supplementation period (HR = 2.88, 95% CI = 1.56 to 5.31) but a lower rate after supplementation was discontinued (HR = 0.41, 95% CI = 0.16 to 1.03). Similarly, the rate of having a recurrence or second primary cancer was higher during (HR = 1.86, 95% CI = 1.27 to 2.72) but lower after (HR = 0.71, 95% CI = 0.33 to 1.53) supplementation with alpha-tocopherol. The proportion of participants free of second primary cancer overall after 8 years of follow-up was similar in both arms. CONCLUSIONS: alpha-Tocopherol supplementation produced unexpected adverse effects on the occurrence of second primary cancers and on cancer-free survival.

-------------------------------------------

The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals.
Comments Erratum in: Arch Intern Med. 2005 Feb 14;165(3):286.
Author(s) Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, Roussel AM, Favier A, Briançon S
Source Archives of internal medicine
Date of Publication 2004 Nov
Volume 164
Issue 21
Pages 2335-42
Abstract BACKGROUND: It has been suggested that a low dietary intake of antioxidant vitamins and minerals increases the incidence rate of cardiovascular disease and cancer. To date, however, the published results of randomized, placebo-controlled trials of supplements containing antioxidant nutrients have not provided clear evidence of a beneficial effect. We tested the efficacy of nutritional doses of supplementation with a combination of antioxidant vitamins and minerals in reducing the incidence of cancer and ischemic cardiovascular disease in the general population. METHODS: The Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) study is a randomized, double-blind, placebo-controlled primary prevention trial. A total of 13 017 French adults (7876 women aged 35-60 years and 5141 men aged 45-60 years) were included. All participants took a single daily capsule of a combination of 120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of beta carotene, 100 mug of selenium, and 20 mg of zinc, or a placebo. Median follow-up time was 7.5 years. RESULTS: No major differences were detected between the groups in total cancer incidence (267 [4.1%] for the study group vs 295 [4.5%] for the placebo group), ischemic cardiovascular disease incidence (134 [2.1%] vs 137[2.1%]), or all-cause mortality (76 [1.2%] vs 98 [1.5%]). However, a significant interaction between sex and group effects on cancer incidence was found (P = .004). Sex-stratified analysis showed a protective effect of antioxidants in men (relative risk, 0.69 [95% confidence interval [CI], 0.53-0.91]) but not in women (relative risk, 1.04 [95% CI, 0.85-1.29]). A similar trend was observed for all-cause mortality (relative risk, 0.63 [95% CI, 0.42-0.93] in men vs 1.03 [95% CI, 0.64-1.63] in women; P = .11 for interaction). CONCLUSIONS: After 7.5 years, low-dose antioxidant supplementation lowered total cancer incidence and all-cause mortality in men but not in women. Supplementation may be effective in men only because of their lower baseline status of certain antioxidants, especially of beta carotene.

-------------------------------------------

related to above article
Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels?
Author(s) Galan P, Briançon S, Favier A, Bertrais S, Preziosi P, Faure H, Arnaud J, Arnault N, Czernichow S, Mennen L, Hercberg S
Source The British journal of nutrition
Date of Publication 2005 Jul
Volume 94
Issue 1
Pages 125-32
Abstract The SUpplementation en VItamines et Mineraux AntioXydants (SU.VI.MAX) study, a randomised double-blind, primary-prevention trial showed that after 7.5 years, low-dose antioxidant supplementation lowered the total cancer incidence in men, but not in women. To explain this difference in the impact of antioxidant supplementation in men and women, we hypothesised that the effect of supplementation is dependent on initial antioxidant status; 12 741 French adults (7713 females aged 35--60 years; 5028 males aged 45--60 years) received daily antioxidant supplementation (120 mg vitamin C, 30 mg vitamin E, 6 mg beta-carotene, 100 microg Se, 20 mg Zn daily) or a matching placebo. Cut-off limits for baseline serum concentrations of the different antioxidant vitamins and minerals were defined as follows for both men and women: 0.3 micromol/l for beta-carotene, 11.4 micromol/l for vitamin C, 15 micromol/l for vitamin E, 0.75 micromol/l for Se and 10.7 micromol/l for Zn. The percentage of men with serum concentrations under cut-off limits was higher for vitamins C and E and beta-carotene in those who developed a cancer than in those who did not. The risk of cancer was higher in men with baseline concentrations of serum vitamin C or vitamin E under cut-off limits, but not in women. The effect of supplementation was greater in men with baseline serum concentrations of vitamin C, vitamin E and beta-carotene below the cut-off limits compared with those above it. This effect was maintained only for vitamin E after adjustment for age, tobacco, and alcohol consumption and BMI. No effect of supplementation could be seen in women. Baseline antioxidant status is related to the risk of cancer in men but not in women and therefore does not entirely explain the differences observed in the effect of antioxidant supplementation on cancer risk between sexes in the SU.VI.MAX study.

-------------------------------------------

Effect of bitter melon (Momordica charantia Linn) on level and function of natural killer cells in cervical cancer patients with radiotherapy.
Author(s) Pongnikorn S, Fongmoon D, Kasinrerk W, Limtrakul PN
Source Journal of the Medical Association of Thailand = Chotmaihet thangphaet
Date of Publication 2003 Jan
Volume 86
Issue 1
Pages 61-8
Abstract Cervical cancer patients have a defective immune system. There is a decrease of total white blood cell count including lymphocytes and natural killer (NK) cells. NK cells, one type of lymphocytes, play a role to eliminate cancer cells by antibody dependent cell mediated cytotoxicity (ADCC) mechanism. Previous studies have shown that P-glycoprotein (170 kDa, transmembrane protein) may be a transporter for cytokine releasing in ADCC mechanism. This study proposed to explore the role of bitter melon intake in cervical cancer patients undergoing normal treatment (radiotherapy). Subjects were divided into three groups: 1) normal control (women 35-55 years, n = 35), 2) patient control (n = 30) and 3) patient treatment (n = 30) groups. Patient control and patient treatment groups were cervical cancer patients (stage II or III) treated with radiotherapy (without or with bitter melon ingestion). Blood samples of patient control and patient treatment groups were analyzed for NK cells percentage and P-glycoprotein level. Bitter melon is a Thai herb. Previous studies have shown that bitter melon can stimulate lymphocyte activity in vitro and in vivo (mouse). The authors hope that bitter melon could stimulate the increase of NK cells percentage and P-glycoprotein level on the membrane in blood samples from cervical cancer patients who ingest bitter melon. The results showed an increased percentage of NK cells in patient control and patient treatment groups. The increase in each group is significant (p < 0.05) when compared with the percentage of NK cells from second and third blood sampling time (after radiation with of without bitter melon intake for 45 and 90 days) with first blood sampling time (before treatment). The results also show a significant decrease of P-glycoprotein level (p < 0.05) in second and third blood sampling times when compared with first blood sampling time of the patient treatment group. There was no significant difference of P-glycoprotein (P-gp) level from first, second and third blood sampling times in patient control group. Bitter melon ingestion did not affect NK cell level but it affected the decrease of P-gp level on NK cell membrane.

-------------------------------------------

more to come still

"Confront the dark parts of yourself, and work to banish them with illumination and forgiveness. Your willingness to wrestle with your demons will cause your angels to sing. Use the pain as fuel, as a reminder of your strength.”
- August Wilson

No Shoes Lyrics

No Shoes

(Written by Paranoid Lary, As performed by the Roches)


One, Two Three, Four

I had no shoes
And I complained until I met a man
Who had no feet
That's really beat

I had no feet
And I complained until I met a man
Who had no knees
That was his disease

I had no knees
And I complained until I met a man
And you know what?
He had no butt

I had no butt
And I complained about it all
And then I met a man
Who had no balls

I had no balls
And I complained until I met a man
Who had no guts
No balls, no butt, and now no guts

I had no guts
And I complained until I met a man
Who had no heart
The most important part

I had no heart
And I complained, I did not understand
And then I met a man
Who had no hands

I had no hands
And I complained until I met a man
Who was a wreck
He had no neck

I had no neck
And I complained until I met a man
Who had no chin
Some folks lose, some folks win (Ahhhh)

I had no chin
And I complained until I met a man
Who had no nose
That really blows

I had no nose
And I complained until I met a man
Who never cries
He had no eyes

I had no eyes
And I complained until I met a man
Who felt no pain
He had no brain

I had no brain
And I complained until I met a man
Who had no head
As good as dead

I had no head
And I complained until I met a man
Who had no hair
There was nothing there

I had no hair
And I complained until I met a man
Who had no hat
Picture that. Not even a hat (Ahhhh)

I had no hat (had no hat? no hat!)
And I complained until I met a man
Who had no sky (no sky)
No reason why

I had no sky (why?)
And I complained until I met a man
Who had no stars (he had no stars?)
No Venus or Mars (no Venus or Mars?)

And not any stars!

I had no stars
And I complained until I met a man
Who had no God
That's rather odd

I had no God
And I complained until I met a man
Who had no faith
Nothing just in case

I had no faith
And I complained until I met a man
Who had no love
Nothing to dream of

I had no love
And I complained until I met a man
Who had no hope
At the end of his rope

I had no hope
And I complained until I met a man
Who had no luck
That really sucks

I had no luck
And I complained that I had nothing left to lose
And then I met a man
Who had no shoes... (Ahhhh)

Cervies

National Cancer Institute, US National Institutes of Health "General Information About Cervical Cancer"
http://www.cancer.gov/cancertopics/pdq/treatment/cervical/Patient/page1

------------------------------------------

American Cancer Society "What Is Cervical Cancer?"
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_cervical_cancer_8.asp

------------------------------------------

A Major Constituent of Green Tea, EGCG, Inhibits the Growth of a Human Cervical Cancer Cell Line, CaSki Cells, through Apoptosis, G1 Arrest, and Regulation of Gene Expression
http://www.liebertonline.com/doi/abs/10.1089/104454903321655846?cookieSet=1&journalCode=dna

(You can buy green tea extract caps that have a shit ton of EGCG in them)

------------------------------------------

Surgery for cervical intraepithelial neoplasia

PL Martin-Hirsch, E Paraskevaidis, H Kitchener

Cochrane Database of Systematic Reviews 2007 Issue 4
Copyright © 2007 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
DOI: 10.1002/14651858.CD001318 This version first published online: 26 July 1999 in Issue 3, 1999
Date of Most Recent Substantive Amendment: 19 May 1999

This record should be cited as: Martin-Hirsch PL, Paraskevaidis E, Kitchener H. Surgery for cervical intraepithelial neoplasia. Cochrane Database of Systematic Reviews 1999, Issue 3. Art. No.: CD001318. DOI: 10.1002/14651858.CD001318.

Abstract

Background
Cervical intra-epithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the severity of the disease.

Objectives
The objective of this review was to assess the effects of alternative surgical treatments for cervical intra-epithelial neoplasia.

Search strategy
We searched the Cochrane Gynaecological Cancer Group trials register and MEDLINE up to July 1997. Update: in July 2004 a further search was conducted.

Selection criteria
Randomised and quasi-randomised trials of alternative surgical treatments in women with cervical intra-epithelial neoplasia.

Data collection and analysis
Trial quality was assessed and two reviewers abstracted data independently.

Main results
Twenty eight trials were included. Seven surgical techniques were tested in various comparisons. No significant difference in eradication of disease was shown, other than between laser ablation and loop excision. This was based on one trial where the quality of randomisation was doubtful. Large loop excision of the transformation zone appeared to provide the most reliable specimens for histology with the least morbidity. Morbidity was lower than with laser conisation, although all five trials did not provide data for every outcome. There were not enough data to assess the effect on morbidity compared with laser ablation.

Authors' conclusions
The evidence suggests that there is no obviously superior surgical technique for treating cervical intra-epithelial neoplasia.

-----------------------------------------------

Cochrane Library search terms "cancer alternative medicine"

Randomized trial of neoadjuvant chemotherapy comparing paclitaxel, ifosfamide, and cisplatin with ifosfamide and cisplatin followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the SNAP01 (Studio Neo-Adjuvante Portio) Italian Collaborative Study.

Author(s) Buda A, Fossati R, Colombo N, Fei F, Floriani I, Gueli Alletti D, Katsaros D, Landoni F, Lissoni A, Malzoni C, Sartori E, Scollo P, Torri V, Zola P, Mangioni C

Source Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Date of Publication 2005 Jun
Volume 23
Issue 18
Pages 4137-45

Abstract PURPOSE: Neoadjuvant chemotherapy may represent an alternative to irradiation in locally advanced squamous cell cervical cancer. Aims of this study were to compare a three-drug (paclitaxel, ifosfamide, and cisplatin [TIP]) with a two-drug (ifosfamide and cisplatin [IP]) regimen and to assess the prognostic value of pathologic response on survival. PATIENTS AND METHODS: Patients (n = 219) were randomly assigned to ifosfamide 5 g/m(2) during 24 hours plus cisplatin 75 mg/m(2), or paclitaxel 175 mg/m(2) plus ifosfamide 5 g/m(2) during 24 hours and cisplatin 75 mg/m(2) every 3 weeks for three courses. RESULTS: Grades 3 to 4 neutropenia, anemia, and thrombocytopenia were more frequent with TIP. We recorded four deaths related to toxicity. The optimal pathologic response (OPT) rate (residual disease < 3 mm stromal invasion) was higher with TIP than with IP (48% v 23%; odds ratio, 3.22; 95% CI, 1.69 to 5.88; P = .0003). At a median follow-up of 43.4 months, 79 women experienced disease progression or died (46 in the IP arm, 33 in the TIP arm). Patients receiving TIP experienced a treatment failure rate 25% less than those receiving IP, but this difference was not statistically significant (hazard ratio [HR], 0.75; 95% CI, 0.48 to 1.17; P = .20). Sixty-one patients died (37 in the IP arm, 24 in the TIP arm), and the HR of death was in favor of TIP, although not significantly (HR, 0.66; 95% CI, 0.39 to 1.10; P = .11). In patients assessable for response (n = 189), the average death rates were higher in the group that did not achieve OPT (HR, 5.88; 95% CI, 2.50 to 13.84; P < .0001). CONCLUSION: The TIP regimen is associated with a higher response rate than the IP regimen, without a statistically significant effect on overall survival. OPT was a prognostic factor for survival.

----------------------------------------------

Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multicenter randomized study.

J Clin Oncol. 2002 Jun 15;20(12):2908-9; author reply 2809-10. PMID: 12065571.
Author(s) Benedetti-Panici P, Greggi S, Colombo A, Amoroso M, Smaniotto D, Giannarelli D, Amunni G, Raspagliesi F, Zola P, Mangioni C, Landoni F
Source Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Date of Publication 2002 Jan
Volume 20
Issue 1
Pages 179-88

Abstract PURPOSE: Neoadjuvant chemotherapy (NACT) and radical surgery (RS) have emerged as a possible alternative to conventional radiation therapy (RT) in locally advanced cervical carcinoma. In 1990, a phase III trial was undertaken to verify such a hypothesis in terms of survival and treatment-related morbidity. PATIENTS AND METHODS: Patients with squamous cell, International Federation of Gynecology and Obstetrics stage IB2 to III cervical cancer were eligible for the study. They received cisplatin-based NACT followed by RS (type III to V radical hysterectomy plus systematic pelvic lymphadenectomy) (arm A) or external-beam RT (45 to 50 Gy) followed by brachyradiotherapy (20 to 30 Gy) (arm B). RESULTS: Of 441 patients randomly assigned to NACT+RS or RT, eligibility was confirmed in 210 and 199 patients, respectively. Treatment was administered according to protocol in 76% of arm A patients and 72% of arm B patients. Adjuvant treatment was delivered in 48 operated patients (29%). There was no evidence for any significant excess of severe morbidity in one of the two arms. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 58.9% and 55.4% for arm A and 44.5% and 41.3% for arm B (P =.007 and P =.02), respectively. Subgroup survival analysis shows OS and PFS rates of 64.7% and 59.7% (stage IB2-IIB, NACT+RS), 46.4% and 46.7% (stage IB2-IIB, RT) (P =.005 andP =.02), 41.6% and 41.9% (stage III, NCAT+RS), 36.7% and 36.4% (stage III, RT) (P =.36 and P =.29), respectively. Treatment had a significant impact on OS and PFS. CONCLUSION: Although significant only for the stage IB2 to IIB group, a survival benefit seems to be associated with the NACT+RS compared with conventional RT.

----------------------------------------------

to continue

"Pain is inevitable. Suffering is optional."
M. Kathleen Casey

Sugar and Spice and Cool As Ice

I was going to buy her a get well card and maybe a flower, but once I got to the Hallmark store, I had to change my strategy. All of their get well cards sucked. So instead, I bought like three of those cards that play music when you open them, and two non musical cards. The music ones included a Buffy the Vampire Slayer birthday, a Grey's Anatomy "hope your life is going alright" card, and a Blazin' Saddles "you have hot tittayz" card. The other two included a fold up that had three pictures of a cat dangling from a branch, and a lame ass get well soon card with some noodle assed chicken. I wrote a tiny note in each one, and a poem in the chicken noodies one. Then I found this cute whale named "Spirtle" that made a sneezing sound, and I wrote "Get WHALE Soon!!!" on its tag thing. I threw all this shiz in a giftbag and left it at her door (she wasn't home at the time). She called me later and we spoke for like an hour or something on the phone about all sorts of crap. If I'm not in by now, then what the frik?

"With all regards,
and regardless of these cards,
I hope you feel better soon."

First Stanza, Healing Poem by Nathies