Carboplatin

To evaluate intraoperative irradiation (IORT) as a method of limb spare with preservation of the radiocarpal joint. Prospective case series. Dogs (n=5) with stage II sarcoma of the distal aspect of the radius. A bone segment containing the tumor was isolated surgically, treated by IORT, reimplanted, and secured by internal fixation. In 1 dog, the postradiation tumor bed was curetted and filled with bone cement. Dogs were administered alternating adriamycin and carboplatin starting 2 weeks after IORT and monitored at regular intervals. Four dogs had osteosarcoma and 1 had undifferentiated sarcoma. Implant failure (n=3), deep tissue infection (3), and pathologic fracture (3) resulted in amputation (3) or pancarpal plating (2). The dog with undifferentiated sarcoma was euthanatized because of suspected tumor recurrence 4 months postoperatively. Osteotomy healing was documented by radiography (1), histopathology (2), or by direct observation (2). A technique for limb-sparing surgery of the distal portion of the radius in dogs using IORT had advantages include healing of the autograft and a source for a perfectly fitting autograft but did not appear to offer any advantage with respect to infection rate. Long-term preservation of the radiocarpal joint was not successful. It was not possible to preserve the function of the radiocarpal joint and so this technique cannot be recommended currently. Further study is needed to evaluate whether or not IORT can be considered in combination with pancarpal plating and possibly curettage and cementation of the tumor to prevent subchondral bone collapse.

Platinum-based doublet chemotherapy is the standard first-line treatment for advanced non-small cell lung cancer (NSCLC), but earlier studies have suggested that non-platinum combinations are equally effective and better tolerated. We conducted a national, randomised study to compare a non-platinum with a platinum combination. Eligible patients had stage IIIB/IV NSCLC and performance status (PS) 0-2. Patients received up to three cycles of vinorelbine 60 mg m(-2) p.o.+gemcitabine 1000 mg m(-2) i.v. day 1 and 8 (VG) or vinorelbine 60 mg m(-2) p.o. day 1 and 8+carboplatin area under the curve=5 (Calvert's formula) i.v. day 1 (VC). Patients ≥75 years received 75% of the dose. Endpoints were overall survival, health-related quality of life (HRQoL), toxicity, and the use of radiotherapy. We randomised 444 patients from September 2007 to April 2009. The median age was 65 years, 58% were men and 25% had PS 2. Median survival was VG: 6.3 months; VC: 7.0 months, P=0.802. Vinorelbine plus...