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1.
ME BURGE AM JOSHUA CM McNEIL R HUI MJ BOYER R ABRAHAM 《Asia-Pacific Journal of Clinical Oncology》2005,1(1):47-52
Background: Pemetrexed and cisplatin have recently been shown to significantly improve survival compared with cisplatin alone. However, there are only limited data reflecting teaching hospital experience outside a clinical trial. Pemetrexed has only been available in Australia on a restricted basis since 2002. We reviewed our experience of patients treated on the Australian ‘Special Access Scheme’ at three major thoracic oncology units. Methods: Charts were reviewed for all patients enrolled on the scheme. Data was extracted on age, World Health Organization (WHO) performance status, histology, prior therapy, time from diagnosis to starting pemetrexed, chemotherapy (pemetrexed alone or with a platinum), cycle number, response rate, actuarial progression‐free and overall survival. Doses were cisplatin 75 mg/m2 or carboplatin AUC = 5 and pemetrexed 500 mg/m2 every 21 days. Results: 52 patients (32 male and 20 female) were reviewed. Median age was 58 years and 88% were WHO 0–1. Histology included 54% epithelial, 17% biphasic (epithelial and sarcomatoid) and 21% undefined. The median time from diagnosis to administration of pemetrexed was 145 days. Sixty‐five percent had minimal surgical intervention with video assisted thoracoscopy, pleurodesis and biopsy, while 19% had received prior palliative radiation. Seventy‐one percent were chemotherapy naïve, the remaining 29% having received previous platinum and/or gemcitabine regimens. Twenty‐three percent had pemetrexed alone, 35% in combination with carboplatin and 42% with cisplatin. The median number of cycles was 4 (range 1–13). The response rate was 33%. No toxicity was observed in 20% grade 3–4 toxicity in 10% (majority nausea/vomiting). The median progression‐free and overall survival times from starting pemetrexed were 184 days and 298 days, respectively. Conclusions: Pemetrexed‐based regimens are safe and effective in a community setting in malignant mesothelioma. 相似文献
2.
Pertice M Moffitt 《Journal of transcultural nursing》2004,15(4):323-330
Childbirth for many Aboriginal women living in remote communities of the Northwest Territories, Canada, includes separation from their family and community for weeks at a time. This colonialization of childbirth, enforced for decades, is true for Dogrib Dene. Colonialization produces serious social consequences on the everyday lives of pregnant Aboriginal women, which results in lower health outcomes. This article provides a literature review of colonialization in Canada's far north establishing the position that colonialization is a determinant of health. The purpose of this article is to generate knowledge that will inform health professionals and ultimately reduce health disparities as experienced and evident among Dogrib women. By highlighting the concept of colonialization and establishing this concept as a determinant of health, nurses and midwives will identify disparities created through stressors of power and control. From there, culturally meaningful health promotion strategies will be developed and implemented within their nursing practice. 相似文献
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