Summary The purpose of this systematic study was to provide an up to date and reliable quantitative summary of the relative benefits of various types of chemotherapy (non-platinum vs platinum, single-agent vs combination and carboplatin vs cisplatin) in the treatment of advanced ovarian cancer. Also, to investigate whether well-defined patient subgroups benefit more or less from cisplatin-or carboplatinbased therapy. Meta-analyses were based on updated individual patient data from all available randomized controlled trials (published and unpublished), including 37 trials, 5667 patients and 4664 deaths. The results suggest that platinum-based chemotherapy is better than nonplatinum therapy, show a trend in favour of platinum combinations over single-agent platinum, and suggest that cisplatin and carboplatin are equally effective. There is no good evidence that cisplatin is more or less effective than carboplatin in any particular subgroup of patients.Keywords: meta-analysis; systematic review; randomized controlled trials; advanced ovarian cancer; chemotherapy Health care professionals and patients alike are becoming increasingly aware of the need to make medical decisions on the basis of up-to-date, objective and unbiased research (Chalmers and Haynes, 1994). The most reliable information results from randomized controlled trials (RCTs). Unfortunately, most RCTs, including those conducted in ovarian cancer, have been too small to demonstrate moderate treatment benefits with reliability, and many results have been inconclusive or contradictory. The Advanced Ovarian Cancer Trialists Group (AOCTG) recognized that the best means of synthesizing such randomized evidence is by systematic meta-analysis. In 1988, five meta-analyses of chemotherapy in advanced ovarian cancer using updated individual patient data were initiated. The first results were published in 1991 (AOCTG, 1991). The AOCTG recognized the importance of updating these results especially for the comparison of carboplatin and cisplatin, in which the data were relatively immature. The comparison of platinum analogues was considered of such clinical importance that further new investigations were initiated to identify whether any particular type of women or tumour would benefit more from either cisplatin-or carboplatin-based chemotherapy. PATIENTS AND METHODSTrials were eligible for inclusion provided they examined first-line chemotherapy for advanced ovarian cancer, were properly randomized and made one of the treatment comparisons described below. Trials were identified by bibliographic searches using MEDLINE and CancerLit, by hand searching relevant meeting proceedings and by consulting trial registers (AOCTG, 1991). Both published and unpublished trials were included and updated data were sought for all randomized patients. All data were checked thoroughly and the final database entries for each trial were verified by the responsible trialist or data centre.All analyses were based on intention to treat. Survival analyses were stratified by trial, and t...

a y l o r , MS William W o l b e r g , MD James S t e w a r t , MS Richard V. S m a l l e y , MD Kris B o s w o r t h , PhDABSTRACT. A computer-based support system was developed t o help women cope with the crisis of breast cancer. The system, called JOURNAL OF PSYCHOSOCIAL ONCOLOGYcontains integrated information, referral, decision, and social support programs. It was developed with intensive input from potential users through needs-assessment surveys and field testing. This article reports on the results of two pilot studies involving 30 women with breast cancer. The preliminary versions of CHESS were used extensively by older and younger women and by college and high school graduates. Participants in the pilot studies suggested several content enhancements and user-friendly aids for the developing system. User surveys indicated that CHESS was easy to use and would be valuable to other women with breast cancer, their partners, and their adult children. The women reported that they experienced more positive emotions and fewer negative emotions as a result of using the system.

Interferon alfa, when added to a four-drug doxorubicin-based chemotherapy regimen, is an effective antitumor agent in patients with clinically aggressive low-grade or intermediate-grade non-Hodgkin's lymphoma.

IV allopurinol is as efficacious and safe as oral allopurinol and will be of significant benefit to patients at risk of TLS and AUAN and unable to take oral medication.

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The ability of IFN-gamma given IP to increase TAG-72 and CEA expression on tumor cells in vivo provides additional argument for the use of the cytokine as an adjuvant to enhance MoAb binding to human carcinoma-cell populations.

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A prospective randomized study was carried out to evaluate the effectiveness of additional regional cytostatic perfusion of the extremities in patients with malignant melanoma. In a control group (n = 54), the tumors were widely excised, and regional lymph nodes were dissected. The patients in the perfusion group (n = 53) received additional hyperthermic (42 degrees C) perfusion with Melphalan. The disease-free survival time was chosen as the criterion for evaluation. An intermediate analysis revealed a highly significant difference between the 2 groups (21 recurrences in the control group and 4 recurrences in the perfusion group, p less than 0.001). Therefore, the study was discontinued prematurely. In an analysis of the data performed after a median observation time of 5 years and 11 months, 26 recurrences were diagnosed in the control group, whereas 6 recurrences were noted in the perfusion group (p less than 0.001). The retrospective breakdown into different risk groups according to tumor thickness also demonstrates a significant difference. For patients with a primary tumor of 1.5-3.0-mm in thickness, 2 of 25 in the perfusion group and 10 of 25 in the control group have relapsed. For those with a primary tumor of greater than 3.0-mm in thickness, 4 of 28 in the perfusion group and 16 of 29 in the control group have relapsed. Eleven patients in the control group and 3 patients in the perfusion group have died due to metastatic spread of the melanoma (p less than 0.01). The results most clearly demonstrate the benefits of additional hyperthermic cytostatic perfusion.