No abstract

Wenn E‐Faktoren sinken profitieren Chemie und Umwelt gleichermaßen. In ihrem Kurzaufsatz auf dokumentieren B. H. Lipshutz und Mitarbeiter anhand direkter Vergleiche übergangsmetallkatalysierter Kreuzkupplungen, wie tief man mit einem kommerziell verfügbaren Tensid in Wasser als Reaktionsmedium gelangen kann. Und durch den verringerten Einsatz organischer Lösungsmittel können E‐Faktoren um bis zu eine Größenordnung gedrückt werden. Lasst uns organische Reaktionen ohne organische Lösungsmittel durchführen!

BACKGROUND The purpose of the current study was to assess the value of routine imaging and liver function tests in detecting metastases from malignant melanoma of the uvea. METHODS Forty‐six consecutive patients diagnosed with metastatic uveal melanoma between 1985 and 1996 who had participated in a screening program that included annual liver function tests (LFT), chest X‐ray, and abdominal ultrasonography (US) were eligible for this retrospective cohort study. Main outcome measures were the sensitivity of screening tests, presence of symptoms, recurrence free interval, and metastatic burden. RESULTS Metastases were diagnosed in 74% of patients (95% confidence interval [95% CI], 59–86) at screening and in 26% (95% CI, 14–41) when the patient consulted a physician because of symptoms that developed before the next scheduled visit. Of all the patients, 59% (95% CI, 43–73) were asymptomatic, and 80% (95% CI, 66–91) had only hepatic metastases. The median recurrence free interval, greatest dimension of the largest metastasis, and metastatic burden of the two groups did not differ. US was diagnostic in 78% (95% CI, 64–89), at least 1 LFT test was abnormal in 70% of patients (95% CI, 54–82), and a chest X‐ray was abnormal in 2% of patients (95% CI, 0–12). LFTs and US did not reveal hepatic metastases in 33% and 4% of patients, respectively. The sensitivity of individual LFTs ranged from 0.27 to 0.67, and their specificity from 0.90 to 0.96, with lactate dehydrogenase being the most sensitive LFT used. CONCLUSIONS The authors believe that annual screening with LFTs and abdominal US will identify 59% of patients while they are still asymptomatic and that semiannual screening will detect >95% of such patients. Chest X‐ray has a very low yield and is recommended only at baseline to exclude metastatic disease to the eye and if pulmonary symptoms develop. Cancer 1999;85:1151–9. © 1999 American Cancer Society.

BACKGROUNDA Phase II trial comprising patients with metastatic uveal melanoma (Stage IVB) was undertaken to determine the activity of bleomycin, vincristine, lomustine, and dacarbazine (BOLD) chemotherapy with human leukocyte interferon, as well as the progression‐free and overall survival of the patients according to the substage before treatment.METHODSTwenty‐two patients with histologically proven metastatic uveal melanoma received 15 mg of bleomycin (Days 2 and 5), 1 mg/m2 vincristine (Days 1 and 4), 200 mg/m2 dacarbazine (Days 1 to 5), and 80 mg lomustine (Day 1) every 4 weeks together with a leukocyte interferon preparation (3 × 106 IU daily for 6 weeks followed by 6 × 106 IU three times per week).RESULTSOf 20 evaluable patients, 3 (15%; 95% confidence interval [CI] 0–38) obtained a partial objective response in hepatic and extrahepatic sites and 11 (55%; 95% CI 32–77) showed stable disease after receiving more than two cycles. The median progression‐free survival was 4 months (95% CI 2–10) and the median overall survival was 12 months (95% CI 8–22). Eleven patients who had favorable pretreatment characteristics (Stage IVBa) survived a median of 17 months (95% CI 4–37) whereas 10 patients with less favorable characteristics (Stage IVBb) survived a median of 11 months (95% CI 1–23). Moderate toxicity occurred with this outpatient regimen.CONCLUSIONSThe BOLD/human leukocyte interferon regimen had modest activity against metastatic uveal melanoma in hepatic and extrahepatic sites. The median overall survival approached that reported for more aggressive intrahepatic therapy regimens. Substage differences can significantly impact study outcomes. Therefore, substage information should be reported to facilitate comparisons between studies. Cancer 2002;95:2366–72. © 2002 American Cancer Society.DOI 10.1002/cncr.10996