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1.
Eur J Neurol ; 26(3): 468-475, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30326172

RESUMEN

BACKGROUND AND PURPOSE: Caffeine is associated with a lower risk of some neurological diseases, but few prospective studies have investigated caffeine intake and risk of amyotrophic lateral sclerosis (ALS) mortality. We therefore determined associations between coffee, tea and caffeine intake, and risk of ALS mortality. METHODS: We conducted pooled analyses of eight international, prospective cohort studies, including 351 565 individuals (120 688 men and 230 877 women). We assessed coffee, tea and caffeine intake using validated food-frequency questionnaires administered at baseline. We used Cox regression to estimate study- and sex-specific risk ratios and 95% confidence intervals (CI) for ALS mortality, which were then pooled using a random-effects model. We conducted analyses using cohort-specific tertiles, absolute common cut-points and continuous measures of all exposures. RESULTS: During follow-up, 545 ALS deaths were documented. We did not observe statistically significant associations between coffee, tea or caffeine intake and risk of ALS mortality. The pooled multivariable risk ratio (MVRR) for ≥3 cups per day vs. >0 to <1 cup per day was 1.04 (95% CI, 0.74-1.47) for coffee and 1.17 (95% CI, 0.77-1.79) for tea. The pooled MVRR comparing the highest with the lowest tertile of caffeine intake (mg/day) was 0.99 (95% CI, 0.80-1.23). No statistically significant results were observed when exposures were modeled as tertiles or continuously. CONCLUSIONS: Our results do not support associations between coffee, tea or total caffeine intake and risk of ALS mortality.


Asunto(s)
Esclerosis Amiotrófica Lateral/mortalidad , Cafeína , Café , Medición de Riesgo , , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
2.
Br J Cancer ; 97(9): 1291-4, 2007 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-17923877

RESUMEN

In a cohort study, ovarian cancer (280 cases) showed no significant association with tea or coffee, the multivariable rate ratios being 0.94 (95% confidence interval (CI): 0.89, 1.00) and 1.04 (95% CI: 0.97, 1.12) per cup per day, respectively. A meta-analysis also produced no significant findings overall, though the cohort studies showed a significant inverse association for tea.


Asunto(s)
Bebidas , Café , Conducta de Ingestión de Líquido , Neoplasias Ováricas/epidemiología , , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Conducta Alimentaria , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Países Bajos/epidemiología , Neoplasias Ováricas/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Encuestas y Cuestionarios
3.
Anticancer Drugs ; 10(3): 257-61, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10327029

RESUMEN

Cisplatin is the most important drug in the treatment of advanced ovarian cancer. The role of anthracyclines is controversial. We compared a combination of epirubicin plus cisplatin (EP) with a regimen of cyclophosphamide, epirubicin and cisplatin (CEP). Patients with stage Ic-IV ovarian cancer were randomized to receive either epirubicin 100 mg/m2 plus cisplatin 75 mg/m2 q 4 weeks or cyclophosphamide 500 mg/m2 plus epirubicin 75 mg/m2 plus cisplatin 50 mg/m2 q 4 weeks, which we considered the reference treatment based on our previous experience. Patients were initially debulked, followed by six cycles of chemotherapy, or in case primary debulking was insufficient or considered inappropriate, secondary debulking was attempted in selected cases after sufficient chemotherapy-induced regression. Optimal debulking was defined as residual lesions < or = 2 cm. A total of 210 patients (191 eligible) were randomized. Results did not show significant differences in all major endpoints (pathologically documented complete response and survival). The median survival for all patients was 34 months, for patients with stage III 26 months, for patients with stage IV 20 months and it has not been reached for patients with stage Ic-II. As no significant differences between an equitoxic regimen of EP and CEP were detected, it might be more useful to look again at the anthracyclines as part of combination chemotherapy instead of the alkylating agents.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Ováricas/tratamiento farmacológico , Cisplatino/administración & dosificación , Ciclofosfamida/administración & dosificación , Epirrubicina/administración & dosificación , Femenino , Humanos , Estadificación de Neoplasias , Neoplasias Ováricas/patología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Análisis de Supervivencia
5.
Ann Oncol ; 7(7): 677-85, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8905025

RESUMEN

BACKGROUND: In the Netherlands, 45% of all cancer cases occur in men and women aged 70 years and older. Since the population is ageing and cancer incidence rises with age, the number of new malignancies in the elderly is increasing. It has become apparent that there is a relationship between age at diagnosis and the treatment received. Therefore, age-specific variations in patterns of care for six common forms of cancer in the elderly, are examined. PATIENTS AND METHODS: Patients aged 50 years and older, diagnosed in the period 1988-1992 in Middle and South Limburg with breast, colorectal, lung, ovarian, head and neck cancer and non-Hodgkin lymphoma were included (n = 6911). Data were obtained from the population-based Regional Cancer Registry of the Comprehensive Cancer Centre Limburg. Age-specific differences in diagnostics and treatment were analysed using chi-square analysis (age categories: 50-59, 60-69, 70+). Logistic regression analyses were used to examine the extent to which age increased the chance of not being treated or of receiving less intensive treatment, while controlling for the stage of the disease and the sex of the patient. RESULTS: For all malignancies the stage was unknown in a larger proportion of the patients aged 70 years and older than in the younger patient groups. Compared to their younger counterparts, the diagnosis of elderly breast, colorectal and lung cancer patients was more often based solely on clinical grounds. In the total study population, 16% were not treated. Per age category 50-59 years, 60-69 years and 70+ these percentages were 7%, 12% and 22%, respectively, (P-trend = 0.001). For all malignancies the chance of not receiving treatment increased with increasing age. However, the size and nature of the differences varied with the localisation of the tumour. The proportion of untreated patients was particularly high in the patients with lung cancer and metastatic colorectal and ovarian cancer, and there was an increase with increasing age (P-trend = 0.001). The vast majority of patients with NHL, breast, head and neck and non-metastatic colorectal cancer received treatment, 90%, 94%, 91%, and 99%, respectively. However, elderly patients less often received a combination of treatment modalities. CONCLUSIONS: The diagnostics and choice of treatment for several common types of cancer were dependent on age. This study could not take into account the major problem of co-morbidity which can be a reason to choose for lesser therapy in the elderly. More research is necessary to determine which factors determine the diagnostics and choice of treatment and whether these factors differ between young and elderly patients.


Asunto(s)
Factores de Edad , Manejo de la Enfermedad , Neoplasias/diagnóstico , Neoplasias/terapia , Edad de Inicio , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Terapia Combinada , Intervalos de Confianza , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neoplasias/patología , Neoplasias/fisiopatología , Países Bajos , Sistema de Registros
7.
J Epidemiol Community Health ; 48(6): 596-600, 1994 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-7830016

RESUMEN

STUDY OBJECTIVE: To study differences between various methods of estimating cancer risk in individuals. DESIGN: Information was obtained from a cancer registry. Lifetime risk was calculated using the life table method, taking competing causes of death into account and using well recognised methods such as the cumulative rate and risk. SETTING: Regional cancer registry of the Comprehensive Cancer Centre IKL, located in Maastricht, The Netherlands. PATIENTS: Patients with a first primary malignancy in 1989-90 in the catchment area of the cancer registry. MAIN RESULTS: The lifetime risk of developing cancer was estimated to be 34.8% for males and 30.4% for females. In males, especially, the risk estimates were considerably higher when the cumulative risk was used. CONCLUSIONS: The life table method is convenient for estimating the probability that a person will develop cancer during a defined period or during his or her lifetime. The other estimates overestimate the risk of the disease under investigation, especially in the very elderly.


Asunto(s)
Neoplasias/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Esperanza de Vida , Tablas de Vida , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Países Bajos/epidemiología , Sistema de Registros , Medición de Riesgo , Factores Sexuales
8.
Ann Oncol ; 4(4): 295-301, 1993 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8518219

RESUMEN

BACKGROUND: The Comprehensive Cancer Center trial 82-01 is a prospective randomized study to investigate the value of the addition of high-dose medroxyprogesterone acetate (MPA) to chemotherapy in patients with node-positive operable breast cancer. MPA may be of advantage in this setting because of its activity in estrogen receptor ER-positive as well as ER-negative tumors and since it may protect against chemotherapy-induced myelosuppression and thus enable maintenance of the appropriate chemotherapeutic scheduling. PATIENTS AND METHODS: Four hundred eight evaluable patients with node-positive (N+) operable breast cancer (T1-3, N1) were entered in a multicenter randomized trial. Two hundred nine patients were randomized in the MPA- arm and 199 in the MPA+ arm. CAF chemotherapy was given as a short i.v. bolus infusion: cyclophosphamide 500 mg/m2 i.v. day 1, doxorubicin 40 mg/m2 i.v. day 1, and 5-fluorouracil 500 mg/m2 i.v. day 1, q 4 wks x 6. MPA was given intramuscularly (i.m.) 500 mg q d x 28 days, followed by 500 mg i.m. twice weekly during 5 months. RESULTS: The main side effects of MPA were weight gain with a mean of 5.5 kg as opposed to 1.8 kg in the control group (p = 0.01) and vaginal bleeding in 30/199 in the MPA+ group and 0 in the MPA- group. MPA ameliorated vomiting grade III, IV (45% vs. 28%, p < 0.001), nausea grade III, IV (50% vs. 34%, p < 0.001) and leucocyte nadir grade III, IV (20% vs. 11%, p = 0.003). Disease-free survival (DFS) after 5 years was 59% in the MPA+ and 49% in the MPA- group (p = 0.12). Patients > or = 60 years benefitted most from MPA treatment, in particular if freedom from distant metastases was taken as the endpoint (p = 0.02). Overall survival (OS) was not significantly different between the two treatment groups (p = 0.18), but within subgroups analysed there was an advantage for MPA+ in patients > or = 55 years (p = 0.002) and in pT1 patients (p = 0.045). CONCLUSIONS: High-dose MPA ameliorates CAF side effects and reduces the risk of metastatic disease, especially in elderly breast cancer patients.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Quimioterapia Adyuvante , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Estudios de Seguimiento , Humanos , Metástasis Linfática , Acetato de Medroxiprogesterona/administración & dosificación , Persona de Mediana Edad , Estudios Prospectivos , Tasa de Supervivencia
9.
Cancer Invest ; 11(1): 1-5, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8422593

RESUMEN

Between January 1985 and May 1988, 87 patients with stage III-IV ovarian carcinoma were entered in a study assessing chemotherapy consisting of cyclophosphamide, 500 mg/m2, epirubicin, 75 mg/m2, and cisplatin, 50 mg/m2, intravenously (IV) on day 1, every 4 weeks (CEP-1). The results after a median follow-up of 4 years are presented. The pathologically complete remission rate was 36%. The median survival of all patients was 26 months. For patients with stage III disease debulked to lesions < or = 1.5 cm before the initiation of chemotherapy (n = 35), the median survival was 61+ months. These data are not clearly different from the results of a previous study conducted by our group utilizing CAP-1 chemotherapy.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Ováricas/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Epirrubicina/administración & dosificación , Epirrubicina/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/patología
10.
Ned Tijdschr Geneeskd ; 136(19): 927-31, 1992 May 09.
Artículo en Holandés | MEDLINE | ID: mdl-1594067

RESUMEN

To estimate the cancer incidence in the middle and southern part of the province of Limburg and to compare these rates with results of the Eindhoven Cancer Registry (IKZ/SOOZ), we carried out a descriptive investigation in the regional cancer registry Comprehensive Cancer Centre Limburg (IKL). The IKL has started a cancer registry in the province of Limburg in the framework of the national cancer registry. Since 1986 all hospitals and pathological laboratories in the area make their data available to the IKL cancer registry. Age-standardized incidence rates were calculated using the European Standard Population. The incidence rate for all malignancies combined over 1986-1988 was 406.3 per 100,000 per year in males and 273.0 per 100,000 per year in females. These incidence rates are very similar to the rates calculated by the Eindhoven Cancer Registry for the years 1983-86. However, the incidence rates are lower in the IKL area for malignancies of the stomach (males, females), bladder (males, females) and ovary. The incidence rates are higher for malignancies of the lung (females), pleura (males) and for 'primary tumor unknown' (males). The incidence rates of the IKL cancer registry correspond very closely to the rates of the Eindhoven cancer registry. However, differences in published mortality rates of both regions compared with the remaining part of the Netherlands suggest that the incidence rates in males differ from the Netherlands as a whole.


Asunto(s)
Neoplasias/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Sistema de Registros , Factores Sexuales
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