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Biomedical subjects

J Norum

Publications and source records attributed to J Norum.

At least 55 records · Page 3Linked to original sources
PubMed1995

Chemotherapy in gastric cancer: an economic evaluation of the FAM (5-fluorouracil, adriamycin, mitomycin C) versus ELF (etoposide, leucovorin, 5-fluorouracil) regimens.

The prognosis in gastric cancer has been almost unchanged for the last 20 years. At the time of diagnosis the majority of patients have disseminated disease. The 5-year survival is only about 15%. Several efforts with numerous antineoplastic regimens have been studied. The most widely used regimen has been the FAM (5-fluorouracil, adriamycin, mitomycin C) regimen. Because of the cardiotoxicity and dose intensity of the FAM regimen, a low toxicity regimen, the ELF (etoposide, leucovorin, 5-fluorouracil) regimen, has been introduced. We present the data from the treatment of 26 patients (17 FAM, 9 ELF) with advanced gastric cancer at the University Hospital of Tromsø. The monthly costs of FAM and ELF treatment were calculated to a price of 553 pounds and 2976 pounds (British pounds). The median survival of 5 months (FAM) and 6 months (ELF) is in accordance with other studies. Assuming that the median survival in our study is correct, the cost of one year saved was 123,834 pounds, while the cost of one QALY (quality adjusted life year) employing the ELF compared to the FAM regimen was 104,334 pounds. We conclude that the standard ELF regimen too expensive in the treatment of gastric cancer.

Adult↗
PubMed1994

Intrapleural bleomycin in the treatment of chylothorax.

Chylothorax is an accumulation of thoracic lymph or chyle in the pleural cavity. It is a rare condition and is usually caused by trauma or malignant disease. We present three cases with chylothorax due to malignant non-Hodgkin's lymphoma [high grade malignant (1 case) and low grade malignant (2 cases)] treated with pleurodesis with bleomycin and systemic chemotherapy (CHOP, CNOP, trofosfamide). Complete remissions (CR) were achieved in all three cases. Two patients had a recurrent chylothorax 3 and 12 months after initial treatment. They were treated with a second intrapleural installation of bleomycin and continuing systemic chemotherapy (CNOP, trofosfamide) and are still alive in CR with a follow-up period of 28 and 30 months respectively. One patient died of relapsing non-Hodgkin's lymphoma after 23 months of follow-up. There was no sign of recurrent chylothorax. We conclude that chylothorax caused by lymphoma can be satisfactorily controlled by pleurodesis with bleomycin combined with systemic chemotherapy. Immediate action is necessary to prevent great loss of lipids and proteins. The underlying malignancy must be controlled to achieve a good prognosis.

Antineoplastic Agents↗
PubMed1994

Multiple lymphomatous polyposis of the gut.

Multiple lymphomatous polyposis is very rare. We report two cases affecting duodenum, small intestine and colon/rectum, both with extensive disease, making radical surgery impossible and chemotherapy the treatment of choice. One patient died 23 days after initial treatment of myocardial infiltration, and the other is still alive 21 months after initial treatment.

Aged↗
PubMed1993

[On what indication should serotonin antagonists be used? A retrospective study of the use of ondansetron at an oncologic unit].

561 chemotherapy-cycles administered to 191 patients during the period 1990-92 at the University Hospital, Tromsø, were retrospectively analysed for combination with ondansetron. 65% of the cycles were combined with ondansetron. The frequency increased from 1991 (50%) to 1992 (69%). Among moderate emetogenic regimens (MIME, MMM, High-dose MTX, EBVP, ELF) the frequency had changed from 44% to 91%. The increased ondansetron-treatment in moderate emetogenic regimens raised the total cost of treatment. Better cost-effectiveness can possibly be achieved by "low dose-ondansetron" (4 mg x 2) and more frequent supplementary use of diazepam, corticosteroids or haloperidol. Use of ondansetron regimens extending beyond 24 hours is not cost-effective. Peroral treatment is less expensive and usually adequate to control acute emesis.

Administration, Oral↗
PubMed1993

[Cancer patients who want to die at home].

During the years from 1989-92, 18 patients, at their own wish and the wishes of their family were transferred from the Department of Oncology at the University Hospital of Tromsø, to their homes for terminal care. There were nine women and nine men, all from the city of Tromsø. Their age varied from 28-82 years. The most frequent disease was colorectal carcinoma, and the most frequent occupations were housewife and office worker. Women and patients with adult children remained at home for a longer period of time than the others. Six patients lived at home for more than one month. The care was most often provided by the spouse.

Adult↗
PubMed1993

[When a cancer patient dies at home--experience of the relatives].

Between 1989-92, 19 patients were transferred from the Department of Oncology to their homes for terminal care. Their care providers were questioned retrospectively. 16 responded. They all recommended other families with cancer patients to care for these patients at home. 14 reported feelings of inadequacy, anxiety, burn-out, insecurity or loneliness. Their most important contacts were nurses from the municipal home care service and the oncologists. Small children were not reported to limit the possibility of care at home. Family and friends were the best source of support during the period following the bereavement.

Adult↗
PubMed1992

[Intestinal lymphoma presented as multiple intestinal polyposis].

Primary gastrointestinal lymphoma is a rare condition. It constitutes approximately 5% of all lymphoid malignancies. Primary lymphomas of the intestinal tract rarely present as multiple polyposis. We describe such a patient who was treated with chemotherapy. The treatment of choice is surgery when possible. Chemotherapy is used in addition when high grade non-Hodgkin lymphoma is revealed. Chemotherapy should be used for patients who are unable to undergo curative resections. Prognosis is poor for patients with a non-resectable disease.

Aged↗
PubMed1992

[Accidents with radioactive pollution. Can we do something?].

Nuclear accidents are a cause of widespread fear. Treatment of patients exposed to high doses of total body irradiation has very often been ineffective. The use of hematopoietic growth factors may be a new way of treating these patients. This article describes results from studies of total body irradiated animals and clinical experience from treating humans who have been involved in nuclear accidents. G-CSF or GM-CSF administered within three hours after a nuclear accident seems to be of value. Surprisingly, so far bone marrow transplantation seems to be of limited value. Intravenous transfusions of thrombocytes and red blood cells, and the treatment of burns and gastrointestinal symptoms, are important parts of the medical therapy.

Accidents↗
PubMed1992

[Treatment of advanced anal cancer].

Anal carcinoma affects between 30 and 40 Norwegians every year. The disease is twice as frequent in women as in men. It is usually located in the anal canal only, and is cured by a combination treatment with chemotherapy and radiotherapy. Metastatic anal carcinoma has a poor prognosis. We present two such cases. 5-fluorouracil in combination with cisplatin or mitomycin C can give responses even in advanced cases. Radiotherapy may also be of value. In view of the difference between norwegian clinics in the treatment of anal carcinoma, there would appear to be a need of a Scandinavian or international study based on standardized treatment.

Aged↗
PubMed1991

[Infusor--an aid in cytostatic therapy].

Infusor is a pump controlled by an elastomeric balloon. It has been used for continuous infusion of morphine, heparin, antiemetics and different kinds of cytostatics. The article presents our experience of Infusor when used for intravenous infusion of fluorouracil to patients with head and neck cancer. Infusor had many practical advantages. It provides a new possibility for continuous administration of cytostatics at home. A disadvantage was a slightly unstable infusion velocity.

Antineoplastic Agents↗
PubMed1991

[Merkel cell carcinoma].

Merkel cell carcinoma is a rare disease. During the last five years we have treated two patients at the Cancer Department, University Hospital Tromsø. These two cases are reported. Immunohistochemical analysis and electron microscopy are important for a precise diagnosis. The primary treatment is surgery. There is usually a need for supportive radiotherapy. The disease is also sensitive to chemotherapy.

Aged↗
PubMed1990

[Cerebral metastasis in Hodgkin's disease].

The article describes the case history of a 31 year old woman with a solitary intracranial metastasis from Hodgkin's lymphoma, and reviews the relevant literature. Metastasis to the central nervous system from Hodgkin's disease is uncommon. This affection is usually a result of metastasis to the meninges or bone, or of direct extension from paracranial or paraspinal lymph node involvement. Hematogenous metastasis of Hodgkin's disease confined to the brain is rare. Affection of the central nervous system is most common in lymphocyte depletion Hodgkin's disease. A higher frequency is seen in advanced clinical stages. The prognosis is poor.

Adult↗