Estimates of the worldwide incidence, mortality and prevalence of 26 cancers in the year 2002 are now available in the GLOBOCAN series of the International Agency for Research on Cancer. The results are presented here in summary form, including the geographic variation between 20 large "areas" of the world. Overall, there were 10.9 million new cases, 6.7 million deaths, and 24.6 million persons alive with cancer (within three years of diagnosis). The most commonly diagnosed cancers are lung (1.35 million), breast (1.15 million), and colorectal (1 million); the most common causes of cancer death are lung cancer (1.18 million deaths), stomach cancer (700,000 deaths), and liver cancer (598,000 deaths). The most prevalent cancer in the world is breast cancer (4.4 million survivors up to 5 years following diagnosis). There are striking variations in the risk of different cancers by geographic area. Most of the international variation is due to exposure to known or suspected risk factors related to lifestyle or environment, and provides a clear challenge to prevention.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/canjclin.55.2.74

Global cancer statistics, 2002.

Background We conducted a randomized study to determine whether any of three chemotherapy regimens was superior to cisplatin and paclitaxel in patients with advanced non–small-cell lung cancer. Methods A total of 1207 patients with advanced non–small-cell lung cancer were randomly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens: cisplatin and gemcitabine, cisplatin and docetaxel, or carboplatin and paclitaxel. Results The response rate for all 1155 eligible patients was 19 percent, with a median survival of 7.9 months (95 percent confidence interval, 7.3 to 8.5), a 1-year survival rate of 33 percent (95 percent confidence interval, 30 to 36 percent), and a 2-year survival rate of 11 percent (95 percent confidence interval, 8 to 12 percent). The response rate and survival did not differ significantly between patients assigned to receive cisplatin and paclitaxel and those assigned to receive any of the three experimental regimens. Treatment with cisplatin...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa011954

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.

https://redbook.streamliners.co.nz/MPD_WHO-classification_vardiman_blood2009.pdf

The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes

The response rate for all 1155 eligible pa-tients was 19 percent, with a median survival of 79months (95 percent confidence interval, 73 to 85), a1-year survival rate of 33 percent (95 percent confi-dence interval, 30 to 36 percent), and a 2-year surviv-al rate of 11 percent (95 percent confidence interval,8 to 12 percent) The response rate and survival didnot differ significantly between patients assigned toreceive cisplatin and paclitaxel and those assigned toreceive any of the three experimental regimens Treat-ment with cisplatin and gemcitabine was associatedwith a significantly longer time to the progression ofdisease than was treatment with cisplatin and pacli-taxel but was more likely to cause grade 3, 4, or 5 re-nal toxicity (in 9 percent of patients, vs 3 percent ofthose treated with cisplatin plus paclitaxel) Patientswith a performance status of 2 had a significantlylower rate of survival than did those with a perform-ance status of 0 or 1

/pdf/comparison-of-four-chemotherapy-regimens-for-advanced-non-1hqyri1i1e.pdf

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer

Polyphenols constitute one of the most numerous and ubiquitous groups of plant metabolites and are an integral part of both human and animal diets. Ranging from simple phenolic molecules to highly polymerized compounds with molecular weights of greater than 30,000 Da, the occurrence of this complex group of substances in plant foods is extremely variable. Polyphenols traditionally have been considered antinutrients by animal nutritionists, because of the adverse effect of tannins, one type of polyphenol, on protein digestibility. However, recent interest in food phenolics has increased greatly, owing to their antioxidant capacity (free radical scavenging and metal chelating activities) and their possible beneficial implications in human health, such as in the treatment and prevention of cancer, cardiovascular disease, and other pathologies. Much of the literature refers to a single group of plant phenolics, the flavonoids. This review offers an overview of the nutritional effects of the main groups of polyphenolic compounds, including their metabolism, effects on nutrient bioavailability, and antioxidant activity, as well as a brief description of the chemistry of polyphenols and their occurrence in plant foods.

Polyphenols: Chemistry, Dietary Sources, Metabolism, and Nutritional Significance

1. Non-haem iron absorption from a variety of vegetable meals was studied in parous Indian Women, using the erythrocyte utilization of radioactive Fe method.2. The studies were undertaken to establish whether Fe absorption could be correlatedwith the chemical composition of the foodstuff.3. Addition of the following organic acids commonly found in vegetables, improved the geometric mean Fe absorption from a basic rice meal as follows: from 0·028 to 0·085 with 1 g citric acid, from 0·031 to 0·081 with 15 mg ascorbic acid, from 0·048 to 0·095 with 1 g L-malic acid, from 0·041 to 0·096 with 1 g tartaric acid. The only exception was oxalic acid; the addition of 1 g calciumoxalate to cabbage (Brassica oleraceae) was associated with some depression in Fe absorption from 0·320 to 0·195.4. There was a marked inhibition of the geometric mean absorption when 500 mg tannic acid was added to a broccoli (Brassica oleraceae) meal (0·015 v. 0·297). Sodium phytate (2 g) caused a similar, though less profound inhibition (0·035 to 0·152).5. When 3 mg ferrous sulphate was added to different vegetables the geometric mean absorption varied widely. Vegetables of low Fe bioavailability were wheat germ (Triticum aestivum) 0·007, aubergine (Solanum melongena) 0·007, butter beans (Phaseolus lunatus) 0·012, spinach (Spinacea oleraceae) 0·014, brown lentils (Lens culinaris) 0·024, beetroot greens (Beta vulgaris) 0·024 and green lentils (Lens culinaris) 0·032. In contrast, bioavailability was moderate or good with carrot (Daucus carota) 0·098, potato (Solanum tuberosum) 0·115, beetroot (Beta vulgaris) 0·185, pumpkin (Cucurbita mixta) 0·206, broccoli 0·260, tomato (Lycopersicon esculentum) 0·224, cauliflower (Brassica oleraceae) 0·263, cabbage 0·320, turnip (Brassica rapa) 0·327 and sauerkraut 0·327.6. All the vegetables associated with moderate or good Fe bioavailability contained appreciable amounts of one or more of the organic acids, malic, citric and ascorbic acids.7. Poor Fe bioavailability was noted in vegetables with high phytate contents (e.g. wheat germ 0·007, butter beans 0·012, brown lentils 0·024 and green lentils 0·032).8. The fact that a number of vegetables associated with low Fe-absorption turned bluish-black when Fe was added to them, suggested that the total polyphenol content in them was high. The vegetables included aubergine spinach, brown lentils, green lentils and beetroot greens. When the total polyphenol content in all the vegetables tested was formally measured, there was a significant inverse correlation (r 0·859, P < 0·001) between it and Fe absorption. The inverse correlation between the non-hydrolysable polyphenol content and Fe absorption was r 0·901 (P < 0·001).9. The major relevance of these findings is the fact that the total absorption of non-haem-Fe from a mixed diet may be profoundly influenced by the presence of single vegetables with either marked enhancing or inhibiting effects on Fe bioavailability.

/pdf/the-effects-of-organic-acids-phytates-and-polyphenols-on-the-3y40483noh.pdf

The effects of organic acids, phytates and polyphenols on the absorption of iron from vegetables.

PURPOSEThe aims of this study were to compare in a randomized trial the results of high-dose versus conventional-dose chemotherapy as first-line treatment for metastatic breast cancer. The comparison included complete response (CR) rate, duration of response, and duration of survival.PATIENTS AND METHODSNinety patients were entered onto a study to compare two cycles of high-dose cyclophosphamide 2.4 g/m2, mitoxantrone 35 to 45 mg/m2, and etoposide (VP16) 2.5 g/m2 (HD-CNV) versus six to eight cycles of conventional-dose cyclophosphamide 600 mg/m2, mitoxantrone 12 mg/m2, and vincristine 1.4 mg/m2 (CNV) as first-line treatment for metastatic breast cancer. The high-dose regimen included either autologous bone marrow or peripheral-blood stem-cell rescue. All 90 patients are assessable.RESULTSThe response rates were significantly different. The overall response rate for HD-CNV was 43 of 45 (95%), with 23 of 45 patients (51%) achieving CR. Twenty-four of 45 patients (53%) who received conventional CNV have resp...

High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial.

PURPOSEThe aim of this study was to evaluate the efficacy and toxicity of gemcitabine at higher doses than had been used previously in patients with non-small-cell lung cancer (NSCLC).PATIENTS AND METHODSEighty-four patients (65 men, 19 women; age range, 35 to 75 years; mean age, 59 years) with locally advanced or metastatic pathologically documented NSCLC were enrolled. Patients had bidimensionally measurable disease, as defined by computed tomographic (CT) scan or chest x-ray. A total of 28.6% had previously been surgically treated, while 9.5% had received radiotherapy. Fifty-three patients commenced at a dose of 1,000 mg/m2, and 31 at a dose of 1,250 mg/m2. Patients were to receive two dose escalations of 25%, provided that overall toxicity was no worse than World Health Organization (WHO) grade 1 or WHO grade 0 for platelets. Responding patients were reviewed and validated by a blinded oncology review board (ORB) of experts not involved with the study. Of the original 84 patients enrolled, 76 were ass...

Efficacy and safety profile of gemcitabine in non-small-cell lung cancer: a phase II study.

PURPOSEThe aim of this study was to examine the efficacy of a regimen of initial gemcitabine followed by cisplatin in patients with advanced non-small-cell lung cancer (NSCLC).PATIENTS AND METHODSFifty-three patients (36 men and 17 women; age range, 35 to 74 years) were enrolled. Patients had bidimensionally measurable disease. Gemcitabine (phase-specific agent) was administered on days 1, 8, and 15 at a dose of 1,000 mg/m2. Cisplatin (cycle-specific agent) was administered on day 15 (100 mg/m2). Chemotherapy was administered in 28-day cycles.RESULTSOf 53 patients enrolled, 50 were assessable for response. The overall response rate was 52%. There were two complete responses (4%) and 24 partial responses (48%). The median survival duration was 13 months and the 1-year survival rate was 61%. The regimen was generally well tolerated. World Health Organization (WHO) grade 3 and 4 neutropenia occurred in 38.8% and 19.2% of patients, respectively. Grade 3 and 4 thrombocytopenia occurred in 13.3% and 7.7% of pat...

Weekly gemcitabine with monthly cisplatin: effective chemotherapy for advanced non-small-cell lung cancer.

Despite the high prevalence of infection by the Human Immunodeficiency Virus (HIV) in South Africa, information on its association with cancer is sparse. Our study was carried out to examine the relationship between HIV and a number of cancer types or sites that are common in South Africa. A total of 4,883 subjects, presenting with a cancer or cardiovascular disease at the 3 tertiary referral hospitals in Johannesburg, were interviewed and had blood tested for HIV. Odds ratios associated with HIV infection were calculated by using unconditional logistic regression models for 16 major cancer types where data was available for 50 or more patients. In the comparison group, the prevalence of HIV infection was 8.3% in males and 9.1% in females. Significant excess risks associated with HIV infection were found for Kaposi's sarcoma (OR=21.9, 95% CI=12.5–38.6), non‐Hodgkin lymphoma (OR=5.0, 95%CI=2.7–9.5), vulval cancer (OR=4.8, 95%CI=1.9–12.2) and cervical cancer (OR=1.6, 95%CI=1.1–2.3) but not for any of the other major cancer types examined, including Hodgkin disease, multiple myeloma and lung cancer. In Johannesburg, South Africa, HIV infection was associated with significantly increased risks of Kaposi's sarcoma, non‐Hodgkin lymphoma and cancers of the cervix and the vulva. The relative risks for Kaposi's sarcoma and non‐Hodgkin lymphoma associated with HIV infection were substantially lower than those found in the West. Int. J. Cancer 88:489–492, 2000. © 2000 Wiley‐Liss, Inc.

Werner R. Bezwoda

Papers

The effects of organic acids, phytates and polyphenols on the absorption of iron from vegetables.

High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial.

Efficacy and safety profile of gemcitabine in non-small-cell lung cancer: a phase II study.

Weekly gemcitabine with monthly cisplatin: effective chemotherapy for advanced non-small-cell lung cancer.

The spectrum of HIV-1 related cancers in South Africa