SUMMARY: Fifteen patients with PC who were treated with CS and IPHC were retrospectively identified between January 2002 and December 2006. All patients underwent cytoreduction immediately followed by IPHC with mitomycin or cisplatin. The time between undergoing CS and IPHC and the date of the last follow-up appointment or the date of death was used to calculate survival data for each patient. Nine patients had complete cytoreduction, and all but one patient had evidence of invasive disease at the time of surgery. Eleven patients required concomitant bowel resection at the time of debulking. Thirteen patients required blood transfusions during the perioperative period. Nine patients were discharged home, and four were discharged to a rehabilitation facility. Two patients died during the perioperative hospital admission, both of whom had a preoperative Eastern Cooperative Oncology Group (ECOG) performance status score of 2. The median survival time was 8.4 months, similar to the findings of previously published studies. Further studies are needed to see if tumor type, ECOG performance status score, degree of cytoreduction, and the chemotherapy agent used in IPHC can be correlated to quality of life and survival in patients with heterogeneous primary sources of intraabdominal malignancies.

CONCLUSION: Combination treatment with CS followed by IPHC in 15 patients with heterogeneous primary sources of intraabdominal malignancies resulted in a median survival time of 8.4 months.

Methods: In this retrospective study, the clinical course of hypomagnesemia is described in three 64- to 68-year-old men who received panitumumab monotherapy or panitumumab-plus-irinotecan therapy for colorectal cancer for 8 to 21 weeks.

Results: The onset of hypomagnesemia was variable, ranging from 1 week to 10 weeks following the initiation of panitumumab. Magnesium levels did not normalize until 4 to 8 weeks after discontinuation of the agent. Of the patients in the study, 2 had new onset of grade 3 hypomagnesemia 1 to 3 weeks after panitumumab was discontinued. Management was magnesium sulfate 2 g infusion weekly and magnesium oxide 1,200 mg oral repletion daily. With severe hypomagnesemia (grade 3 and higher) or significant diarrhea (grade 3 and higher), a daily infusion of magnesium sulfate 2 or 4 g was administered.

Conclusion: When administering panitumumab therapy, magnesium levels should be monitored from the initiation of the agent to at least 8 weeks following cessation. Hypomagnesemia usually can be managed with magnesium sulfate 2 to 4 g infusion weekly and magnesium oxide 1,200 mg oral repletion daily. Future research is warranted to identify simple and efficient strategies for monitoring and treating EGFR blockade with monoclonal antibody–associated hypomagnesemia.

Methods: Twenty-five patients admitted between February and December 2007 were identified as having received ursodiol as part of their transplant regimens. Seventeen of the twenty-five patients received at least one of the treatment regimens including cytarabine, cyclophosphamide, busulfan, and/or total body irradiation. None of the patients received prophylactic heparin for VOD. The records of each patient were screened retrospectively for documentation of veno-occlusive disease.

Results: None of the twenty-five patients who received Ursodiol as part of their stem cell transplant regimen developed VOD.

Conclusion: Stem cell transplant patients are at risk for VOD, based on their conditioning regimens. Ursodiol was used as VOD prophylaxis in twenty-five patients, none of whom developed VOD. Ursodiol should be further studied as a prophylactic part of stem cell transplant regimens.

SUMMARY: Fourteen patients (median age, 57 years) with NM were treated with the standard of care (i.e., regional or systemic chemotherapy or irradiation or both) plus intrathecal topotecan between January 2004 and September 2005. Three patients developed NM in the setting of systemic cancer; 11 patients had primary central nervous system (CNS) malignancies. All patients received 0.4 mg of topotecan intrathecally two times per week. The efficacy of intrathecal topotecan was assessed on the basis of the number of doses to cerebrospinal fluid (CSF) cytologic clearing--defined as the disappearance of malignant cells from a previously positive CSF cytology. Safety was evaluated by chart documentation of adverse events that might have been associated with topotecan given intrathecally. Of the 11 patients with primary CNS tumors, 6 patients achieved CSF clearing after the first dose of intrathecal topotecan, 2 patients after the second dose, and 1 patient after the fifth dose. For the 3 patients with secondary CSF tumors, 1 patient achieved CSF clearing after the third dose and 2 patients did not reach the primary endpoint. Overall, 6 of the 14 patients achieved CSF clearing after the first dose of intrathecal topotecan; in 10 of the 14 patients, CSF clearing of malignant cells was observed at some point during treatment. Toxicity was modest. The most common adverse effect reported was fatigue.

CONCLUSION: Intrathecal topotecan appeared to be effective and safe in adult patients with NM.

SUMMARY: Condyloma acuminata are warts of the genital and perianal region caused by various types of human papillomavirus (HPV). Intraurethral condylomas are associated with complications such as urinary burning, frequency, urgency, urethral bleeding, obstruction, fistula formation, and dyspareunia. A 55-year-old white man had a chief complaint of profuse, but painless, hematuria when he urinated. Cystourethroscopy confirmed extensive intraurethral condylomatous lesions at the external urethral meatus. A biopsy revealed mild squamous dysplasia and cellular changes consistent with HPV infection. A treatment was prepared that included fluorouracil 250 mg combined with 0.18% lidocaine hydrochloride gel. This mixture was given intraurethrally once weekly, and the tip of the penis was clamped immediately after administration using an occlusive penile clamp. The clamp was retained for 10 minutes for the first treatment, 15 minutes for the second, and 20 minutes for the remainder of the treatments. Six treatments were given initially and were well tolerated, although the patient did report occasional pain while urinating and occasional drops of urine. After six weeks of rest, another cycle of six weekly treatments was given. Two weeks after the second course of treatment, one small condyloma was observed in the distal anterior urethra. The urethra was found to be unblocked after three months, and the six-month evaluation revealed no new growth and a clear urethra.

CONCLUSION: Urethral instillation via urethral syringe of fluorouracil injection mixed with lidocaine gel reduced the size and number of a man's intraurethral condyloma acuminata, allowed cystourethroscopy, and eliminated hematuria. There was no new growth of condyloma acuminata after six months.