In a randomized crossover study 57 cancer patients receiving chemotherapy with high emetic potential were treated with low-dose levonantradol or standard-dose metoclopramide and crossed over to the other antiemetic drug in the next identical chemotherapy cycle. In the 45 patients evaluable for treatment response the antiemetic efficacy of levonantradol was significantly better: 62% had less nausea and 58% less vomiting, as against 11% and 16%, respectively, with metoclopramide. Patient preference for antiemetic treatment was levonantradol in 49% and metoclopramide in 22% of cases. Levonantradol treatment was accompanied by a relatively high incidence of side-effects (71%) compared with metoclopramide (29%). The antiemetic efficacy of each single drug was incomplete in most cases of this trial, and antiemetic combination therapy is recommended for further trials.

With improved survival, long-term side effects with major impact on quality of life become a most important end point criteria of oncological treatment. The clearly defined documentation concept and the comprehensive recommendations for lymphedema management may assist clinicians and patients to make timely decisions about in- and outpatient health care practice to optimize the interface between acute medicine and rehabilitation. Patients' compliance with treatment and prevention routines will be as important as ensuring the continuity of care. A longitudinal prospective study evaluating the effectiveness and efficacy of the consensus recommendation is currently being implemented.

The results of combined radiation and chemotherapy for the treatment of gastric carcinoma are reviewed.A small amount of postoperative adjuvant combined treatments of the curatively resected gastric carcinoma was performed which do not suggest any advantage of treatment compared to observation. For locally advanced and unresectable gastric carcinoma 5-fluorouracil or ftorafur was administered simultaneously to local irradiation in several phase-II studies. The response rates of 37%-58% and one year survival of 45%-72% do not suggest an advantage of combined modality compared to the one way treatment. The FAM, FAMe or FAB regimen was also used and obviously do not improve the results of combined modality treatment. A small but well conducted prospective randomized trials compared radiotherapy with and without chemotherapy or chemotherapy with and without radiotherapy. Recent results from different cooperative groups failed to improve the treatment results in terms of response and survival.

In einer laufenden Studie wurden bisher 54 Patienten (mittleres Alter 56 Jahre, Ann-Arbor-Stadium II 19, III 10 und IV 25 Patienten) mit einem hochmalignen NHL nach dem VIM-Bleo/CHOP-Protokoll behandelt: Etoposid 100 mg/m² i.v. Tag 1–3, Ifosfamid 1,5 g/m² i.v. Tag 1–5 mit Uromitexan zur Zystitisprophylaxe, Methotrexat 30mg/Πr i.v. Tag 3, Bleomycin 10 mg i.v. Tag 8 und 15, Cyclophosphamid 750 mg/m² Tag 22, Adriamycin 50 mg/m² Tag 22, Vincristin 1,4 mg/m² Tag 22 und Prednisolon 100 mg p.o. Tag 1–5 und 22–26. Die Therapie wird ab Tag 43 insgesamt viermal wiederholt. Bei 35 Patienten ist die Therapie derzeit abgeschlossen. Davon erreichten 27 (77%) eine Vollremission, 6 (17%) kamen in eine Teilremission, bei 2 Patienten (6%) war der Tumor unter der Therapie progredient. In der bisher recht kurzen Nachbeobachtungszeit von 8 Monaten traten 6 Rezidive nach einer Vollremission auf. Die Überlebenswahrscheinlichkeit nach 12 Monaten beträgt 82%. Auffallend gering war die Toxizität der Behandlung. Im Vordergrund stand dabei die Leukopenie. Nur bei 3 Patienten (2%) wurde eine schwerwiegende Infektion beobachtet. Übelkeit und Erbrechen waren nur bei 4% der Patienten stark ausgeprägt. Damit stellt das VIM-Bleo/CHOP-Protokoll nach den bisherigen Ergebnissen ein bei hochmalignen NHL gut wirksames Therapieregime mit geringer Toxizität dar. Zur endgültigen Beurteilung muß der weitere Verlauf abgewartet werden.

Random allocation of 22 patients with benign and malignant diseases with neutrophil counts of up to 1 X 10(9)/l blood and probably infection-caused fever of more than 38 degrees C to intravenous treatment with one of the following antibiotic combinations was performed: carbenicillin (6 g/m(2) . 6 h) plus sisomicin (45 g/m2 . 6 h) or mezlocillin (3 g/m2 . 6 h) plus sisomicin (45 g/m2 . 6 h). Both combinations were tolerated equally well. Patients became afebrile in 16 out of 23 treatment periods. Seven out of 11 patients responded to carbenicillin - sisomicin, and 9 out of 12 to mezlocillin - sisomicin. Mezlocillin thus leads to equal success of treatment in febrile neutropenia as the double dose of carbenicillin when both antibiotics are combined with the same aminoglycoside.