A prospective randomized double-blind trial comparing the butyrophenone analogue domperidone (D) and the synthetic cannabinoid nabilone (N) in the treatment of cytotoxic-induced emesis was conducted in 38 patients receiving highly emetogenic chemotherapy regimens (70% containing cisplatin). Patients received 20 mg D or 1 mg N the night before chemotherapy and 8-hourly on each chemotherapy day for two consecutive cycles of treatment. Three of 19 patients randomized to N completed only one cycle because of disease progression or subjectively adverse effects. Four of 19 patients completed only one cycle of D because of lack of efficacy or chemotherapy toxicity. In all, 32 cycles of N and 33 cycles of D were evaluable for efficacy. The mean number of vomiting episodes in cycle 1 was 4.76 for N and 12.95 for D (P less than 0.02). The corresponding values for cycle 2 were 4.27 and 7.69 (P greater than 0.10), and for cycles 1 and 2 combined, 4.53 for N and 10.81 for D (P less than 0.01). Nausea and food intake scores did not differ significantly, although there was a trend towards less nausea and an increased food intake with N. Subjectively adverse effects were more frequent with N and included drowsiness, dizziness, dry mouth, and postural hypotension. N is superior to D for the control of cytotoxic-induced emesis.

We reviewed the relative incidence of histological sub-types of thyroid carcinoma at St. Vincent's Hospital between 1970 and 98 Vol. 162 No. 3 1991 and compared survival rates. The findings were compared with previous reports between 1946 and 1970.Patients with thyroid carcinoma from 1970 through 1991 were identified and pathological and clinical data retrieved.Of 141 patients identified, 113 were female and 28 male. Fiftyseven patients had papillary, 41 follicular, 24 anaplastic and 6 medullary carcinoma. There were 10 lymphomas and 3 thryoid metastases. The 10-year actuarial disease-free survival for papinary carcinoma was 93%, follicular 80% and medullary 37%. The median overall survival for anaplastic carcinoma was 5 months. The number of cases seen increased from 2.2 per year between 1946 -1965 to 7.6 per year between 1982-1991 . From 1946to 1991 the relative incidence of papillary carcinoma increased from 19% to 57%.Of interest is the change in relative incidence of the histological sub-types. Follicular carcinoma is associated with endemic goitre and increased iodine intake may explain its reduced incidence. Increased radiation may explain the increase in papillary carcinoma. There is a need for a National Tumour Registry to see if this local trend is reflected nationally. PROTEOLYTIC ENZYMES AS PROGNOSTIC MARKERS IN BREAST CANCER