The five-year assessment of three randomised trials of short course 6, 9 or 18 months chemotherapy for tuberculosis of the spine is reported. In Hong Kong patients were randomised to isoniazid plus rifampicin HR daily for 6 or 9 months, combined with radical surgical resection with bone grafting and streptomycin for 6 months for all patients.
In Madras patients were randomised to chemotherapy with HR for 6 or 9 months, or 6 months HR chemotherapy combined with surgical resection. In Korea all patients were ambulatory and were randomised to different regimens of chemotherapy 6 or 9 months HR, or 9 or 18 months isoniazid plus ethambutol EH or isoniazid plus PAS PH.
In all centres the results of the 6- and 9-month regimens of HR were excellent and similar to the month EH and PH regimens. In Hong Kong excellent results were achieved by the radical resection.
The disease was however less extensive than in Madras, where the results after surgery were no better than with ambulatory chemotherapy. Chemotherapy is the critical factor in the management of tuberculosis of the spine.
Efforts should be concentrated on ensuring that appropriate regimens are given under adequate supervision. À Madras les patients ont été repartis au hasard à recevoir soit la chimiothérapie avec HR pendant 6 ou 9 mois soit la chirurgie radicale plus 6HR. À Korea tous les patients étaient ambulatoires et ils ont été repartis au hasard à recevoir les régimes de chimiothérapie differentes [soit HR pendant 6 ou 9 mois soit isoniazid plus ethambutol EH ou isoniazid plus PAS PH pendant 9 ou 18 mois].
Dans tous les centres les résultats des régimes de 6 et 9 mois étaient excellents et pareils aux régimes PH et EH de 18 mois, mais les régimens PH et EH de 9 mois étaient nettement inférieurs. La chimiothérapie est un élément critique dans la traitement de la tuberculose de la colonne vertébrale. Rituximab was associated in Renal failure was reported in 97 patients, mainly with cisplatin regimen Renal insufficiency was reversible in most patients but remained persistent in 24, with all of them being treated with DHAP except 1.
Cisplatin-based regimen Platinum cumulative dose is a significant risk factor of nephrotoxicity. Hematologic toxicity was more frequent with carboplatin and cisplatin with at least 1 event all toxicity grade respectively in Oxaliplatin was implicated in