Sample records for platinum-containing chemotherapy regimen

  1. Relationship of methylation of MGMT gene regulated by platinum-contained regimens in plasma and efficacy of chemotherapy in diffuse large B cell lymphoma patients%含铂方案调节弥漫大B细胞淋巴瘤患者血浆MGMT基因甲基化及与化疗疗效关系

    Institute of Scientific and Technical Information of China (English)

    康马飞; 廖漓漓; 刘瑛; 骆梅青; 陈莹


    Objective:To detect the methylation of the 06 - methylguanine DNA methyltransferase( MGMT )gene in peripheral plasma in diffuse large B cell lymphoma( DLBCL )patients who treated with platinum - contained regimen and to evaluate whether platinum - contained regimen regulate methylation of MGMT gene and to evaluate the relationship of methylation of MGMT gene and efficacy of chemotherapy in diffuse large B cell lymphoma. Methods: Before and after chemotherapy, a nested methylation - specific PCR( nMSP )was performed for the detection of methylation of MGMT gene in plasma from DLBCL patients who treated with platinum - contained regimens. Results: Thirty plasma samples, before treatment with DHAP regimen, MGMT gene methylation was found in 10. 0% ( 3/30 )of patients with DLBCL which resisted to CHOP regimen. The ratios of methylation, after 2 and 4 cycls of chemotherapy, were respectively 63. 3%( 19/30 )and 73. 3%( 22/30 ) and there was a significant different between pre - therapy group and post - therapy group( P = 0. 000 ). The response rates were respectively 100% ( 3/3 )and 92. 6% ( 25/ 27 )in patients with methylation and non - methylation of MGMT gene after 2 cycles of platinum - contained regimens and were respectively 86. 4%( 19/22 )and 75.0%( 6/8 )after 4 cycles and there was no significant difference between methylation group and non - methylation group. Conclusion: Platinum - contained regimens might regulate methylation of MGMT gene. Efficacy of chemotherapy with platinum - contained regimens was not related with methylation of MGMT gene.%目的 检测弥漫大B细胞淋巴瘤(DLBCL)患者用含铂方案化疗后外周血血浆中O6-甲基鸟嘌呤-DNA甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)基因的甲基化状态,探讨含铂方案能否调节MGMT基因甲基化状态,并观察MGMT基因甲基化与含铂方案化疗疗效的关系.方法 利用巢式甲基化特异性聚合酶链反应法检测DLBCL患者含铂方案治疗前后

  2. 四个第三代含铂联合化疗方案在晚期非小细胞肺癌中的比较%Comparison of four third generation platinum-contained chemotherapy regimens for advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    杨学宁; 吴一龙


    @@ 1文献类型 治疗 2证据水平 1b 3文献来源 Schiller J H, Harrington D, Belani C P, et al. theEastern Cooperative Oncology Group. Comparison ofFour Chemotherapy Regimens for Advanced Non-Small-Cell Lung Cancer [J]. N Eng J Med,2002,346(2):92-98

  3. Novel Approaches for Concurrent Irradiation in Locally Advanced Cervical Cancer: Platinum Combinations, Non-Platinum-Containing Regimens, and Molecular Targeted Agents

    Directory of Open Access Journals (Sweden)

    Giannis Mountzios


    Full Text Available Despite the available prevention and early detection strategies, squamous-cell carcinoma of the uterine cervix is still diagnosed as locally advanced disease in a considerable proportion of patients. As a potent sensitizer of cancer cells, cisplatin has been the “traditional partner” of external beam irradiation in this setting for more than two decades. Induction chemotherapy strategies followed by concurrent chemoradiation or surgery and preoperative concurrent chemoradiation have been recently implemented in clinical trials in an effort to optimize local control and to minimize the risk of distant metastases. In this context, cisplatin has been combined with a number of other potential radiosensitizers, including 5-fluorouracil, capecitabine, and gemcitabine. In patients resistant or intolerant to platinum compounds, numerous non-platinum-containing regimens have been developed, implementing various antimetabolites, taxanes, antineoplastic antibiotics, and topoisomerase II inhibitors. More recently, molecular agents targeting critical pathways in cervical malignant transformation are being assessed in early clinical trials in combination with external-beam irradiation. In the current work, we review the evolving role of cisplatin and other platinum compounds, either alone or in combination regimens, in the context of other potent radiosensitizers. The emerging role of molecular targeted agents, as candidate partners of external beam irradiation, is also discussed.

  4. The efficacy and safety of 80 patientswithⅠ b2 ~Ⅳa squamous carcinoma of the cervix after receiving two platinum-containing chemotherapy regimens%80例Ⅰb2~Ⅳa 期宫颈鳞癌患者两种含铂化疗方案的疗效和安全性分析

    Institute of Scientific and Technical Information of China (English)

    廖丹; 尤共平; 吴进盛


    目的:探讨Ⅰb2~Ⅳa 期宫颈鳞癌患者同步放化疗中两种含铂化疗方案的疗效和安全性。方法:病例选自2010年2月至2013年4月我院的80例Ⅰb2~Ⅳa 期宫颈鳞癌的患者。在患者知情同意的情况下,按照随机数表法,将所有患者均分为观察组和对照组。对照组采用顺铂同步放疗的方案对患者进行治疗,观察组则采用氟尿嘧啶联合顺铂化疗同步放疗的方案对患者进行治疗。治疗后,评定分析两组患者的近期疗效和不良反应,并随访调查患者的远期疗效。结果:治疗3个月后,发现观察组治疗的总有效率为85.00%,对照组的总有效率为77.50%,观察组患者总有效率明显高于对照组(P <0.05)。随访调查3年后,发现观察组患者的3年生存率(87.50%)明显高于对照组(67.50%),两组比较有统计学意义(χ2=4.5878,P =0.0322);局部复发率和远处转移率(20.00%;17.50%)均明显低于对照组(42.50%;37.50%),两组比较有显著性差异(P <0.05)。结论:氟尿嘧啶联合顺铂化疗同步放疗的方案治疗Ⅰb2~Ⅳa 期宫颈鳞癌患者疗效显著,安全性高,值得临床推广应用。%Objectives:To investigate the efficacy and safety of two platinum -containing chemotherapy regimens to patients with Ⅰb2 ~Ⅳa squamous carcinoma of the cervix.Methods:80 patients with Ⅰb2 ~Ⅳa squamous carcinoma of the cervix in our hospital from February 201 0 to April 201 3were studied.With patients’in-formed consent,all the patients were divided into observation group and control group according to a random number table method.The control group was treated with concurrent radiotherapy and cisplatin and the observation group re-ceived fluorouracil and cisplatin combined with concurrent radiotherapy treatment.After treatment,the short -term efficacy and adverse reactions of the two groups were compared,and long -term

  5. Metronomic chemotherapy regimens in oncology

    Directory of Open Access Journals (Sweden)

    M. Yu. Fedyanin


    Full Text Available Metronomic chemotherapy implies the regular use of cytotoxic agents in doses much smaller than the maximum tolerable doses for a long time. Preclinical experiments show that this treatment option has a many-sided (antiangiogenic, immunostimulating, and direct cytotoxic effect on tumor. Moreover, this approach has gained the widest acceptance in treating patients with metastatic breast cancer in clinical practice. By taking into account the high activity of angiogenesis in colon cancer progression, it is interesting to study the impact of metronomic chemotherapy regimens for this nosological entity as well. This literature review considers not only the history of metronomic chemotherapy, the mechanisms of action, and a range of drugs having an antitumor effect in the metronomic regimens, but also analyzes clinical trials of metronomic chemotherapy regimens in patients with metastatic colon cancer.

  6. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract

    DEFF Research Database (Denmark)

    Bellmunt, Joaquim; Théodore, Christine; Demkov, Tomasz;


    experienced progression after a first-line platinum-containing regimen. PATIENTS AND METHODS: The study was designed to compare overall survival (OS) between patients receiving VFL + BSC (performance status [PS] = 0: 320 mg/m(2), every 3 weeks; PS = 0 with previous pelvic radiation and PS = 1: 280 mg/m(2...... neutropenia (50%), febrile neutropenia (6%), anemia (19%), fatigue (19%), and constipation (16%). In the intent-to-treat population, the objective of a median 2-month survival advantage (6.9 months for VFL + BSC v 4.6 months for BSC) was achieved (hazard ratio [HR] = 0.88; 95% CI, 0.69 to 1...... demonstrates a survival advantage in second-line treatment for advanced TCCU. Consistency of results exists with significant and meaningful benefit over all efficacy parameters. Safety profile is acceptable, and therefore, VFL seems to be a reasonable option for TCCU progressing after first-line platinum...

  7. Phase III trial comparing vinflunine with docetaxel in second-line advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy

    DEFF Research Database (Denmark)

    Krzakowski, Maciej; Ramlau, Rodryg; Jassem, Jacek;


    To compare vinflunine (VFL) to docetaxel in patients with stage IIIB/IV non-small-cell lung cancer (NSCLC) who have experienced treatment failure with first-line platinum-based chemotherapy.......To compare vinflunine (VFL) to docetaxel in patients with stage IIIB/IV non-small-cell lung cancer (NSCLC) who have experienced treatment failure with first-line platinum-based chemotherapy....

  8. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  9. Toxicities of different first-line chemotherapy regimens in the treatment of advanced ovarian cancer (United States)

    Qu, Chang-Ping; Sun, Gui-Xia; Yang, Shao-Qin; Tian, Jun; Si, Jin-Ge; Wang, Yi-Feng


    Abstract Background: Ovarian cancer (OC) is the 5th leading cause of cancer-related deaths around the world, and several chemotherapy regimens have been applied in the treatment of OC. We aim to compare toxicities of different chemotherapy regimens in the treatment of advanced ovarian cancer (AOC) using network meta-analysis. Methods: Literature research in Cochrane Library, PubMed, and EMBASE was performed up to November 2015. Eligible randomized controlled trials (RCTs) of different chemotherapy regimens were included. Network meta-analysis combined direct and indirect evidence to assess pooled odds ratios (ORs) and draw the surface under the cumulative ranking (SUCRA) curves. Results: Thirteen eligible RCTs were included in this network meta-analysis, including 8 chemotherapy regimens (paclitaxel + carboplatin [PC], pegylated liposomal doxorubicin [PLD] + carboplatin, carboplatin, gemcitabine + carboplatin, paclitaxel, PC + epirubicin, PC + topotecan, docetaxel + carboplatin). Gemcitabine + carboplatin regimen exerted higher incidence of anemia when compared with carboplatin and paclitaxel regimens. The incidence of febrile neutropenia of gemcitabine + carboplatin regimen was higher than that of PC, PLD + carboplatin, carboplatin, and PC + topotecan regimens. Topotecan PC + epirubicin regimen had a higher toxicity, comparing with PC, PLD + carboplatin, and PC + topotecan regimens. As for thrombocytopenia, gemcitabine + carboplatin chemotherapy regimen produced an obviously higher toxicity than PC and carboplatin. As for nausea, PLD + carboplatin chemotherapy regimen had a significantly higher toxicity than that of carboplatin chemotherapy regimen. Moreover, when compared with PC and carboplatin chemotherapy regimens, the toxicity of PC + epirubicin was greatly higher to patients with AOC. Conclusion: The nonhematologic toxicity of PLD + carboplatin regimen was higher than other regimens, which

  10. Chemotherapy-induced nausea and vomiting. Easing patients' fear and discomfort with effective antiemetic regimens. (United States)

    Bilgrami, S; Fallon, B G


    Patients receiving chemotherapy should be given optimal antiemetic therapy to maximize their comfort initially and to prevent development of delayed and anticipatory nausea and vomiting. Understanding the mechanisms of chemotherapy-induced nausea and vomiting allows the healthcare team to design drug regimens capable of avoiding these side effects. Prevention is important, because side effects can be debilitating and sometimes dose-limiting, and up to 10% of patients refuse chemotherapy altogether to avoid them. In general, combination antiemetic therapy is preferred over single-agent therapy for chemotherapeutic regimens that produce moderate to severe adverse effects.

  11. 参附注射液联合含铂一线化疗方案治疗非小细胞肺癌的Meta分析%Meta-analysis on Treatment of Non-small Cell Lung Cancer with Shenfu Injection in Combination with Platinum-contained First-fine Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    何海浪; 王谦; 赵阳; 刘会平; 曹振东; 周贤梅


    Objective:To study the efficacy and safety of Shenfu injection (SFI) in combination with platinum-contained first-line chemotherapy in treating non-small cell lung cancer (NSCLC).Method:Cochrane library,PubMed,CBM,CNKI,VIP,WANFANG DATA and Traditional Chinese Medicine Database System were searched through computers.The search was finished in September,2012.Randomized controlled trials (RCTs) of SFI in combination with platinum-contained first-line chemotherapy (versus chemotherapy alone) in any language were included.Two researchers extracted data and assess literature quality separately,and made a metaanalyses by RevMan 5.1 software.Result:A Total of 19 RCTs was included.The Meta-analysis showed thatcompared with the pure application of platinum-contained first-line chemotherapy,the combination of SFI and chemotherapy can not enhance the near-term curative effect [OR =1.41,95% CI (0.98,2.02),P =0.06],but may improve the quality of life [OR =2.72,95% CI (1.48,5.00),P =0.001],enhance CD3 + [SMD =0.41,95% CI (0.10,0.71),P =0.008],CD4 + [SMD =7.58,95% CI (4.32,10.84),P <0.00001] and CD4+/CD8+ [SMD =9.89,95% CI (4.76,15.02),P =0.000 2] and reduced WBC toxicity[RR=0.35,95% CI (0.23,0.54),P <0.000 01],Hemoglobin toxicity (RR =0.41,95% CI:0.20~ 0.83,P =0.01),Platelet toxicity [RR =0.34,95% CI (0.18,0.65),P =0.001],the gastrointestinal reactions [RR =0.24,95% CI (0.13,0.45),P < 0.000 01)].Conclusion:The current evidence indicates that SFI can not enhance the chemotherapeutic effect on NSCLC patients,but may improve the quality of life and reduce adverse effect of contained therapy of platinum and chemotherapeutics.These results require confirmation with rigorously controlled trials.%目的:系统评价参附注射液联合含铂一线化疗方案治疗非小细胞肺癌(Non-small cell lung carcinoma,NSCLC)的有效性及安全性.方法:计算机检索Cochrane Library,PubMed,CBM,CNKI,VIP,万方数据库,中国中医药数据库等数据库,检索

  12. Unusual nail pigmentation following cyclophosphamide-containing chemotherapy regimen

    Directory of Open Access Journals (Sweden)

    Kumar Santosh


    Full Text Available Cyclophosphamide therapy may rarely cause pigmentation of the nails which is of different patterns. We report a patient who developed pigmentation of nails after six cycles of cyclophosphamide, methotrexate, and 5-flourouracil chemotherapy, each repeated after 28 days for breast cancer. The patient developed nail pigmentation that started proximally and spread distally and involved all the nails of both hands and feet except the second and third toenails of right foot. Using Naranjo ADR Probability Scale, the case revealed a "probable" association with cyclophosphamide.

  13. First-line treatment of chronic lymphocytic leukemia with three combined chemotherapy regimens

    Directory of Open Access Journals (Sweden)

    Matevž Škerget


    Conclusions: RFC is the first-line treatment of choice for younger fit patients without deletion 17. For older and frail patients, alternative newer chemotherapy regimens should be sought. Patients with deletion 17 should receive alemtuzumab treatment, and allogeneic bone marrow transplantation should be considered.

  14. HER2 over-expression and response to different chemotherapy regimens in breast cancer

    Institute of Scientific and Technical Information of China (English)

    Jin ZHANG; Yan LIU


    Purpose: To exam the relationship between HER2 over-expression and different adjuvant chemotherapies in breast cancer. Patients and Methods: A total of 1625 primary breast cancer patients who received post-surgery adjuvant chemotherapy in Tianjin Cancer Hospital, China, from July 2002 to November 2005 were included in the study. Among them, 600 patients were given CMF (CTX+MTX+5-Fu) regimen, 600 given CEF (CTX+E-ADM+5-Fu) regimen, and 425 given anthracyclines plus taxanes regimen, with mean follow-up time of 42 months. Results: In CMF treatment group, the 3-year disease free survival (DFS)in HER2 over-expressed patients was lower than that of the HER2-negative ones (89.80% vs 91.24%, P=0.0348); in node-positive subgroup, the 3-year DFS was 84.72% in HER2 over-expressed patients, and 90.18% in the HER-2-negative ones (P=0.0271).Compared to CMF regimen, anthracyclines and anthracyclines plus taxanes regimens are more effective (P<0.05) in node-positive HER2 over-expression than those in the node-negative. Conclusion: HER2 over-expression is an independent index for predicting poor prognosis and short DFS for breast cancer patients. HER2 over-expressed patients are resistant to CMF regimen chemotherapy, but sensitive to anthracyclines-based or anthracyclines plus taxanes regimen. HER2 expression can be taken as a marker for therapies in breast cancer.

  15. Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens. (United States)

    Liu, Li-Ni; Wen, Fur-Hsing; Miaskowski, Christine; Lin, Yung-Chang; Wang, Jong-Shyan; Jeng, Chii; Chen, Mei-Ling


    To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Longitudinal, clinical observational study. Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed. © 2014 John Wiley & Sons Ltd.

  16. Cost description of chemotherapy regimens for the treatment of metastatic pancreas cancer. (United States)

    Goldstein, Daniel A; Krishna, Kavya; Flowers, Christopher R; El-Rayes, Bassel F; Bekaii-Saab, Tanios; Noonan, Anne M


    Multiple chemotherapy regimens are available for the treatment of metastatic pancreas cancer (mPCA). Choice of regimen is based on the patient's performance status and toxicity profile of the regimen. The objective of this study was to analyze the costs of first-line regimens to further aid in decision-making and develop a platform upon which to assess value. We calculated the monthly cost for individual standard regimens (gemcitabine, gemcitabine/nab-paclitaxel, gemcitabine/erlotinib and FOLFIRINOX) and the overall treatment cost for a course of therapy based on the median progression-free survival achieved in published studies. In addition to cost of drugs, we included administration costs and costs of toxicities (including growth factor support, blood product transfusion and hospitalization for toxicities). Costs for administration and management of adverse events were based on Medicare reimbursement rates for hospital and physician services. Drug costs were based on Medicare average sale prices (all 2014 US$). The monthly costs for gemcitabine, FOLFIRINOX, gemcitabine/erlotinib and gemcitabine/nab-paclitaxel were $1363, $7234, $8007 and $12,221, respectively. The overall treatment costs for a course of the same regimens based on median PFS were $5043, $46,298, $51,004 and $67,216, respectively. The choice of chemotherapy regimen for mPCA should be based on tolerability and efficacy of the regimen individualized to patient's performance status. Healthcare systems have finite resources; thus, there is increasing emphasis on metrics to define value in health care when outcomes of therapy are similar or produce marked differences in value. These data provide useful financial information to incorporate into the decision-making process.

  17. Delayed emesis: moderately emetogenic chemotherapy (single-day chemotherapy regimens only)

    DEFF Research Database (Denmark)

    Roila, Fausto; Warr, David; Aapro, Matti


    An update of the recommendations for the prophylaxis of delayed emesis induced by moderately emetogenic chemotherapy discussed during the third Perugia Consensus Conference (June 2009) sponsored by MASCC-ESMO was presented. The review considered new studies published since the second consensus co...

  18. Efficacy and safety of the HAA regimen as induction chemotherapy in 236 de novo acute myeloid leukemia

    Institute of Scientific and Technical Information of China (English)



    Objective To evaluate the efficacy and safety of the HAA regimen (homoharringtonine,cytarabine and aclarubicin) as induction chemotherapy in de novo acute myeloid leukemia (AML) .Methods The efficacy and safety of 236 de novo AML patients who received the HAA regimen as induction chemotherapy were retrospectively analyzed.The complete remission (CR) rate was assayed.Kaplan-Meier method was used to estimate overall survival (OS) and relapse free survival (RFS) ,and the differ-

  19. Efficacy and safety of crizotinib vs. platinum-containing two-drug-regimens in advanced non-small-cell lung cancer patients with positive echinoderm microtubule-associated protein-like 4-anaplastic ;lymphoma kinase fusion gene%克唑替尼与含铂两药方案治疗棘皮动物微管结合蛋白4-间变性淋巴瘤激酶融合基因阳性晚期非小细胞肺癌疗效与安全性比较

    Institute of Scientific and Technical Information of China (English)

    姚舒洋; 张毅; 胡牧; 王若天; 支修益


    Y. The ORR and DCR were 35. 0% and 70. 0%. The efficacY in the crizotinib group was better than that in the platinum two-drug regimen group(u= -2. 19,P=0. 04). One patient with PD in the crizotinib group was evaluated as PD after 2 cYcles of treatment,its FBs was 2 months,the drugs were not stopped and the patients'conditions were not deteriorated at 10 months of follow-up. Another patient,whose efficacY was PR, changed to PD after 12 months of treatment and died due to progression of nsCLC after one month of crizotinib withdrawal. His( Her)PFs was 2 months. The patient's condition had no further progression during the following 10-month follow-up. There were 6 patients judged as PD after 2 cYcles chemotherapY in the platinum two-drug regimen group. Their PFs were 1. 5 months,and theY were changed the therapeutic regimen after judging as PD. Other 4 patient in the platinum two-drug regimen group judged as PD during follow-up,and their PFs were 10. 0,4. 5,5. 0,and 6. 0 months,respectivelY. The incidence of Ⅰ-Ⅱadverse reactions in the crizotinib group was 81. 8%(9/11),and there was no Ⅲ-Ⅳ adverse reactions in the crizotinib group. The incidence of Ⅰ-Ⅱ adverse reactions in the platinum two-drug regimen group was 55. 0%(11/20),and Ⅲ-Ⅳ was 45. 0%(9/20). The difference in total incidence of adverse reactions between the 2 groups was statisticallY significant(χ2 =5. 872,P=0. 027). Conclusion The efficacY and safetY of crizotinib are better than those of platinum-containing two-drug regimens in the treatment of advanced nsCLC patients with positive EML4-ALK fusion gene.%目的:比较克唑替尼与含铂两药方案治疗棘皮动物微管结合蛋白4( EML4)-间变性淋巴瘤激酶(ALK)融合基因阳性晚期非小细胞肺癌(nsCLC)患者的疗效与安全性。方法收集2013年12月至2015年2月首都医科大学宣武医院胸外科收治的所有EML4-ALK融合基因阳性晚期nsCLC患者的住院病历和门诊随访资料进行回顾

  20. Cisplatin-based chemotherapy: Add high-frequency audiometry in the regimen

    Directory of Open Access Journals (Sweden)

    R Arora


    Full Text Available Background : Cisplatin-induced ototoxicity shows high interindividual variability and is often accompanied by transient or permanent tinnitus. It is not possible to identify the susceptible individuals before commencement of the treatment. We conducted a prospective, randomized and observational study in a tertiary care centre and evaluated the effects of different doses of cisplatin on hearing. Materials and Methods : Fifty-seven patients scheduled for cisplatin-based chemotherapy were included in the study. All patients were divided into three groups depending on the dose of cisplatin infused in 3 weeks. Results : The subjective hearing loss was found in seven patients, while six patients had tinnitus during the chemotherapy. The hearing loss was sensorineural, dose dependent, symmetrical, bilateral and irreversible. Higher frequencies were first to be affected in cisplatin chemotherapy. Conclusion : As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.

  1. The cost-effectiveness of adjuvant chemotherapy for early breast cancer: A comparison of no chemotherapy and first, second, and third generation regimens for patients with differing prognoses. (United States)

    Campbell, H E; Epstein, D; Bloomfield, D; Griffin, S; Manca, A; Yarnold, J; Bliss, J; Johnson, L; Earl, H; Poole, C; Hiller, L; Dunn, J; Hopwood, P; Barrett-Lee, P; Ellis, P; Cameron, D; Harris, A L; Gray, A M; Sculpher, M J


    The risk of recurrence following surgery in women with early breast cancer varies, depending upon prognostic factors. Adjuvant chemotherapy reduces this risk; however, increasingly effective regimens are associated with higher costs and toxicity profiles, making it likely that different regimens may be cost-effective for women with differing prognoses. To investigate this we performed a cost-effectiveness analysis of four treatment strategies: (1) no chemotherapy, (2) chemotherapy using cyclophosphamide, methotrexate, and fluorouracil (CMF) (a first generation regimen), (3) chemotherapy using Epirubicin-CMF (E-CMF) or fluorouracil, epirubicin, and cyclophosphamide (FEC60) (a second generation regimens), and (4) chemotherapy with FEC60 followed by docetaxel (FEC-D) (a third generation regimen). These adjuvant chemotherapy regimens were used in three large UK-led randomised controlled trials (RCTs). A Markov model was used to simulate the natural progression of early breast cancer and the impact of chemotherapy on modifying this process. The probability of a first recurrent event within the model was estimated for women with different prognostic risk profiles using a parametric regression-based survival model incorporating established prognostic factors. Other probabilities, treatment effects, costs and quality of life weights were estimated primarily using data from the three UK-led RCTs, a meta-analysis of all relevant RCTs, and other published literature. The model predicted the lifetime costs, quality adjusted life years (QALYs) and cost-effectiveness of the four strategies for women with differing prognoses. Sensitivity analyses investigated the impact of uncertain parameters and model assumptions. For women with an average to high risk of recurrence (based upon prognostic factors and any other adjuvant therapies received), FEC-D appeared most cost-effective assuming a threshold of £20,000 per QALY for the National Health Service (NHS). For younger low risk

  2. The clinical observation of neoadjuvant chemotherapy in locally advanced breast cancer with DX regimen

    Institute of Scientific and Technical Information of China (English)

    Miao Zhang; Jianing Qiu; Shuxian Qu; Yaling Han; Zhaozhe Liu; Xiaodong Xie


    Objective:The recent clinical curative ef ect and adverse events of docetaxel and capecitabine (DX) of neo-adjuvant chemotherapy in patients with local y advanced breast cancer was discussed. Methods:The data of 72 cases of neoadjuvant chemotherapy (DX) in local y advanced breast cancer after 4 cycles were retrospectively analyzed. Docetaxel 75 mg/m2 by infusion 1 h on d1, capecitabine 2000 mg/m2 by oral for twice daily on d1–14, 21 days was a cycle. Results:Al 72 patients were assessed for ef icacy and adverse events. The total ef ective rate was 80.5%(58/72), including pathological complete response (pCR) was 7 (9.7%), clinical complete remission (cCR) was 15(20.8%), clinical partial response (PR) was 43 (59.7%), stable disease (SD) was 8 (11.1%) and progressive disease (PD) was 6 (8.3%). The main adverse events were gastrointestinal reactions and bone marrow suppression. The 3 to 4 degrees of adverse reactions including granulocytopenia in 7 patients (20.6%), hand-foot syndrome in 6 patients (15.2%). Conclusion:The DX regimen provide a favorable ef icacy and safety profile in patients with local y advanced breast cancer for neoadjuvant chemotherapy.

  3. DNA修复率与晚期消化道肿瘤含铂化疗方案疗效相关性的研究%Correlation between DNA repair rates and platinum-containing chemotherapy efficacy for patients with ad-vanced gastrointestinal cancer

    Institute of Scientific and Technical Information of China (English)

    王丹丹; 顾康生


    Objective To investigate the relationship between the DNA repair rate( DRR) of peripheral blood lymphocytes ( PBLC) and platinum⁃containing chemotherapy efficacy in advanced gastrointestinal malignancies. Methods The DRR of PBLC from 112 patients with advanced gastrointestinal cancer patients( cancer group) were detected by single cell gel electrophoresis( SCGE) , and other 60 patients with healthy subjects were selected as controls( control group) . Cancer patients were treated in parallel platinum⁃con⁃taining chemotherapy regimens to evaluate the short⁃term effect. In cancer group, the DRR of the two platinum groups before and after exposure to platinum were analyzed. Then, the correlation between the DRR of cancer group and clinical pathological features and effi⁃cacy of chemotherapy regimens containing platinum was also investigated. Results Tail length( TL) and tail moment( TM) were uti⁃lized to detect the DRR of esophageal cancer(Z=-4�687, P=0�000; Z=-4�939, P=0�000), gastric cancer(Z=-5�473, P=0�000;Z=-3�789, P=0�000) and colorectal cancer( Z=-5�796, P=0�000;Z=-5�206, P=0�000) . The PBLC DRRs of cancer group were lower than that of control group counterpart. The PBLC DRR of cancer group exhibit no correlation to sex, age, ECOG score, alcohol habits and tissue differentiation of the tumor( P>0�05) . Among 112 patients, 110 cases were evaluable for efficacy. For esophageal cancer, there were 3 cases of PR, 6 cases of SD and 12 cases of PD with response rate( RR) of 14�3% and disease control rate( DCR) of 42�9%. For gastric cancer, there were 1 case of CR, 5 cases of PR, 10 cases of SD and 20 cases of PD with RR of 16�7% and DCR of 44�4%. For colorectal cancer, there were 2 cases of CR, 8 cases of PR, 13 cases of SD and 30 cases of PD with RR of 18�9% and DCR of 43�4%.When TL was utilized as an evaluation index of DRR, the DRR of esophageal cancer(r=-0�500, P=0�021), gastric cancer(r=-0�546, P=0�001

  4. Neoadjuvant chemotherapy of cisplatin and fluorouracil regimen in head and neck squamous cell carcinoma: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    SU Yu-xiong; ZHENG Jia-wei; ZHENG Guang-sen; LIAO Gui-qing; ZHANG Zhi-yuan


    Background The benefit of neoadjuvant chemotherapy in the management of head and neck squamous cell carcinomas (HNSCC) still remains controversial. The aim of this meta-analysis is to evaluate the role of the neoadjuvant chemotherapy with the cisplatin and fluororacil (PF) regimen in enhancing the overall survival of and decreasing locoregional relapse and distant metastasis in HNSCC patients.Methods Medline and manual searches were performed to identify all published randomized controlled trials (RCTs) investigating the efficacy of the neoadjuvant chemotherapy with the PF regimen. Outcomes assessed by meta-analysis included Iocoregional relapse, distant metastasis, and overall survival. The odds ratio was the principle measurement of effect, which was calculated as the treatment group (chemotherapy plus Iocoregional treatment) versus the control group (Iocoregional treatment alone) and was presented as a point estimate with 95% confidence intervals (Cl).Results Eight RCTs were adopted for analysis. The meta-analysis showed that the odds ratio for the Iocoregional relapse was 0.92 (0.70-1.22, 95%Cl), which was not statistically significant. The odds ratios for distant metastasis and overall survival were 0.47 (0.33-0.68, 95% Cl) and 1.28 (1.01-1.62, 95% Cl) respectively, which were both statistically significant.Conclusions Neoadjuvant chemotherapy with the PF regimen in HNSCC patients has no effect on Iocoregional relapse. However, it shows a small but significant benefit in reducing distant metastasis and improving the overall survival.

  5. [The fourth report from Sapporo Tsukisamu Hospital - chemotherapy and its regimen as second choice for patients with early gastric cancer]. (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Yamaguchi, Kouji; Shirasaka, Tetsuhiko


    Surgical treatments for early gastric cancer, such as endoscopic procedures, are currently performed as standard therapy. However, when surgery is not possible due to physical or mental conditions, effective chemotherapy with minimum side effects is a second choice, although a suitable regimen has yet to be recommended. We thus retrospectively evaluated the Int FP regimen for 10 early gastric cancer patients. The results show an efficacy ratio of 100% (CR 8 cases, PR 2 cases). The two PR cases subsequently underwent surgical treatment. The 1-, 3-, and 5-year survival rates of all cases were 100%, 90% and 60%, respectively. The 1-, 3-, and 5-year survival rates of patients with chemotherapy alone were 100%, 87.5% and 50%, respectively, although none of the patients died of cancer (5-year survival rate of 100%). One out of the 8 CR cases relapsed 7 months after achieving CR. This patient then received chemotherapy with the same regimen, achieving a second CR and survived for 66 months without disease. All cases developed hematological toxicities, although they were all under grade 2 except for 2 cases which were grade 3 (decrease of WBC or Hb). Non-hematological toxicities were seen in 7 cases, all under grade 2. These results, although from a limited number of subjects, indicated that the IntFP regimen is safe and may contribute to achieving pathological CR and long-term survival of patients with early gastric cancer.

  6. Acute lymphoblastic leukaemia: cyclical chemotherapy with three combinations of four drugs (COAP-POMP-CART regimen). (United States)

    Spiers, A S; Roberts, P D; Marsh, G W; Parekh, S J; Franklin, A J; Galton, D A; Szur, Z L; Paul, E A; Husband, P; Wiltshaw, E


    Forty-two adults and children with previously untreated acute lymphoblastic leukaemia (ALL) were entered into a programme of chemotherapy in which three combinations, each of four drugs were administered in a predetermined cyclical rotation together with cranial irradiation and intrathecal injections of methotrexate. Forty-one patients (98%) entered remission and no patient developed neuroleukaemia. Relapse of ALL occurred in 10 patients, and three patients died during remission, while eight patients stopped treatment after two and a half years and have remained in remission for two to 26 months. Comparison of remission and survival experience in this mixed group of children and adults with the experience of children treated at Memphis and in the Medical Research Council's UKALL-I trial showed no significant differences. On the other hand, analysis by prognostic factors showed that neither age nor blast cell count at presentation had any adverse effect in patients treated in this study. No relapses occurred in nine patients with blast cell counts greater than 20 x 109/1 at presentation. This regimen is effective treatment for ALL and may be of special value in patients with poor prognoses. The regiment has not as yet proved superior for the treatment of children with ALL who do not have adverse prognostic features.

  7. Toxicity during l-LV/5FU adjuvant chemotherapy as a modified RPMI regimen for patients with colorectal cancer. (United States)

    Hotta, Tsukasa; Takifuji, Katsunari; Arii, Kazuo; Yokoyama, Shozo; Matsuda, Kenji; Higashiguchi, Takashi; Tominaga, Toshiji; Oku, Yoshimasa; Yamaue, Hiroki


    l-leucovorin (LV)/5-fluorouracil (5FU) may play an important role, as an adjuvant chemotherapy, in improving the survival of patients with stage III colorectal cancer. However, severe toxicity of the chemotherapeutic agent could be fatal. Adverse effects, including bone marrow suppression, liver damage, renal damage, and glucose tolerance, were evaluated daily during 3 courses of l-LV/5FU-modified RPMI regimen adjuvant chemotherapy for 22 patients with stage III colorectal cancer. Decrease in the serum levels of neutrophils and platelets occurred in the 1st course, which became more obvious after three or four administrations of l-LV/5FU in the 1st course. Furthermore, serum levels of leukocytes, neutrophils, and platelets on the re-start day of this chemotherapy after 2-week intervals were lower than those on the start day of this chemotherapy. In the evaluation of liver damage, renal damage, and glucose tolerance; serum alanine aminotransferase level in the 2nd course, serum total bilirubin (T.Bil) level in the 1st course, and serum creatinine level in the 1st course deteriorated during the course. T.Bil levels on the re-start day of this chemotherapy after 2-week intervals were especially high compared to that on the start day. The more courses of this chemotherapy we perform, the more attention we must pay to bone marrow suppression and hyperbilirubinemia. Thus, we clarified the attentive point of side effect of l-LV/5FU adjuvant chemotherapy for colorectal cancer.

  8. Resource Utilization for Chemotherapy-Induced Nausea and Vomiting Events in Patients with Solid Tumors Treated with Antiemetic Regimens (United States)

    Schwartzberg, Lee; Harrow, Brooke; Lal, Lincy S.; Radtchenko, Janna; Lyman, Gary H.


    Background Chemotherapy-induced nausea and vomiting (CINV) can lead to increased emergency department visits and hospitalizations, which may contribute to increased cost of care. Antiemetic agents, such as neurokinin-1 (NK1) receptor antagonists and 5-hydroxytryptamine (5-HT3) receptor antagonists, are prescribed for patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). The current guidelines recommend a 3-drug combination of an NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone with HEC regimens and certain MEC regimens. Objective To compare the incidence of CINV and CINV-related resource utilization among patients who receive guideline-adherent HEC and MEC regimens and patients who receive non–guideline-adherent regimens. Methods In this retrospective, claims-based study, Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) Research Edition database was used to identify 8089 patients with solid tumors receiving therapy with anthracycline plus cyclophosphamide (AC), cisplatin, or carboplatin from June 2013 to December 2013. The patients were stratified according to the use of an NK1 receptor antagonist regimen. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify CINV events associated with hospital, emergency department, and outpatient office visits among patients in the NK1 receptor antagonist group and the non-NK1 receptor antagonist group. Results A total of 1059 patients were included in the analysis, of whom 51% (N = 536) used an NK1 receptor antagonist–based regimen and 49% (N = 523) used non-NK1 receptor antagonist therapy. A higher percentage of patients receiving AC (73%) than cisplatin (56%) or carboplatin (23%) received an NK1 receptor antagonist. The incidence rates of total CINV events and CINV-related emergency department visits were lower in the group receiving an NK1 receptor

  9. Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jun; CHEN Ren-xiong; ZHANG Jing; CAI Jun; MENG Hua; WU Guo-cong; ZHANG Zhong-tao; WANG Yu; WANG Kang-li


    Background Gastric cancer is one of the most common types of malignant tumors in China and East Asia and has the highest mortality rate of the malignant gastrointestinal tumors.Neoadjuvant chemotherapy is a systemic or local chemotherapy that is given prior to the local treatment of malignant tumors.Neoadjuvant therapy is currently showing some positive prospects; however,its clinical effects remain controversial.In this study,we used the modified FOLFO×7 (mFOLFO×7) regimen as a neoadjuvant chemotherapy regimen.Perioperative clinical and pathological efficacy,toxicity,effects of surgery,postoperative observation,and prognosis were studied to investigate its clinical efficacy and safety.Methods Eighty patients with advanced gastric cancer were treated in our surgery department from 2005 to 2009; 38 of these patients received mFOLFO×7 neoadjuvant chemotherapy,the other 42 patients assigned to the control group.The perioperative effects of mFOLFO×7 chemotherapy,including clinical effects and toxicity,were observed in each patient.Results After mFOLFO×7 chemotherapy,clinical and pathologic stages decreased in 21.1% and 36.8% of the patients,respectively,but the results were not statistically significant (P=0.129).The clinical response rate was 50% (19/38).Toxicity was mild; most adverse events were grade I or ll and involved no severe infections or deaths.Compared with the control group,the radical resection rate increased (92.1% vs.85.7%; P=0.437); surgical effects were completed without an increased incidence of perioperative complications.The 1-,2-,and 3-year survival rates were 78.70%,57.40%,and 51.66%,respectively,in the neoadjuvant chemotherapy group and 78.57%,56.87%,and 43.16%,respectively,in the control group.Conclusions The mFOLFO×7 regimen was very effective and well-tolerated as a neoadjuvant chemotherapy for advanced gastric cancer.However,the 1-,2-,and 3-year survival rates in the mFOLFO×7 group were not significantly

  10. Effectiveness of multi-drug regimen chemotherapy treatment in osteosarcoma patients: a network meta-analysis of randomized controlled trials. (United States)

    Wang, Xiaojie; Zheng, Hong; Shou, Tao; Tang, Chunming; Miao, Kun; Wang, Ping


    Osteosarcoma is the most common malignant bone tumour. Due to the high metastasis rate and drug resistance of this disease, multi-drug regimens are necessary to control tumour cells at various stages of the cell cycle, eliminate local or distant micrometastases, and reduce the emergence of drug-resistant cells. Many adjuvant chemotherapy protocols have shown different efficacies and controversial results. Therefore, we classified the types of drugs used for adjuvant chemotherapy and evaluated the differences between single- and multi-drug chemotherapy regimens using network meta-analysis. We searched electronic databases, including PubMed (MEDLINE), EmBase, and the Cochrane Library, through November 2016 using the keywords "osteosarcoma", "osteogenic sarcoma", "chemotherapy", and "random*" without language restrictions. The major outcome in the present analysis was progression-free survival (PFS), and the secondary outcome was overall survival (OS). We used a random effect network meta-analysis for mixed multiple treatment comparisons. We included 23 articles assessing a total of 5742 patients in the present systematic review. The analysis of PFS indicated that the T12 protocol (including adriamycin, bleomycin, cyclophosphamide, dactinomycin, methotrexate, cisplatin) plays a more critical role in osteosarcoma treatment (surface under the cumulative ranking (SUCRA) probability 76.9%), with a better effect on prolonging the PFS of patients when combined with ifosfamide (94.1%) or vincristine (81.9%). For the analysis of OS, we separated the regimens to two groups, reflecting the disconnection. The T12 protocol plus vincristine (94.7%) or the removal of cisplatinum (89.4%) is most likely the best regimen. We concluded that multi-drug regimens have a better effect on prolonging the PFS and OS of osteosarcoma patients, and the T12 protocol has a better effect on prolonging the PFS of osteosarcoma patients, particularly in combination with ifosfamide or vincristine

  11. Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?

    NARCIS (Netherlands)

    Hendriks, L.E.; Brouns, A.J.; Amini, M.; Uyterlinde, W.; Wijsman, R.; Bussink, J.; Biesma, B.; Oei, S.B.; Stigt, J.A.; Bootsma, G.P.; Belderbos, J.S.; Ruysscher, D.K. De; Heuvel, M.M. Van den; Dingemans, A.C.


    OBJECTIVES: Symptomatic brain metastases (BM) occur frequently after chemoradiotherapy (CRT) for stage III NSCLC. Aim of the current study was to determine whether the specific chemotherapy used in a CRT regimen influences BM development. MATERIALS AND METHODS: Retrospective multicenter study

  12. Toxicity assessment of molecularly targeted drugs incorporated into multiagent chemotherapy regimens for pediatric Acute Lymphocytic Leukemia (ALL): Review from an International Consensus Conference

    NARCIS (Netherlands)

    T.M. Horton (Terzah); R. Sposto (Richard); P. Brown (Patrick); C.P. Reynolds (Patrick); S.P. Hunger (Stephen); N.J. Winick (Naomi); E.A. Raetz (Elizabeth); W.L. Carroll (William); R.J. Arceci (Robert); M.J. Borowitz (Michael); P.S. Gaynon (Paul); L. Gore (Lia); S. Jeha (Sima); B.J. Maurer (Barry); S.E. Siegel (Stuart); A. Biondi (Andrea); P. Kearns (Pamela); A. Narendran (Aru); L.B. Silverman (Lewis); M.A. Smith (Malcolm); C.M. Zwaan (Christian Michel); J.A. Whitlock (James)


    textabstractOne of the challenges of incorporating molecularly targeted drugs into multi-agent chemotherapy (backbone) regimens is defining dose-limiting toxicities (DLTs) of the targeted agent against the background of toxicities of the backbone regimen. An international panel of 22 pediatric acute

  13. Phase III study of TAC and TP regimens as neoadjuvant chemotherapy in patients with triple-negative breast cancer

    Institute of Scientific and Technical Information of China (English)

    Hanguang Ruan; Juan Xiong; Meng Wu


    This study aimed to compare the eficacy and safety of neoadjuvant chemotherapy with TAC and TP regimens of triple negative breast cancer (TNBC).Methods: A total of 102 patients with TNBC were confirmed by histopathol-ogy. They were divided into TAC group (52 cases) and TP group (50 cases). Group TAC: Docetaxel 75 mg/m2 or paclitaxel (taxol liposome) 135 mg/m2 on d1, pirarubicin 40 mg/m2 or epirubicin 75 mg/m2 on d2, cyclophosphamide 600 mg/m2 on d1;Group TP: Docetaxel 75 mg/m2 or paclitaxel (taxol liposome) 135 mg/m2 on d1, cisplatin 30 mg/m2on d2-d4, with 21 days as a cycle. Al patients underwent operation after 2-4 cycles of chemotherapy. The short-term efects and toxic and adverse efects were evaluated. Results: In TAC group, 5 cases (9.6%) had pathological complete release (pCR), 35 cases (67.3%) partial release (PR), 9 cases (17.3%) stable disease (SD), and the response rate (RR) was 76.9%. In TP group, 4 cases (8%) had pCR, 32 cases (64%) PR, 5 cases (10%) SD, and RR was 72%. In 102 patients, 12 patients with tumor progression after 2 cycles of chemotherapy, included 3 cases in TAC group, 9 cases in TP group. In TAC group, 2 cases occurred atrial premature contraction; while 3 cases developed grade 2 renal injury in TP group. In TAC group, grade 3-4 hematologic toxicity and alo-pecia was significantly higher than that in TP group, but grade 3-4 gastrointestinal reaction rate in TP group was significantly higher than TAC group.Conclusion:TAC and TP regimens al had certain eficacy in the neoadjuvant chemotherapy for TNBC, and the toxicity reactions can be tolerated.

  14. Docetaxel, cisplatin and fluorouracil (DCF regimen compared with non-taxane-containing palliative chemotherapy for gastric carcinoma: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiao-Long Chen

    Full Text Available BACKGROUND: Gastric carcinoma (GC is one of the highest cancer-mortality diseases with a high incidence rate in Asia. For surgically unfit but medically fit patients, palliative chemotherapy is the main treatment. The chemotherapy regimen of docetaxel, cisplatin and 5-fluorouracil (DCF has been used to treat the advanced stage or metastatic GC. It is necessary to compare effectiveness and toxicities of DCF regimen with non-taxane-containing palliative chemotherapy for GC. METHODS: PubMed, EmBase, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure databases were searched to select relative randomized controlled trials (RCTs comparing DCF to non-taxane-containing chemotherapy for patients with palliatively resected, unresectable, recurrent or metastatic GC. Primary outcome measures were 1-year and 2-year overall survival (OS rates. Secondary outcome measures were median survival time (MST, median time to progression (TTP, response rate and toxicities. RESULTS: Twelve RCTs were eligible and 1089 patients were analyzed totally (549 in DCF and 540 in control. DCF regimen increased partial response rate (38.8% vs 27.9%, p = 0.0003 and reduced progressive disease rate (18.9% vs 33.3%, p = 0.0005 compared to control regimen. Significant improvement of 2-year OS rate was found in DCF regimen (RR = 2.03, p = 0.006, but not of 1-year OS rate (RR = 1.22, p = 0.08. MST was significantly prolonged by DCF regimen (p = 0.039, but not median TTP (p = 0.054. Both 1-year OS rate and median TTP had a trend of prolongation by DCF regimen. Chemotherapy-related mortality was comparable (RR = 1.23, p = 0.49 in both regimens. In grade I-IV toxicities, DCF regimen showed a major raise of febrile neutropenia (RR = 2.33, p<0.0001 and minor raises of leucopenia (RR = 1.25, p<0.00001, neutropenia (RR = 1.19, p<0.00001, and diarrhea (RR = 1.59, p<0.00001, while in other toxicities

  15. Metastatic medullary thyroid cancer: a dramatic response to a systemic chemotherapy (temozolomide and capecitabine regimen

    Directory of Open Access Journals (Sweden)

    Lacin S


    Full Text Available Sahin Lacin, Ece Esin, Yusuf Karakas, Suayib Yalcin Department of Medical Oncology, Institute of Cancer, Hacettepe University, Ankara, Turkey Abstract: A 40-year-old male patient presented with increasing serum levels of calcitonin and CEA. He underwent potential curative surgery for medullary thyroid carcinoma, 3 years ago and then 7 months later he had metastasectomy and cervical lymph node dissection for recurrent disease. On admission he had multiple metastatic skin nodules on the chest wall and positron emission tomography–computed tomography revealed multiple visceral metastases as well. The patient had not received any systemic treatment up to that time; therefore, we considered systemic treatment with the new tyrosine kinase inhibitors (vandetanib, cabozantinib, etc. However, since these drugs are only available after cytotoxic chemotherapy, we started temozolomide and capecitabine chemotherapy. After two courses of the treatment all skin nodules disappeared and CEA and calcitonin levels normalized, radiological imaging showed a good partial response. Keywords: medullary thyroid cancer, capecitabine, temozolomide, chemotherapy

  16. Evaluation of two preoparative chemotherapy regimens for complete operability of advanced gastric adenocarcinoma: a clinical trial

    Directory of Open Access Journals (Sweden)

    S. Sedighi


    Full Text Available Background: This prospective phase III study was designed to compare the activity of two combinations chemotherapy drugs in advanced gastric adenocarcinoma Methods: In a double blinded clinical trial, From Jan. 2002 to Jan. 2005, ninety patients with advanced gastric adenocarcinoma were randomly assigned to 1 Cisplatin and continuous infusion of 5FU and Epirubicin (ECF, and 2 Cisplatin and continuous infusion of 5FU with Docetaxel (TCF. Reduction in tumor mass, overall survival (OS, time to progression (TTP, and safety were measured outcome. Results: About 90% of patients had stage III or IV disease and the most common sites of tumor spread were peritoneal surfaces, liver and Paraaortic lymph nodes in either group. The objective clinical response rate (more than 50% decreases in tumor mass was 38% and 43% in ECF and TCF group respectively. Global quality of life increased (p=0 002 and symptoms of pain and insomnia decreased after chemotherapy. Patients in TCF had more grade one or two skin reactions, neuropathy and diarrhea. Fourteen patients underwent surgery. Complete microscopic (R0 resection had done in two of ECF and six of TCF tumors (p=0.015. Two cases in TCF group showed complete pathologic response. Median TTP was nine months and 10 months in ECF and TCF group respectively. Median OS was 12 months in both groups. Conclusion: Although there wasn’t statistically significant difference regarded to clinical response or survival between two groups, TCF showed more complete pathologic response.

  17. Investigation of morphological changes in platinum-containing nanostructures created by electron-beam-induced deposition

    NARCIS (Netherlands)

    Botman, A.; Hesselberth, M.; Mulders, J.J.L.


    Focused electron-beam-induced deposition (EBID) allows the rapid fabrication of three-dimensional nanodevices and metallic wiring of nanostructures, and is a promising technique for many applications in nanoresearch. The authors present two topics on platinum-containing nanostructures created by EBI

  18. Choroid plexus papilloma-A case highlighting the challenges of extrapolating pediatric chemotherapy regimens to adult populations. (United States)

    Barman, Stephen L; Jean, Gary W; Dinsfriend, William M; Gerber, David E


    The treatment of adults who present with rare pediatric tumors is not characterized well in the literature. We report an instance of a 40-year-old African American woman with a diagnosis of choroid plexus carcinoma admitted to the intensive care unit for severe sepsis seven days after receiving chemotherapy consisting of carboplatin (350 mg/m(2) on Days 1 and 2 plus etoposide 100 mg/m(2) on Days 1-5). Her laboratory results were significant for an absolute neutrophil count of 0/µL and blood cultures positive for Capnocytophagia species. She was supported with broad spectrum antibiotics and myeloid growth factors. She eventually recovered and was discharged in stable condition. The management of adults with malignancies most commonly seen in pediatric populations presents substantial challenges. There are multiple age-specific differences in renal and hepatic function that explain the need for higher dosing in pediatric patients without increasing the risk of toxicity. Furthermore, differences in pharmacokinetic parameters such as absorption, distribution, and clearance are present but are less likely to affect patients. It is expected that the pediatric population will have more bone marrow reserve and, therefore, less susceptible to myelosuppression. The extrapolation of pediatric dosing to an adult presents a problematic situation in treating adults with malignancies that primarily effect pediatric patients. We recommend extrapolating from adult treatment regimens with similar agents rather than extrapolating from pediatric treatment regimens to reduce the risk of toxicity. We also recommend the consideration of adding myeloid growth factors. If the treatment is tolerated without significant toxicity, dose escalation can be considered.

  19. Improved control of nausea and emesis with a new bromazepam-containing ondansetron regimen in ovarian cancer patients receiving chemotherapy with carboplatin and cyclophosphamide. (United States)

    Meden, H; Meissner, O; Conrad, A; Kuhn, W


    Ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin. Its role in milder emetogenic regimes has not been fully defined. This study investigated the efficacy of two different antiemetic regimes in thirty-five patients with ovarian cancer receiving 68 cycles of chemotherapy with carboplatin (350 mg/m2) and cyclophosphamide (600 mg/m2). Ondansetron (3 x 8 mg i.v.) was compared to a bromazepam-containing ondansetron regimen. Nausea was absent in 65% of chemotherapy courses in patients receiving the combination of ondansetron and bromazepam and in 38% of chemotherapy courses in patients receiving ondansetron alone. Complete control of emesis was achieved in 93% of the courses in patients receiving the combination and in 81% of the courses using ondansetron alone. The addition of bromazepam to ondansetron, and the extension of antiemetic prophylaxis to the day before and the day after chemotherapy improves the control of nausea and emesis compared to ondansetron monotherapy in patients with ovarian cancer.

  20. Comparison of MACT and 5Fu+ACT-D chemotherapy regimens in the treatment of low-risk gestational trophoblastic neoplasia. (United States)

    Wang, Yu; Miao, Jin-Wei; Wang, Tong; Wang, Yan; Wu, Yu-Mei; Kong, Wei-Min; Su, Li; Duan, Wei


    The study aimed to compare the efficacy of methotrexate (MTX) cervical injections + actinomycin-D (ACT-D)(MACT) and 5-fluorouracil (5-Fu) + actinomycin-D (5-Fu plus ACT-D) chemotherapy regimens for low-risk gestational trophoblastic neoplasia (LR-GTN). Clinical data from 66 LR-GTN patients, admitted to the Beijing Obstetrics and Gynecology Hospital from January 2010 to April 2012, were analysed retrospectively. In total, 32 patients were treated with a MACT therapeutic regimen and the remaining 34 with a 5Fu + ACT-D therapeutic regimen. Complete remission rates (CR), duration of treatment, hospital stay and toxicity effects were compared. There was no statistical difference in CR for the MACT (90.63%) or the 5-Fu plus ACT-D (100%) therapeutic regimens (p = 0.0676) or in the duration of treatment [MACT (3.50) or 5-Fu plus ACT-D (3.71; p = 0.2021)]. Moreover, the hospital stay in the 5-Fu plus ACT-D group (32.88 days) was significantly longer than for the MACT group (22.09 days; p < 0.001). Furthermore, the degree of myelosuppression, nausea and vomiting, diarrhoea, stomatitis and alopecia was more severe in the 5Fu + ACT-D group (p < 0.01). However, there was no statistical difference in the severity of liver function damage between the two groups. A shorter hospital stay, lower hospitalization cost and slightly more toxic effects were observed in LR-GTN patients treated with the MACT therapeutic regimen. We suggest that the MACT regimen should be used as first-line chemotherapy for LR-GTN.

  1. ¹⁸F-FDG PET/CT for the Early Evaluation of Response to Neoadjuvant Treatment in Triple-Negative Breast Cancer: Influence of the Chemotherapy Regimen. (United States)

    Groheux, David; Biard, Lucie; Giacchetti, Sylvie; Teixeira, Luis; Hindié, Elif; Cuvier, Caroline; Vercellino, Laetitia; Merlet, Pascal; de Roquancourt, Anne; de Cremoux, Patricia; Resche-Rigon, Matthieu; Espié, Marc


    Patients with triple-negative breast cancer (TNBC) have poor outcome when pathologic complete response (pCR) is not reached after neoadjuvant chemotherapy. Early prediction would be helpful. We evaluated the association between metabolic response after 2 cycles of neoadjuvant chemotherapy, pCR, and outcome in patients receiving 2 different anthracycline-based regimens (conventional and intensified). Of 77 consecutive TNBC patients, 23 received EC-D (4 cycles of epirubicin + cyclophosphamide followed by 4 cycles of docetaxel at conventional doses) and 55 received a dose-intensified, dose-dense concomitant regimen of epirubicin + cyclophosphamide (historically called SIM) for 6 cycles. PET/CT with (18)F-FDG was performed at baseline and after 2 cycles of neoadjuvant chemotherapy. The associations between clinical factors, biologic factors, early metabolic change, pCR, and event-free survival (EFS) were examined (log-rank test). Of the 78 patients, 29 (37%) achieved pCR. The change in SUVmax (∆SUVmax) after 2 cycles was more pronounced in patients who achieved pCR (-72% vs. -42%;P< 0.0001). ∆SUVmax was more pronounced under SIM than under EC-D (-68% vs. -35%, P= 0.009), and there was a trend for a higher pCR rate (44% vs. 22%, P= 0.078). Twenty-two patients relapsed and 10 of them died (median follow-up, 34 mo). pCR was associated with EFS (log-rank, P= 0.001). ∆SUVmax was also significantly associated with EFS both in patients receiving SIM (P= 0.028) and in those receiving EC-D (P= 0.021). The optimal ∆SUVmax for predicting pCR and EFS was, however, specific to the treatment regimen. EFS was not associated with tumor grade (P= 0.98), histologic subtype (P= 0.17), or clinical stage (P= 0.097). Early metabolic change during neoadjuvant chemotherapy can predict pathologic response and EFS in TNBC patients under different chemotherapy regimens. However, the metabolic response varies with the type of chemotherapy. © 2016 by the Society of Nuclear Medicine and

  2. Safety and radiation-enhancing effect of sodium glycididazole in loco regionally advanced laryngeal cancers previously treated with platinum-containing chemotherapy regimens: a preliminary report; Tolerance et effet radiosensibilisateur du sodium glycididazole chez des patients atteints de cancer du larynx localement evolue ayant prealablement recu une chimiotherapie a base de cisplatine: rapport preliminaire

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Y.C.; Wu, R.; Xu, Z.G.; Zhang, X.Y.; Wu, L.N.; Wang, Y.M.; Zheng, W.; Chen, X.D.; Chi, F.; Zhang, Z.Y.; Li, X.; Jin, X.Y.; Chen, W.; Wang, S.L.; Xiao, F.D.; Wang, E.Y.; Dong, X.Q.; Jia, M.X.; Li, Y. [China Medical Univ., Dept. of Medical Oncology, Shengjing Hospital, Shenyang, PR (China); Fan, G.L. [Harbin First Hospital, Dept. of Otorhinolaryngology, PR (China); Hao, S.H.; Zhang, L.B.; Zhang, H.B. [General Hospital of Shenyang Military Region, Dept. of Nuclear Medicine and Radiology, Shenyang, PR (China); Xia, H.H.X. [Novartis Pharmaceuticals Corporation, East Hanover, New Jersey (United States)


    Purpose: To determine the safety and radiation-enhancing effect of sodium glycididazole in laryngeal squamous cell carcinoma (stage T3-4,N0-3,M0) with conventional radiotherapy. Patients and methods: Patients with locoregional advanced laryngeal cancer (stage T3-4,N0-3,M0) were included: group 1(control, n = 30)were not administered of sodium glycididazole; group 2 (test, n = 30) received sodium glycididazole at a dose of 700 mg/m2 intravenous infusion 30 minutes before radiotherapy three times a week. Surrogate end-points of efficacy were tumor and nodal size. Safety parameters were vomiting, nausea, mucositis, laryngeal edema, esophagus and skin reaction, dysphagia, dyspnea, neurological deficit. Patients were evaluated weekly during treatment for 7 weeks and thereafter monthly for 3 months. Results: In the test, the overall response rate was 88.89% (95% CI, 71.00-97.00%) at 7 weeks and 92.59% (95% CI, 76.00 to 99.00%) at 1 month of follow-up. In the control, the overall response rate was 62.5% (95% CI, 41.00 to 81.00%) at 7 weeks and 58.33% (95% CI, 37.00 to 78.00%) at 1 month of follow-up. The short-term locoregional response rate was better in the test group at 7 weeks (p = 0.027) and at 1 month (p = 0.005) of follow-up. The test group had significantly more nausea and vomiting in weeks 1 (p = 0.047), 2 (p = 0.007), and 3 (p = 0.01) of treatment. Conclusions: The study indicates sodium glycididazole is an effective radiation-enhancing agent that improves short-term locoregional control and is well tolerated in patients with loco regionally advanced laryngeal cancer. (authors)

  3. Differential effect of adjuvant taxane-based and taxane-free chemotherapy regimens on the CK-19 mRNA-positive circulating tumour cells in patients with early breast cancer. (United States)

    Xenidis, N; Perraki, M; Apostolaki, S; Agelaki, S; Kalbakis, K; Vardakis, N; Kalykaki, A; Xyrafas, A; Kakolyris, S; Mavroudis, D; Georgoulias, V


    To determine the effect of adjuvant taxane-free and taxane-based chemotherapy regimens on the elimination of circulating tumour cells (CTCs) in patients with early breast cancer. The presence of CK-19 mRNA-positive CTCs in the peripheral blood was evaluated before and after chemotherapy, using a real-time RT-PCR assay, in a historical comparison of two cohorts of women with stage I-III breast cancer treated with adjuvant taxane-free (N=211; FE(75)C or E(75)C) and taxane-based (N=334; T/E(75)C or T/E(75)) chemotherapy. Taxane-based chemotherapy resulted in a higher incidence of CTCs' elimination than taxane-free regimens since 49.7% (74 of 149) and 33.0% (29 of 88) of patients with detectable CTCs before chemotherapy, respectively, turned negative post-chemotherapy (P=0.015). Patients treated with taxane-free regimens had a significantly lower disease-free survival (DFS) (P=0.035) than patients treated with taxane-based regimens; this difference was observed in patients with but not without detectable CTCs before chemotherapy (P=0.018 and P=0.481, respectively). The incidence of deaths was significantly higher in the taxane-free cohort of patients with but not without detectable CTCs before chemotherapy compared with that of the taxane-based cohort (P=0.002). Multivariate analysis revealed that the chemotherapy regimen was significantly associated with prolonged DFS (HR: 2.00; 95% CI=1.20-3.34). Elimination of CK-19 mRNA-positive CTCs during adjuvant chemotherapy seems to be an efficacy indicator of treatment and is associated with a favourable clinical outcome of patients with detectable CTCs before chemotherapy.

  4. Successful treatment of low-grade oligodendroglial tumors with a chemotherapy regimen of procarbazine, lomustine, and vincristine

    NARCIS (Netherlands)

    Stege, Elize M Biemond-ter; Kros, Johan M; de Bruin, Hein G; Enting, R H; van Heuvel, Irene; Looijenga, Leendert H J; van der Rijt, Carin D D; Smitt, Peter A E Sillevis; van den Bent, Martin J


    BACKGROUND: Anaplastic oligodendroglioma (OD) tumors, especially those with the combined loss of the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q), are sensitive to chemotherapy. Only limited data are available on the role of chemotherapy in low-grade OD. The authors retrosp

  5. Receipt of maintenance therapy is most predictive of survival in older acute lymphoblastic leukemia patients treated with intensive induction chemotherapy regimens. (United States)

    Landsburg, Daniel J; Stadtmauer, Edward; Loren, Alison; Goldstein, Steven; Frey, Noelle; Nasta, Sunita D; Porter, David L; Tsai, Donald E; Perl, Alexander E; Hexner, Elizabeth O; Luger, Selina


    While the prognosis for older adults diagnosed with acute lymphoblastic leukemia (ALL) is frequently poor, long-term survival can be achieved in patients treated with curative intent. We reviewed the outcomes of 37 patients age ≥60 treated at our institution with either DVP- or hyperCVAD-based chemotherapy regimens from 2003-2011. In this patient population, a complete response rate of 92%, relapse rate of 56% and median overall survival of 18.1 months was experienced. Univariate analysis revealed that receipt of maintenance therapy vs. no maintenance therapy was associated with a statistically-significant impact on overall survival (p = 0.001, HR 0.15 for death), while disease-related characteristics including high-risk white blood cell count at diagnosis and Philadelphia chromosome status as well as treatment-related factors including chemotherapy regimen or completion of intensive therapy were not. Many patients were unable to initiate or remain on maintenance therapy due to toxicities including infections and cytopenias. Our analysis reveals the benefit of prolonged therapy in the treatment of older adults with ALL as well as the high incidence of treatment-related toxicity experienced by these patients.

  6. Cold Autoimmune Hemolytic Anemia due to High-grade non Hodgkin's B cell Lymphoma with Weak Response to Rituximab and Chemotherapy Regimens. (United States)

    Nazel Khosroshahi, Behzad; Jafari, Mohammad; Vazini, Hossein; Ahmadi, Alireza; Shams, Keivan; Kholoujini, Mahdi


    Autoimmune hemolytic anemia (AIHA) is characterized by shortening of red blood cell (RBC) survival and the presence of autoantibodies directed against autologous RBCs. Approximately 20% of autoimmune hemolytic anemia cases are associated with cold-reactive antibody. About half of patients with AIHA have no underlying associated disease; these cases are termed primary or idiopathic. Secondary cases are associated with underlying diseases or with certain drugs. We report herein a rare case of cold autoimmiune hemolytic anemia due to high-grade non-Hodgkin's lymphoma of B-cell type with weak response to rituximab and chemotherapy regimens. For treatment B cell lymphoma, Due to lack of treatment response, we used chemotherapy regimens including R- CHOP for the first time, and then Hyper CVAD, R- ICE and ESHAP were administered, respectively. For treatment of autoimmune hemolytic anemia, we have used the corticosteroid, rituximab, plasmapheresis and blood transfusion and splenectomy. In spite of all attempts, the patient died of anemia and aggressive lymphoma nine months after diagnosis. To our knowledge, this is a rare report from cold autoimmune hemolytic anemia in combination with high-grade non-Hodgkin's lymphoma of B-cell type that is refractory to conventional therapies.

  7. Platinum containing amorphous hydrogenated carbon (a-C:H/Pt) thin films as selective solar absorbers

    Energy Technology Data Exchange (ETDEWEB)

    Lan, Yung-Hsiang; Brahma, Sanjaya [Department of Materials Science and Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Tzeng, Y.H. [Department of Electrical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Ting, Jyh-Ming, E-mail: [Department of Materials Science and Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Research Center for Energy Technology and Strategy, National Cheng Kung University, Tainan 701, Taiwan (China)


    We have investigated a double-cermet structured thin film in which an a-C:H thin film was used as an anti-reflective (AR) layer and two platinum-containing amorphous hydrogenated carbon (a-C:H/Pt) thin films were used as the double cermet layers. A reactive co-sputter deposition method was used to prepare both the anti-reflective and cermet layers. Effects of the target power and heat treatment were studied. The obtained films were characterized using X-ray diffraction, scanning electron microscopy, high-resolution transmission electron microscopy. The optical absorptance and emittance of the as deposited and annealed films were determined using UV–vis-NIR spectroscopy. We show that the optical absorptance of the resulting double-cermet structured thin film is as high as 96% and remains to be 91% after heat treatment at 400 °C, indicating the thermal stability of the film.

  8. Copper transporters and the cellular pharmacology of the platinum-containing cancer drugs. (United States)

    Howell, Stephen B; Safaei, Roohangiz; Larson, Christopher A; Sailor, Michael J


    Multiple lines of evidence indicate that the platinum-containing cancer drugs enter cells, are distributed to various subcellular compartments, and are exported from cells via transporters that evolved to manage copper homeostasis. The cytotoxicity of the platinum drugs is directly related to how much drug enters the cell, and almost all cells that have acquired resistance to the platinum drugs exhibit reduced drug accumulation. The major copper influx transporter, copper transporter 1 (CTR1), has now been shown to control the tumor cell accumulation and cytotoxic effect of cisplatin, carboplatin, and oxaliplatin. There is a good correlation between change in CTR1 expression and acquired cisplatin resistance among ovarian cancer cell lines, and genetic knockout of CTR1 renders cells resistant to cisplatin in vivo. The expression of CTR1 is regulated at the transcriptional level by copper via Sp1 and at the post-translational level by the proteosome. Copper and cisplatin both trigger the down-regulation of CTR1 via a process that involves ubiquitination and proteosomal degradation and requires the copper chaperone antioxidant protein 1 (ATOX1). The cisplatin-induced degradation of CTR1 can be blocked with the proteosome inhibitor bortezomib, and this increases the cellular uptake and the cytotoxicity of cisplatin in a synergistic manner. Copper and platinum(II) have similar sulfur binding characteristics, and the presence of stacked rings of methionines and cysteines in the CTR1 trimer suggest a mechanism by which CTR1 selectively transports copper and the platinum-containing drugs via sequential transchelation reactions similar to the manner in which copper is passed from ATOX1 to the copper efflux transporters.

  9. [Clinical evaluations of neoadjuvant chemotherapy with DN and FP regimens for patients with middle or lower thoracic locally advanced esophageal squamous cell carcinoma]. (United States)

    Yang, Hongxia; Yao, Juan; Wen, Hong; Yu, Lan; Liu, Wu; Liang, Hua; Han, Shuhong


    To explore the efficacies and side effects of neoadjuvant chemotherapy with DN (docetaxel plus cisplatin) and FP (nedaplatin plus cisplatin) regimens for patients with upper or middle thoracic locally advanced esophageal squamous cell carcinoma. From January 2008 to January 2012, a total of 124 patients with upper or middle thoracic locally advanced esophageal squamous cell carcinoma were randomized into DN group (n = 64) and FP group (n = 60). Both groups received neoadjuvant chemotherapy. The treatment schedule was recycled every 3 weeks. After 2 cycles, those with potential surgical resection underwent surgery. The 2-year overall, locoregional relapse-free and distant metastasis-free survival rates in DN and FP groups were 71.1% and 66.7%, 65.0% and 63.0%, 78.3% and 74.3% respectively (P > 0.05). The incidence of leucopenia was higher in DN group than that in FP group (P DN group. No perioperative mortality occurred with a low incidence of postoperative complications. The rates of overall response, resection, postoperative complications and pathological complete rates response were similar in two groups. And the rates of downstage and R0 resection were significantly higher in DN group than those in FP group (P < 0.05). For patients with middle or lower thoracic locally advanced esophageal squamous cell carcinoma, neoadjuvant chemotherapies of docetaxel and nedaplatin may achieve excellent outcomes in clinical response and 2-year survival rate. And the side effects are clinically acceptable.

  10. Long-term remission in mantle cell lymphoma following high-dose sequential chemotherapy and in vivo rituximab-purged stem cell autografting (R-HDS regimen). (United States)

    Gianni, Alessandro M; Magni, Michele; Martelli, Maurizio; Di Nicola, Massimo; Carlo-Stella, Carmelo; Pilotti, Silvana; Rambaldi, Alessandro; Cortelazzo, Sergio; Patti, Caterina; Parvis, Guido; Benedetti, Fabio; Capria, Saveria; Corradini, Paolo; Tarella, Corrado; Barbui, Tiziano


    Mantle cell lymphoma (MCL) is rarely cured with standard-dose chemotherapy. From January 1997 to February 2000, 28 previously untreated advanced-stage MCL patients younger than 61 years of age were treated at 9 Italian hematologic departments with 3 cycles of standard-dose debulking chemotherapy followed by a high-dose rituximab-supplemented sequence (R-HDS) including intravenous administration of high-dose cyclophosphamide, high-dose cytarabine, high-dose melphalan, and high-dose mitoxantrone plus melphalan. Study end points included toxicity, clinical and molecular response rates, long-term event-free survival (EFS), and overall survival (OS) rates, as well as the ability to harvest tumor-free peripheral blood stem cells. Optimal amounts of polymerase chain reaction-negative (PCR-negative) CD34+ cells were collected from all 20 informative patients. One patient died of toxicity. All 27 patients assessable for response achieved a complete response (CR), of which 24 remain in continuous complete remission (CCR) after a median follow-up of 35 months. Three patients had transient evidence of PCR-detectable disease in the bone marrow. The OS and EFS rates at 54 months were 89% and 79%, respectively. These results compare with the 42% OS rate and the 18% EFS rate observed in 35 age-matched historic controls treated with standard-dose chemotherapy at the participating centers. The use of rituximab in combination with high-dose chemotherapy represents a very effective in vivo purging method. The R-HDS regimen can be safely applied in a multicenter hematology setting and leads to long-term EFS and OS in the majority of patients with an otherwise incurable disease.

  11. Nutritional status is superior to the ECOG performance status in predicting the dose-intensity of the GEMOX chemotherapy regimen in patients with advanced cancer. (United States)

    Cessot, Anatole; Coriat, Romain; Mir, Oliver; Boudou-Rouquette, Pascaline; Giroux, Julie; Durand, Jean-Philippe; Alexandre, Jérôme; Goldwasser, Francois


    The increasing number of unfit patients calls for better risk assessment prior to initiating anti-tumor treatment. This is a major concern in the prevention and reduction of treatment-related complications. The aim of our study was to evaluate the nutritional status for the risk assessment of patients qualifying to receive the gemcitabine and oxaliplatin (GEMOX) regimen. This single-center, retrospective study examined baseline clinical and biological characteristics in a cohort of 165 unselected, consecutive cancer patients receiving GEMOX. Malnutrition was defined as either body mass index (BMI) 10% over 3 mo, or albuminemia 0.05). Median relative dose-intensity was 0.90 (0.17-1.04). GEMOX dose-intensity correlated negatively with loss of baseline weight (r = -0.24, P chemotherapy, median PS (P nutritional status, including albuminemia and BMI, is recommended.

  12. Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are NOT suitable for a "standard chemotherapy regimen": the CASA randomized trial. (United States)

    Crivellari, Diana; Gray, Kathryn P; Dellapasqua, Silvia; Puglisi, Fabio; Ribi, Karin; Price, Karen N; Láng, István; Gianni, Lorenzo; Spazzapan, Simon; Pinotti, Graziella; Lüthi, Jean-Marc; Gelber, Richard D; Regan, Meredith M; Colleoni, Marco; Castiglione-Gertsch, Monica; Maibach, Rudolf; Rabaglio, Manuela; Coates, Alan S; Goldhirsch, Aron


    There is no optimal treatment for breast cancers lacking estrogen (ER) and progesterone (PgR) receptors in elderly women with co-morbidities that prevent use of "standard chemotherapy regimens" such as AC or CMF. The CASA trial studied pegylated liposomal doxorubicin (PLD) and low dose, metronomic cyclophosphamide + methotrexate (CM) for older (>65), vulnerable women with operable, ER and PgR-negative breast cancer. After two years the trial closed early, due to slow and inadequate accrual, with 77 patients (38:PLD, 36:CM, 3:nil). Sixty-eight percent completed PLD; 83% completed CM (both 16 weeks). Patients on PLD reported worse quality of life, cognitive and physical functioning than non-PLD regimens (primarily CM). At a median follow-up of 42 months, 81% of randomized patients remained free of any breast cancer recurrence. Based on our limited experience, PLD and CM may be reasonable options for further study for elderly vulnerable patients with endocrine nonresponsive breast cancer.

  13. Standard intensive chemotherapy is less effective and far more toxic than attenuated induction and post-induction regimen in elderly patients with acute myeloid leukemia. (United States)

    Huang, Bin-Tao; Zhao, Wei-Hong; Zeng, Qing-Chun; Li, Bing-Sheng; Chen, Rui-lin


    The open-label, prospective study aimed to evaluate the efficacy and safety for standard intensive chemotherapy compared with attenuated therapy in elderly patients with acute myeloid leukemia (AML). A total of 297 patients between 65 and 82 years were enrolled in the study. The 141 patients received standard-dose therapy (daunorubicin 45 mg/m(2) × 3 days with cytarabine 100 mg/m(2) × 7 days for induction therapy, while post-induction therapy consisted of high-dose cytarabine 1.5 g/m(2) × 4 days), and the attenuated treatment (daunorubicin 30 mg/m(2) × 3 days with cytarabine 75 mg/m(2) × 7 days for induction therapy, while post-induction therapy consisted of attenuated high-dose Ara-C 1.0 g/m(2) × 3 days) was administered to the remaining 156 patients, based on a random number assigned. Total 168 patients (56.6%) achieved complete remission with an incomplete blood recovery (CR)/CRi. No significant differences were observed between the two treatments (P = 0.60). Attenuated chemotherapy improved overall survival (OS) and progression-free survival (PFS) compared to standard-dose therapy; 5-year OS values for these two groups were 39 and 24 months, respectively (P negative impact and yielded OS and PFS values similar to those of the standard-dose chemotherapy with a better-to-intermediate risk profile. Five-year OS values for these two groups were 28 versus 28 months (P = 0.89), and the 5-year PFS values were 27 and 28 months, respectively (P = 0.89). The most common adverse drug effect for chemotherapy was agranulocytosis (98.3%). There was a significant difference in early mortality between the attenuated and standard-dose treatment groups (0.64% vs. 7.1%, respectively, P chemotherapy is less effective and far more toxic than attenuated induction and post-induction regimen in elderly patients with AML.

  14. [Clinical efficacy of decitabine plus improved CAG chemotherapy and haplo-identical donor peripheral lymphocyte infusion regimen on elderly patients with high risk myelodysplastic syndrome and acute myeloid leukemia]. (United States)

    Dou, Li-Ping; Jing, Yu; Wang, Quan-Shun; Mei, Jun-Hui; Yu, Li


    This study was aimed to observe the clinical efficacy and adverse effects of decitabine plus improved CAG chemotherapy and haploid-identical donor peripheral lymphocyte infusion regimen on elderly patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Five elderly patients with MDS and AML were treated with decitabine plus improved CAG chemotherapy and donor peripheral lymphocyte infusion regimen. Examinations on liver and renal function, electrocardiogram and bone marrow analysis were performed before and after treatment, and adverse effects were observed. The results indicated that after a course of treatment by decitabine plus improved CAG chemotherapy and haplo-identical donor peripheral lymphocyte infusion regimen, the total effective rate was 100%, and 4 patients (80%) achieved complete remission, 1 patient achieved partial remission. The dominant clinical adverse effect was bone marrow depression, the median time of neutrophil>0.5×10(9)/L and platelet>20×10(9)/L was 15 d and 16 d respectively for patients without previous MDS. It is concluded that decitabine plus improved CAG chemotherapy and haploid-identical donor peripheral lymphocyte infusion regimen may be effective with less adverse effects for elderly primary AML and high risk MDS patients, it is a promising therapeutic methods and worthy to deeply study.

  15. patients with Acute Myeloid leukemia or high-risk Myelodisplastic syndrome according to IPSS score treated with AML-like multiple days chemotherapy regimen | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available e con aprepitant verso dosi multiple di palonosetron nel prevenire la nausea ed il vomito da chemioterapia in pazienti con leucemia... prevenire la nausea ed il vomito da chemioterapia in pazienti con leucemia mieloide acuta o con sindrome mi...ltiple days chemotherapy regimen pazienti con leucemia mieloide acuta o con sindr

  16. Reliability of estimated glomerular filtration rate in patients treated with platinum containing therapy

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Gundgaard, Maria G; Mortensen, Mette S


    Estimates of glomerular filtration rate (eGFR) are widely used when administering nephrotoxic chemotherapy. No studies performed in oncology patients have shown whether eGFR can safely substitute a measured GFR (mGFR) based on a marker method. We aimed to assess the validity of four major formula...

  17. Time-Series Modeling and Simulation for Comparative Cost-Effective Analysis in Cancer Chemotherapy: An Application to Platinum-Based Regimens for Advanced Non-small Cell Lung Cancer. (United States)

    Chisaki, Yugo; Nakamura, Nobuhiko; Yano, Yoshitaka


    The purpose of this study was to propose a time-series modeling and simulation (M&S) strategy for probabilistic cost-effective analysis in cancer chemotherapy using a Monte-Carlo method based on data available from the literature. The simulation included the cost for chemotherapy, for pharmaceutical care for adverse events (AEs) and other medical costs. As an application example, we describe the analysis for the comparison of four regimens, cisplatin plus irinotecan, carboplatin plus paclitaxel, cisplatin plus gemcitabine (GP), and cisplatin plus vinorelbine, for advanced non-small cell lung cancer. The factors, drug efficacy explained by overall survival or time to treatment failure, frequency and severity of AEs, utility value of AEs to determine QOL, the drugs' and other medical costs in Japan, were included in the model. The simulation was performed and quality adjusted life years (QALY) and incremental cost-effectiveness ratios (ICER) were calculated. An index, percentage of superiority (%SUP) which is the rate of the increased cost vs. QALY-gained plots within the area of positive QALY-gained and also below some threshold values of the ICER, was calculated as functions of threshold values of the ICER. An M&S process was developed, and for the simulation example, the GP regimen was the most cost-effective, in case of threshold values of the ICER=$70000/year, the %SUP for the GP are more than 50%. We developed an M&S process for probabilistic cost-effective analysis, this method would be useful for decision-making in choosing a cancer chemotherapy regimen in terms of pharmacoeconomic.

  18. Comparison of the effectiveness and toxicity of neoadjuvant chemotherapy regimens, capecitabine/epirubicin/cyclophosphamide vs 5-fluorouracil/epirubicin/cyclophosphamide, followed by adjuvant, capecitabine/docetaxel vs docetaxel, in patients with operable breast cancer (United States)

    Zhang, Minmin; Wei, Wei; Liu, Jianlun; Yang, Huawei; Jiang, Yi; Tang, Wei; Li, Qiuyun; Liao, Xiaoming


    The aim of this study was to compare the effectiveness and toxicity of neoadjuvant chemotherapy regimens, xeloda/epirubicin/cyclophosphamide (XEC) vs 5-fluorouracil/epirubicin/cyclophosphamide (FEC), followed by adjuvant chemotherapy regimens, capecitabine/taxotere (XT) vs taxotere (T), in axillary lymph node (LN)-positive early-stage breast cancer. In this randomized, Phase III trial, 137 patients with operable primary breast cancer (T2-0, N0-1) who were tested axillary LN positive through aspiration biopsy of axillary LNs were randomized (1:1) to four 3-weekly cycles of XEC or FEC. Patients underwent surgery within 4–6 weeks after the fourth cycle, followed by four adjuvant cycles of 3-weekly XT or T. The primary end point was tumor pathological complete response. Toxicity profiles were secondary objectives. In total, 131 patients had clinical and radiological evaluation of response and underwent surgery. Treatment with XEC led to an increased rate of pathological complete response in primary tumor (18% vs 6%, respectively, P=0.027) and objective remission rate (87% vs 73%, P=0.048) compared to FEC. Clinical complete response occurred in 20% and 7% for XEC and FEC, respectively. Compared to FEC, XEC was associated with more hand-foot syndrome (57% vs 11%, P<0.001) and 3/4 grade nausea/vomiting/diarrhea (30% vs 14%, P=0.034) but less phlebitis (3% vs 14%, P=0.035). XT and T adjuvant chemotherapy regimens were well tolerated: treatment-related 3/4 grade adverse events occurred in 28% and 17% of patients receiving XT and T, respectively. PMID:27354816

  19. Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study. (United States)

    Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki


    The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV.


    Directory of Open Access Journals (Sweden)

    Deyan N. Davidov


    Full Text Available Objective: Single agent Docetaxel is a standard therapy for patients with non- small cell lung cancer after the failure of platinum- containing regimens. The aim of this study was to explore the efficacy and safety of Docetaxel monotherapy as second- line chemotherapy in pretreated patient with inoperable non- small cell lung cancer. Methods: From January 2005 to May 2008 thirty- six consecutive patients with locally advanced or metastatic morphologically proven stage IIIB/ IV non- small cell lung cancer entered the study after failure of previous platinum- based regimens. Treatment schedule consist of Docetaxel 75 mg/m2 administered every three weeks with repetition after 21 days with Dexamethasone premedication. Results: Overall response rate, median time to progression and median survival was 16,6 %, 4,5 months and 5,6 months respectively. The main hematological toxicity was neutropenia. Conclusions: That data suggest that single agent Docetaxel remain reasonable choices for the chemotherapy in pretreated patients with non- small cell lung cancer.

  1. BCVPP chemotherapy for advanced Hodgkin's disease: evidence for greater duration of complete remission, greater survival, and less toxicity than with a MOPP regimen. Results of the Eastern Cooperative Oncology Group study. (United States)

    Bakemeier, R F; Anderson, J R; Costello, W; Rosner, G; Horton, J; Glick, J H; Hines, J D; Berard, C W; DeVita, V T


    Two chemotherapy regimens for treatment of patients with advanced Hodgkin's disease, BCVPP (carmustine, cyclophosphamide, vinblastine, procarbazine, and prednisone) and MOPP (mechlorethamine hydrochloride, vincristine, procarbazine, and prednisone), were compared in a randomized prospective study. Two hundred ninety-three patients were evaluable in the induction phase of this study. The complete remission rate with BCVPP was 76% (112/147) and with MOPP, 73% (106/146) (p = 0.51). The duration of complete remissions for previously untreated patients given BCVPP was significantly longer than that for previously untreated patients given MOPP (p = 0.02). Although hematologic toxicities were similar, BCVPP caused less gastrointestinal (p = 0.0001) and neurologic toxicity (p = 0.01) than MOPP. Previously untreated patients achieving complete remission with BCVPP survived significantly longer than those receiving MOPP (p = 0.03). As primary induction chemotherapy for advanced Hodgkin's disease, BCVPP is an effective alternative to MOPP, having equal or greater therapeutic benefit with less toxicity.

  2. Detection of Asymptomatic Cardiac Metastasis and Successful Salvage Chemotherapy Comprising a Prednisone, Etoposide, Procarbazine, and Cyclophosphamide Regimen in an Elderly Japanese Patient Suffering from a Delayed Recurrence of Diffuse Large B-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Keita Tagami


    Full Text Available We report a case of facial diffuse large B-cell lymphoma (DLBCL associated with recurrent metastasis in the heart and other sites in a 76-year-old Japanese woman. Initially, she developed DLBCL in her left upper eyelid that spread into the left orbit (Ann Arbor classification stage I. The lesion went into clinical regression after 4 cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy followed by radiotherapy. More than 3 years later, the lymphoma recurred in her facial skin, together with metastases in the mediastinal lymph nodes and the heart; the tumor in the heart was successfully detected by PET/CT and cardiac MRI. To treat the recurrent lesions, we performed a salvage chemotherapy regimen comprising prednisone, etoposide, procarbazine, and cyclophosphamide, which successfully induced tumor regression.

  3. 晚期食管癌2种化疗方案疗效对比观察%Two regimens for chemotherapy of advanced esophageal cancer in comparison

    Institute of Scientific and Technical Information of China (English)



    目的:观察DF/TP方案化疗晚期食管癌疗效.方法:按治疗方案将患者分为A、B两组,A组予DF(DDP 20mg/m2,d1-5;5-FU 0.5g/m2,d1-5)化疗,有效者(CR/PR)共3-4个周期,化疗2周期未达PR改用TP方案化疗2周期;B组予TP( TAX 175mg/m2,d1,DDP 30mg/m2,d1,2,3)方案化疗,有效者(CR/PR)共3-4个周期、化疗2周期未达PR改用其他治疗方案.结果:两组有效率相近(P>0.05),无显著差异;恶心、呕吐、胆红素、转氧酶毒性无显著差异(P>0.05);白细胞与血红蛋白毒性、脱发、神经毒性有显著差异(P<0.05);TP方案对DF方案化疗进展或无效者有效率21.05%;DF方案中位进展期3个月,TP方案中位进展期4个月.结论:TP方案二线使用更有优势.%Objective:To observe the effect of the chemotherapy with DF or TP regimen for advanced esophageal cancer. Methods: Group A: patients were treated with DF regimen ( DDP 20mg/mJ d1_5,5-FU 0. 5g/m2 d1-5). Patients who were effective(CR or PR) were treated continued with the treatment for 3 to 4 cycles. Patients who were not effective( PR) after 2 chemotherapy cycles were administered with TP ( TAX 175mg/m2, d,, DDP 30mg/m2, d1,2,3) regimen for 2 cycles; Group B: patients were treated with TP regimen(TAX 175mg/m2,di ,DDP 3Omg/m2, d1, 2,3 ). Patients who were effective( CR or PR) were continued treatment for 3 to 4 cycles. Patients who were not ef-fective( PR) after 2 chemotherapy cycles were administered with other regimen. Results;The effective rate of the two groups of initial treatment was not different (P>0.05). Incidences of nausea and vomiting and toxicity of bilirubin and transaminase were not different( P >0.05) ,but the toxicity of leucocyte and hemoglobin and hair and nerve was different (P<0.05). The TP regimen was effective to patients who were worsened or ineffective and their effective rates were 21.05% respectively. Median time to progression was 3 months with DF regimen of initial treatment. Median time to progression was 4

  4. Comparison of the effectiveness and toxicity of neoadjuvant chemotherapy regimens, capecitabine/epirubicin/cyclophosphamide vs 5-fluorouracil/epirubicin/cyclophosphamide, followed by adjuvant, capecitabine/docetaxel vs docetaxel, in patients with operable breast cancer

    Directory of Open Access Journals (Sweden)

    Zhang MM


    Full Text Available Minmin Zhang,* Wei Wei,* Jianlun Liu, Huawei Yang, Yi Jiang, Wei Tang, Qiuyun Li, Xiaoming Liao Department of Breast Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China *These authors contributed equally to this work Abstract: The aim of this study was to compare the effectiveness and toxicity of neoadjuvant chemotherapy regimens, xeloda/epirubicin/cyclophosphamide (XEC vs 5-fluorouracil/epirubicin/cyclophosphamide (FEC, followed by adjuvant chemotherapy regimens, capecitabine/taxotere (XT vs taxotere (T, in axillary lymph node (LN-positive early-stage breast cancer. In this randomized, Phase III trial, 137 patients with operable primary breast cancer (T2-0, N0-1 who were tested axillary LN positive through aspiration biopsy of axillary LNs were randomized (1:1 to four 3-weekly cycles of XEC or FEC. Patients underwent surgery within 4–6 weeks after the fourth cycle, followed by four adjuvant cycles of 3-weekly XT or T. The primary end point was tumor pathological complete response. Toxicity profiles were secondary objectives. In total, 131 patients had clinical and radiological evaluation of response and underwent surgery. Treatment with XEC led to an increased rate of pathological complete response in primary tumor (18% vs 6%, respectively, P=0.027 and objective remission rate (87% vs 73%, P=0.048 compared to FEC. Clinical complete response occurred in 20% and 7% for XEC and FEC, respectively. Compared to FEC, XEC was associated with more hand-foot syndrome (57% vs 11%, P<0.001 and 3/4 grade nausea/vomiting/diarrhea (30% vs 14%, P=0.034 but less phlebitis (3% vs 14%, P=0.035. XT and T adjuvant chemotherapy regimens were well tolerated: treatment-related 3/4 grade adverse events occurred in 28% and 17% of patients receiving XT and T, respectively. Keywords: breast cancer, capecitabine, docetaxel, neoadjuvant chemotherapy, curative effect, toxic side effects

  5. Topoisomerase II alpha and TLE3 as predictive markers of response to anthracycline and taxane-containing regimens for neoadjuvant chemotherapy in breast cancer

    Directory of Open Access Journals (Sweden)

    Susini T


    Full Text Available Tommaso Susini,1 Barbara Berti,1 Carlo Carriero,1 Ketty Tavella,2 Jacopo Nori,3 Ermanno Vanzi,3 Cecilia Molino,1 Mariarosaria Di Tommaso,1 Marco Santini,1 Valeria Saladino,4 Simonetta Bianchi4 1Department of Health Science, Gynecology Section, 2Department of Health Science, Chemotherapy Section, University of Florence, Italy; 3Diagnostic Senology Unit, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; 4Department of Surgery and Translational Medicine, Pathology Unit, University of Florence, Italy Purpose: Anthracyclines and taxanes are considered the standard for neoadjuvant chemotherapy of breast cancer, although they are often associated with serious side effects and wide variability of individual response. In this study, we analyzed the value of topoisomerase II alpha (TOP2A and transducin-like enhancer of split 3 (TLE3 as predictive markers of response to therapy with anthracyclines and taxanes. Materials and methods: TOP2A and TLE3 protein expressions were evaluated using immunohistochemistry on 28 samples, obtained by core needle biopsy in patients with locally advanced breast carcinoma, subsequently subjected to epirubicin- and paclitaxel-based neoadjuvant chemotherapy. The immunohistochemical staining was correlated with the clinical response measured by the tumor size reduction evaluated by breast magnetic resonance imaging, prior and after chemotherapy, and by pathologic evaluation of the surgical specimen. Results: Neoadjuvant chemotherapy achieved a size reduction in 26/28 tumors (92.9%, with an average percentage decrease of 45.6%. A downstaging was achieved in 71.4% of the cases of locally advanced carcinoma. TOP2A positivity was correlated with a greater reduction in tumor diameter (P=0.06; negative staining for TLE3 was predictive of a better response to neoadjuvant chemotherapy (P=0.07. A higher reduction in tumor diameter (P=0.03 was also found for tumors that were concurrently TLE3-negative and TOP2A

  6. Incidence of hand-foot syndrome with capecitabine in combination with chemotherapy as first-line treatment in patients with advanced and/or metastatic gastric cancer suitable for treatment with a fluoropyrimidine-based regimen. (United States)

    Gómez-Martin, Carlos; Sánchez, Antonio; Irigoyen, Antonio; Llorente, Beatriz; Pérez, Begoña; Serrano, Raquel; Safont, M José; Falcó, Esther; Lacasta, Adelaida; Reboredo, Margarita; Aparicio, Jorge; Dueñas, Rosario; Muñoz, Marta Llanos; Regueiro, Pilar; Sanchez-Viñes, Elena; López, Rafael López


    Hand-foot syndrome (HFS) is a limiting toxicity of capecitabine, which is not life-threatening but could compromise capecitabine efficacy. This phase II, multicenter, non-controlled study assessed the safety, particularly grade three HFS incidence, and efficacy of four capecitabine-based chemotherapy regimens [cisplatin/capecitabine (CX), epirubicin/cisplatin/capecitabine (ECX), epirubicin/oxaliplatin/capecitabine (EOX) and docetaxel/cisplatin/capecitabine (DCX)] as first-line treatment for advanced and/or metastatic gastric cancer. One hundred and eight patients were assigned to one of the four treatment groups, according to investigator's criteria, and grouped together for both safety and efficacy primary analyses. HFS was reported in 31 patients (19.6%) and its first presentation occurred at a median of 72 days (range 19-209 days). Grade 3 HFS developed in 6.3, 5.2, 3.7 and 2.4%, of patients receiving ECX, DCX, EOX or CX chemotherapy regimen, respectively. Capecitabine dose reduction/discontinuation due to HFS was required in 5.7% of patients (9/158). The most common (> 10%) grade 3-4 treatment-related AEs were neutropenia (15.2%), asthenia (12.0%) and diarrhoea (11.4%). A moderate incidence of HFS was reported in patients treated with capecitabine, which generally presented late and required dose reduction in < 1/3 of patients. The results suggest that capecitabine may be useful in combination with standard fluorouracil-based regimens in patients with advanced and/or metastatic gastric cancer with favourable safety profile.

  7. Phase II randomized clinical trial evaluating neoadjuvant chemotherapy regimens with weekly paclitaxel or eribulin followed by doxorubicin and cyclophosphamide in women with locally advanced HER2-negative breast cancer: NSABP Foundation Study FB-9. (United States)

    Abraham, Jame; Robidoux, André; Tan, Antoinette R; Limentani, Steven; Sturtz, Keren; Shalaby, Ibrahim; Alcorn, Hope; Buyse, Marc E; Wolmark, Norman; Jacobs, Samuel A


    Locally advanced breast cancer (LABC) is a good setting in which to monitor response to neoadjuvant chemotherapy, to downsize the tumor (which facilitates breast-conserving surgery), and to test newer agents in untreated patients. Eribulin (E) has shown activity in patients who have undergone previous taxane, anthracycline, and capecitabine treatment. We aimed to evaluate the neoadjuvant use of E followed by doxorubicin and cyclophosphamide (AC) in patients with HER2-negative LABC, using as a control a randomized group of women who received weekly paclitaxel (WP). Fifty women with LABC were accrued January-August 2013. Patients were randomized (1:2) to receive either WP (N = 19) for 12 treatments or E (N = 31) every 3 weeks for 4 cycles followed by AC every 3 weeks for 4 cycles before surgery. 17/19 patients who took WP and 25/30 who took E completed all cycles. Patients were evaluated by clinical examination and breast MRI at baseline and after completion of E or WP. Surgical pCR in breast and lymph nodes was determined by a local pathologist following chemotherapy. Forty-nine patients received ≥1 dose of neoadjuvant chemotherapy and are included in this analysis. Forty-eight underwent surgery; one had disease that was inoperable (on E) and is included as no-pCR patient. 17/19 of these patients who took WP completed 12 doses; 28/30 on E completed 4 cycles. Six discontinued treatment on WP, E, or AC. Both treatments were well tolerated. pCR on WP = 5/19(26 %) and on E = 5/30(17 %). Both regimens were equally well tolerated with no unexpected toxicities. pCR did not suggest higher activity with E than with other standard regimens in these LABC patients.

  8. Visible Light-Responsive Platinum-Containing Titania Nanoparticle-Mediated Photocatalysis Induces Nucleotide Insertion, Deletion and Substitution Mutations

    Directory of Open Access Journals (Sweden)

    Der-Shan Sun


    Full Text Available Conventional photocatalysts are primarily stimulated using ultraviolet (UV light to elicit reactive oxygen species and have wide applications in environmental and energy fields, including self-cleaning surfaces and sterilization. Because UV illumination is hazardous to humans, visible light-responsive photocatalysts (VLRPs were discovered and are now applied to increase photocatalysis. However, fundamental questions regarding the ability of VLRPs to trigger DNA mutations and the mutation types it elicits remain elusive. Here, through plasmid transformation and β-galactosidase α-complementation analyses, we observed that visible light-responsive platinum-containing titania (TiO2 nanoparticle (NP-mediated photocatalysis considerably reduces the number of Escherichia coli transformants. This suggests that such photocatalytic reactions cause DNA damage. DNA sequencing results demonstrated that the DNA damage comprises three mutation types, namely nucleotide insertion, deletion and substitution; this is the first study to report the types of mutations occurring after photocatalysis by TiO2-VLRPs. Our results may facilitate the development and appropriate use of new-generation TiO2 NPs for biomedical applications.

  9. Visible Light-Responsive Platinum-Containing Titania Nanoparticle-Mediated Photocatalysis Induces Nucleotide Insertion, Deletion and Substitution Mutations. (United States)

    Sun, Der-Shan; Tseng, Yao-Hsuan; Wu, Wen-Shiang; Wong, Ming-Show; Chang, Hsin-Hou


    Conventional photocatalysts are primarily stimulated using ultraviolet (UV) light to elicit reactive oxygen species and have wide applications in environmental and energy fields, including self-cleaning surfaces and sterilization. Because UV illumination is hazardous to humans, visible light-responsive photocatalysts (VLRPs) were discovered and are now applied to increase photocatalysis. However, fundamental questions regarding the ability of VLRPs to trigger DNA mutations and the mutation types it elicits remain elusive. Here, through plasmid transformation and β-galactosidase α-complementation analyses, we observed that visible light-responsive platinum-containing titania (TiO₂) nanoparticle (NP)-mediated photocatalysis considerably reduces the number of Escherichia coli transformants. This suggests that such photocatalytic reactions cause DNA damage. DNA sequencing results demonstrated that the DNA damage comprises three mutation types, namely nucleotide insertion, deletion and substitution; this is the first study to report the types of mutations occurring after photocatalysis by TiO₂-VLRPs. Our results may facilitate the development and appropriate use of new-generation TiO₂ NPs for biomedical applications.

  10. Prognostic factors in patients with advanced transitional cell carcinoma of the urothelial tract experiencing treatment failure with platinum-containing regimens

    DEFF Research Database (Denmark)

    Bellmunt, Joaquim; Choueiri, Toni K; Fougeray, Ronan;


    Cooperative Oncology Group performance status (PS) more than 0, hemoglobin level less than 10 g/dL, and the presence of liver metastasis as the main adverse prognostic factors for OS. External validation confirmed these prognostic factors. Four subgroups were formed based on the presence of zero, one, two...

  11. Environmental and biological monitoring of platinum-containing drugs in two hospital pharmacies using positive air pressure isolators. (United States)

    Kopp, Bettina; Crauste-Manciet, Sylvie; Guibert, Agnès; Mourier, Wilhelmine; Guerrault-Moro, Marie-Noelle; Ferrari, Sylvie; Jomier, Jean-Yves; Brossard, Denis; Schierl, Rudolf


    Environmental and biological monitoring of platinum containing drugs was implemented in two French hospital pharmacies using positive air pressure isolators and having similar working procedures when preparing antineoplastic drugs. Wipe sampling of surfaces, gloves, and vials was performed in the preparation room and in storage areas. All employees involved in the preparation of antineoplastic drugs were tested for urinary platinum on Monday before work and Friday after shift. Only traces of platinum were detected on surfaces in the preparation room outside the isolators (less than 1.61 pg cm(-2)). However, in one center, significant contamination was found in the storage area of the drug vials, which can most likely be linked to the rupture of a platinum vial and due to inefficient cleaning procedures. Surfaces inside the isolators were found to be contaminated (maximum: 198.4 pg cm(-2)). A higher level of contamination was detected in one pharmacy and could be explained by the lack of overgloving with regular changes during the preparation process. Nitrile gloves used during drug handling outside the isolator showed the highest platinum concentration (maximum: 5.86 ng per pair). With regards to platinum urine concentration, no significant difference was found between exposed and unexposed pharmacy personnel. Isolator technology combined with individual protective measures seems to be efficient to protect workers from occupational exposure to antineoplastic drugs, whereas specific individual protective procedures implemented were focussing on the risk of handling vials outside the isolator (e.g. high frequency of glove changing). Moreover, overgloving inside the isolator would contribute to substantially decrease inner surface contamination and should be recommended in order to limit the transfer of chemical contamination to the end products.

  12. Impact of the Functional CD5 Polymorphism A471V on the Response of Chronic Lymphocytic Leukaemia to Conventional Chemotherapy Regimens (United States)

    Delgado, Julio; Bielig, Torsten; Bonet, Lizette; Carnero-Montoro, Elena; Puente, Xose S.; Colomer, Dolors; Bosch, Elena; Campo, Elias; Lozano, Francisco


    Summary The CD5 lymphocyte receptor -a bona fide immunohistochemical marker of chronic lymphocytic leukaemia (CLL) cells- is a negative regulator of activation signals from the antigen-specific B-cell receptor (BCR). Given that signalling components of the BCR are important contributors to the variable clinical behaviour of CLL, the relevance of functional variants of CD5 on CLL prognosis was explored. The results show that germline-encoded CD5 variants influence the survival to conventional chemotherapies from CLL patients with unmutated IGVH genes. This result supports the notion that CD5 is not only a phenotypic marker but a relevant player in CLL cell biology. PMID:26991857

  13. Hepatitis C-Induced Hepatitis Flare in a Patient with Non-Hodgkin B-Cell Lymphoma Treated by Rituximab Including Chemotherapy (Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin - Vincristine, Prednisolone Regimen

    Directory of Open Access Journals (Sweden)

    Asim Ulcay


    Full Text Available Hepatitis virus infections can lead to more critical outcomes such as severe hepatic dysfunction, failure and fulminancy in immunosuppressive patients compared to immunocompetent individuals. It is globally accepted that reactivation of both Hepatitis B virus [HBV ] and Hepatitis C virus [HCV] occurs after chemotherapy and antibody treatments of malignant diseases or solid organ/ bone marrow transplant in recipient patients. Especially among B-cell Non Hodgkin Lymphoma [NHL] patients, according to various studies, the seroprevelance of HCV is higher than that of the general population. On the other hand the role of HCV in the pathogenesis and etiology of NHL has been suggested. Today, cytotoxic drugs, corticosteroids, rituximab and hepatotoxic regimens are administered to NHL patients. Specifically, it has been emphasized that the utilization of rituximab [Anti CD20 antibody ] regiments for B-cell NHL patients may result with flares in HCV patients conspicuously. Here, we report the case of an acute flare up due to HCV infection in a patient who underwent a 4 month course of rituximab containing chemotherapy against a B cell NHL [CD20+ ] disease and a dramatic recovery from HCV infection at the end. [Dis Mol Med 2014; 2(3.000: 51-54

  14. MFL-P Chemotherapy for Pretreated Metastatic Breast Cancer Patients: A Regimen with Triple Biochemical Modulation by MTX-5FU, LV-5FU and 5FU-CDDP. (United States)

    Kan; Honda


    BACKGROUND: Chemotherapeutic regimens, such as cyclophosphamide + doxorubicin + 5FU (CAF) or cyclophosphamide + methotrexate + 5FU (CMF), are sometimes used in combination with endocrine or radiotherapy as a standard first line of treatment for recurrent or metastatic breast cancer. However, many cases are, or become, refractory to these treatments. METHODS: Twenty-one women with recurrent or metastatic breast cancer who previously underwent treatment were administered our original regimen of combinationchemotherapy, MFL-P: Day 1, bolus methotrexate (MTX) 50 mg/body (median dose, 33 mg/m(2); range, 29-35 mg/m(2)) and 4 hours later 5-fluorouracil (5FU) 750 mg/body/h (median dose, 497 mg/m(2)/h; range, 441-528 mg/m(2) /h); Days 2-3, bolus leucovorin(LV) 15 mg/body every 8 h x 3; Days 2-5, 72 hours continuous 5FU 750 mg/body/24h; Day 6, cisplatin (CDDP) 50 mg/body/h (median dose, 33 mg/m(2)/h; range, 29-35 mg/m(2) /h) with sufficient hydration. The subjects ranged in age from 26 to 63 years (mean age, 51.3 years). RESULTS: One complete and 9 partial responses were achieved among the 20 patients (response rate, 50%). In 1 patient, diffuse liver metastasis was not measurable. Among various metastatic sites, a higher response rate was observed especially for soft tissue lesions (skin, chest wall and lymph nodes; 9 responders among 11 lesions). On the other hand, in visceral or skeletal metastases, the response rate was poor. The adverse effects were tolerable in all patients, except for common low-grade stomatitis or anorexia. CONCLUSION: MFL-P is useful as a second or third line of therapy for patients with refractory, recurrent or metastatic breast cancer with soft tissues lesions.

  15. Cisplatin- vs. oxaliplatin-based radiosensitizing chemotherapy for squamous cell carcinoma of the esophagus. A comparison of two preoperative radiochemotherapy regimens

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, K. [University Clinic of the Ruhr University Bochum, Department of Radiation Oncology, Marien Hospital Herne, Herne (Germany); University of Bochum, Department of Radiation Oncology, Bochum (Germany); Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Ordu, A.D.; Molls, M. [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Haller, B. [Technische Universitaet Muenchen, Department of Epidemiology and Medical Statistics, Klinikum rechts der Isar, Munich (Germany); Theisen, J. [Technische Universitaet Muenchen, Department of Surgery, Klinikum rechts der Isar, Munich (Germany); Lordick, F. [University Clinic Leipzig, University Cancer Center Leipzig (UCCL), Leipzig (Germany); Technische Universitaet Muenchen, Department of Internal Medicine III (Hematology/Oncology), Klinikum rechts der Isar, Munich (Germany); Bisof, V. [Clinical Hospital Centre Zagreb, Department of Oncology, Zagreb (Croatia); Geinitz, H. [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Krankenhaus der Barmherzigen Schwestern Linz, Department of Radiation Oncology, Linz (Austria)


    To compare the outcomes of two neoadjuvant radiochemotherapy (N-RCT) regimens for squamous cell carcinoma of the esophagus (ESCC). The standard N-RCT regimen for ESCC at our institution between 2002 and 2011 was a total dose of 45 Gy (1.8-Gy fractions) with concomitant cisplatin (20 mg/m{sup 2}, days 1-5 and 29-33) and 5-fluorouracil (5-FU; 225 mg/m{sup 2}, 24 h continuous infusion on days 1-33). During the same period, a phase I/II study comparing the standard ESCC N-RCT protocol with a regimen identical except for the replacement of cisplatin with weekly oxaliplatin (40-50 mg/m{sup 2}) was performed at our center. The standard regimen was used to treat 40 patients; 37 received the oxaliplatin regimen. All patients subsequently underwent radical resection with reconstruction according to tumor location and two-field lymph node dissection. Median follow-up time from the start of N-RCT was 74 months (range 3-116 months). The two patient groups were comparable in terms of demographic and baseline tumor characteristics. R0 resection was achieved in 37/39 patients (95 %) in the cisplatin-based N-RCT group, compared to 24/37 (65 %) in the oxaliplatin-based group (p = 0.002). A pathological complete response (pCR) was seen in the resection specimens from 18/39 patients (46 %) in the cisplatin-based N-RCT group and in 8/37 (22 %) oxaliplatin-group patients. In the cisplatin group, 2- and 5-year overall survival (OS) rates were 67 ± 8 % and 60 ± 8 %, respectively (median OS 103 months), compared to 38 ± 8 % and 32 ± 8 %, respectively, for the oxaliplatin group (median OS 17 months; hazard ratio, HR 0.452; 95 % confidence interval, CI 0.244-0.839; p = 0.012). Oxaliplatin-based N-RCT resulted in poorer outcomes in ESCC patients and should not routinely replace cisplatin-based N-RCT. (orig.) [German] Unser Ziel war es, die Ergebnisse zweier neoadjuvanter Radiochemotherapie- (N-RCT-) Konzepte mit nachfolgender Resektion beim fortgeschrittenen Plattenepithelzellkarzinom des

  16. Therapeutic efficacy of TCI chemotherapy regimen for epithelial ovarian cancer and its long- term prognosis%卵巢上皮癌TCI化疗方案的疗效研究及远期预后探讨

    Institute of Scientific and Technical Information of China (English)



    目的 探讨TCI联合化疗方案对于卵巢上皮癌的疗效及远期预后.方法 2000年2月~2010年12月在本院进行规范治疗的卵巢上皮癌158例,运用TCI治疗方案为88例,其化疗方案为TP和值CAP和/或IAP(简称TCI方案);对照组治疗70例,方案选择为PC(环磷酰胺与顺铂),比较两组的临床缓解情况、毒性反应及远期预后,并且对TCI组进行OOX系统回归因素分析.结果 TCI治疗组总体缓解率明显高于对照组,毒性反应方面TCI治疗组的血液系统及神经系统不良反应均显著低于PC组,胃肠道不良反应与心血管系统反应则无显著差异;TCI组5年平均生存率为31.2%,病理分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期中位生存时间分别是79、56、22、18个月,残留灶小于2cm者和治疗次数大于6次者远期预后明显好与相对应者.结论 TCI化疗方案显著优于PC方案,且不良反应相对较少,但胃肠道反应应引起重视,在预后各种因素方面病理分期、术后残留及疗程多少均具有一定相关意义.%Objective To explore the therapeutic efficacy of TCI combined chemotherapy regimen for and its long - term prognosis of epithelial ovarian cancer. Methods A total of 159 patients with epithelial ovarian cancer who received treatments from February 2000 to December 2010 in our hospital were included in the study. Among them, 88 patients were administered with TP and/or CAP and/or IAP regimen (TCI regimen). The control group included 70 patients who were administered with PC (cyclophosphamide and cisplatin). The clinical remission, toxic reactions and long - term prognosis were compared between the two groups. Cox system was applied to the TCI group for regression factor analysis. Results The overall remission was significantly higher in the TCI group than in the control group. In terms of toxic reactions, the adverse reactions of hemato- logical system and nerve system in the TCI group were significantly lower than those in the PC

  17. 化疗联合 DC-CIK方案治疗非小细胞肺癌的疗效分析%Analysis of Efficacy of Chemotherapy Combined with DC-CIK Regimen for NSCLC

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the efficacy of first-line chemotherapy combined with biological therapy for non-small cell lung cancer ( NSCLC) ,and its effect on nutritional status and immune function.Methods 80 cases of non-small cell lung cancer were randomly divided into the experimental group and the control group.The experimental group received first-line chemotherapy regimen combined with dendritic cells (DC) and cytokines induced killer cells (CIK) treatment,the control group received first-line chemotherapy regimen.Results In the experimental group ,the total effective rate was 69.4%,quality of life improvement rate was 89.5%,which were significantly higher than those of the control group ,there had significant difference ( P<0.05);Hb,Alb and BMI in the experimental group were higher than those of the control group ,there had significant difference (P<0.05);T lymphocyte subsets percentage in the experimental group was significantly higher than that of the control group , there had significant difference (P<0.05).Conclusion Chemotherapy combined with biological therapy can significantly im-prove the clinical efficacy of NSCLC ,improve the quality of life of patients ,reduce the incidence of malnutrition ,and can signifi-cantly improve the immune function.It is worthy of clinical application.%目的 探讨一线化疗联合生物治疗对非小细胞肺癌的疗效及对机体营养状况和免疫功能的影响. 方法将非小细胞肺癌患者80例,随机分为实验组与对照组,实验组应用一线化疗方案联合树突状细胞( DC)和细胞因子诱导的杀伤细胞(CIK)方案治疗,对照组仅应用一线化疗方案. 结果 实验组患者总有效率为69.4%,生活质量提高率为89.5%,与对照组比较明显提高,差异具有统计学意义(P<0.05);实验组患者Hb、Alb、BMI均高于对照组,差异具有统计学意义(P<0.05);实验组患者T淋巴细胞亚群百分比明显高于对照组,差异具有统计学意义(P<0.05). 结论 化

  18. Clinical efficacy of docetaxel plus cisplatin regimen and gemcitabine plus cisplatin regimen in first-line chemotherapy for the treatment of advanced non-small cell lung cancer%多西他赛与吉西他滨分别联合顺铂治疗晚期非小细胞肺癌的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘爱学; 李明淑; 周泽强; 张容榕; 金花; 冯天举; 谭淑瑜; 李美香; 林琳


    Objective To compare the therapeutic effects and toxic reactions of DP regimen (docetaxel plus cisplatin) and GP regimen (gemcitabine plus cisplatin) in the treatment of advanced stage non-small cell lung career (NSCLC). Methods A total of 79 patients with advanced stage NSCLC were treated by first-line chemotherapy for 4~6 weeks. The patients were divided into two groups: DP group (docetaxel plus cisplatin) and GP group (gemcitabine plus cisplatin). Patients in DP group (n=43) were treated by 75 mg/m2 docetaxel on day 1 plus 25 mg/m2 cisplatin on day I to day 3. Patients in GP group (n=36) were treated by 1000 mg/m2 gemcitabine on day 1 and day 8 plus 25 mg/m2 cisphtin on day 1 to day 3. Twenty-one days were a treatment cycle. The treatment response rate and survival rate were evaluated by the end of every two cycles. Results The response rate was 37.21% for DP group and 33.33% for GP group, with no statistically significant difference between the two groups (P>0.05). The response rate also had no statistically significant difference in adenocarcinoma and squamous carcinoma sub-groups. The main side effects were myelosup-pression, nausea and omiting. There was no statistically significant difference in Ⅲ ~Ⅳ grade thrombocytopenia and gastrointestinal side effects between the two groups. Conclusion Both DP regimen (docetaxel and cisplatin) and GP regimen (gemcitabine and cisplatin) in first-line chemotherapy have good therapeutic effects and toleranted toxic reactions in the treatment of advanced stage non-small cell lung cancer (NSCLC).%目的 比较多西他赛联合顺铂与吉西他滨联合顺铂一线治疗晚期非小细胞肺癌的疗效和不良反应.方法 晚期非小细胞肺癌患者79例,均接受4~6周期一线化疗.多西他赛联合顺铂组(DP组)43例:多西他赛75 mg/m2,第1天,顺铂25 mg/m2,第1~3天.吉西他滨联合顺铂组(GP组)36例:吉西他滨1 000 mg/m2,第1天、第8天,顺铂用量同DP组.21d为一个化疗周期,每2

  19. C5V作为首选化疗方案治疗肝母细胞瘤效果观察%Outcome of hepatoblastoma: experience with 63 patients received chemotherapy with the regimen C5V

    Institute of Scientific and Technical Information of China (English)

    柳龚堡; 刘百慧; 李凯; 董岿然; 肖现民


    目的 总结C5V方案(顺铂+5-氟尿嘧啶+长春新碱)治疗肝母细胞瘤的经验,并探讨影响治疗效果的相关因素.方法 回顾分析2006年1月至2014年4月在复旦大学附属儿科医院治疗的肝母细胞瘤病例资料,共63例采用C5V作为首选化疗方案,其中男37例,女26例,初诊年龄6d~ 124个月,中位年龄15个月.按照PRETEXT分期系统,其中Ⅰ期4例、Ⅱ期16例,Ⅲ期28例,Ⅳ期15例.其中有9例(Ⅰ期4例、Ⅱ期5例)行一期肿瘤切除术,剩余54例需术前辅助化疗.中位随访时间30个月.结果 40例患儿经辅助化疗后行延期肿瘤切除术,其中C5V方案单独化疗35例,C5V配合CITA方案(顺铂+阿霉素)化疗5例,术前平均化疗时间为(3.4±1.7)个疗程.49例行肿瘤切除术患儿术后平均化疗(5.3±2.0)个疗程.术后复发12例(24.5%),切缘<0.5 cm、静脉瘤栓、Ⅲ或Ⅳ期肿瘤是术后复发的危险因素(P =0.049、0.001、0.022).本组病例2年和5年总体生存率分别为61.1%、58.7%,其中Ⅰ~Ⅲ期分别为75.0%和75.0%,100.0%和100.0%、65.8%和61.4%.Ⅳ期的1年和3年的总体生存率为20.0%和13.3%.单因素分析结果显示,初诊年龄<60个月、静脉瘤栓、初诊时伴有血小板增多症、Ⅲ或Ⅳ期肿瘤、肿瘤完整切除是生存时间的影响因素(P=0.019、<0.001、0.011、0.001、<0.001).多因素分析提示肿瘤完整切除(P<0.001),初诊年龄< 60个月(P =0.004)是重要的影响因素.结论 C5V是肝母细胞瘤有效的治疗方案,肿瘤完整切除仍是治疗的关键.生存时间的影响因素包括年龄、分期、伴随症状等.%Objective To summarize the experience of the chemotherapy regimen cisplatin + fluorouracil + vincristine (C5V) for hepatoblastoma,and analyze the factors associated the outcome.Method A retrospective analysis was conducted for the outcome of hepatoblastoma.Sixty-three patients who received the regimen of C5V as the first choice of

  20. Fertility preservation after chemotherapy for Hodgkin lymphoma

    NARCIS (Netherlands)

    van der Kaaij, Marleen A. E.; van Echten-Arends, Jannie; Simons, Arnold H. M.; Kluin-Nelemans, Hanneke C.


    Treatment for Hodgkin lymphoma can negatively affect fertility. This review summarizes data on fertility after chemotherapy in adult patients. Alkylating chemotherapy, especially if containing procarbazine and/or cyclophosphamide, is most harmful to gonadal functioning. Alkylating regimens cause pro

  1. Risk factors for brain metastases in surgically staged IIIA non-small cell lung cancer patients treated with surgery, radiotherapy and chemotherapy

    Directory of Open Access Journals (Sweden)

    Petrović Marina


    Full Text Available Introduction/Aim. Lung cancer is a leading cause of mortality among patients with carcinomas. The aim of this study was to point out risk factors for brain metastases (BM appearance in patients with IIIA (N2 stage of nonsmall cell lung cancer (NSCLC treated with three-modal therapy. Methods. We analyzed data obtained from 107 patients with IIIA (N2 stage of NSCLC treated surgically with neoadjuvant therapy. The frequency of brain metastases was examined regarding age, sex, histological type and the size of tumor, nodal status, the sequence of radiotherapy and chemotherapy application and the type of chemotherapy. Results. Two and 3-year incidence rates of BM were 35% and 46%, respectively. Forty-six percent of the patients recurred in the brain as their first failure in the period of three years. Histologically, the patients with nonsquamous cell lung carcinoma had significantly higher frequency of metastases in the brain compared with the group of squamous cell lung carcinoma (46% : 30%; p = 0.021. Examining treatment-related parameters, treatment with taxane-platinum containing regimens was associated with a lower risk of brain metastases, than platinum-etoposide chemotherapy regimens (31% : 52%; p = 0.011. Preoperative radiotherapy, with or without postoperative treatment, showed lower rate of metastases in the brain compared with postoperative radiotherapy treatment only (33% : 48%; p = 0.035. Conclusion. Brain metastases are often site of recurrence in patients with NSCLC (IIIA-N2. Autonomous risk factors for brain metastases in this group of patients are non-squamous NSCLC, N1-N2 nodal status, postoperative radiotherapy without preoperative radiotherapy.

  2. Retrospective analysis of the therapeutic efficacy of four chemotherapy regimens for newly diagnosed smear-positive outpatients with pulmonary tuberculosis in Shijingshan District of Beijing during 1985-2008%北京市石景山区1985-2008年新涂阳肺结核非住院患者4种化疗方案疗效回顾性分析

    Institute of Scientific and Technical Information of China (English)

    王珏; 唐桂琴; 张亚敬


    Objective To evaluate the effect of directly observed chemotherapy on newly diagnosed smear-positive outpatients with pulmonary tuberculosis (TB) in Shijingshan District, Beijing, during 1985-2008. Methods Totally 1133 newly diagnosed smear-positive pulmonary TB outpatients in Shijingshan District during 1985-2008 were given 4 chemotherapy regimens, one-year course of standard chemotherapy regimen, short-course (half a year) intermittent chemotherapy regimen 1, short-course (half a year) intermittent chemotherapy regimen 2 and short-course daily chemotherapy regimen. The treatment success rates, incidence of adverse reactions and the three-year recurrence rates of the different treatment groups were compared and analyzed. Results The treatment success rate was the highest in short-course daily chemotherapy regimen group (97.2%) and the lowest in standard chemotherapy regimen group (84.3%). The three-year recurrence rates and adverse reaction rates were the lowest in short-course daily chemotherapy regimen group and short-course intermittent chemotherapy regimen 1 group. Conclusion To take the treatment success rates, three-year recurrence rates and adverse reaction rates into account, shortcourse daily chemotherapy regimen is superior to short-course intermittent chemotherapy regimens and standard chemotherapy regimen.%目的 评价北京市石景山区1985-2008年新涂阳肺结核病例非住院全面督导化疗效果.方法 石景山区1985-2008年管理的1133例新涂阳肺结核患者在不同时期分别采用了12个月疗程的标准化疗方案、2种6个月疗程的短程化疗间歇方案和6个月疗程的短程化疗每日方案4种治疗方案.通过收集这1133例新涂阳肺结核患者资料,对不同治疗方案组的治疗成功率、3年复发率和不良反应发生率等资料进行比较分析.结果 治疗成功率方面,短程化疗每日方案最高(97.2%),标准化疗方案最低(84.3%);短程化疗每日方案

  3. Cetuximab plus platinum-based chemotherapy in head and neck squamous cell carcinoma: a randomized, double-blind safety study comparing cetuximab produced from two manufacturing processes using the EXTREME study regimen. (United States)

    Soulières, Denis; Aguilar, Jose Luis; Chen, Eric; Misiukiewicz, Krzysztof; Ernst, Scott; Lee, Hyun Jung; Bryant, Katherine; He, Shuang; Obasaju, Coleman K; Chang, Shao-Chun; Chin, Steve; Adkins, Douglas


    Cetuximab, in combination with platinum chemotherapy plus 5-fluoruracil (5-FU), is approved for the first-line treatment of recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN). Cetuximab manufactured by ImClone (US commercial cetuximab) potentially results in higher systemic exposures than cetuximab manufactured by Boehringer Ingelheim (BI-manufactured cetuximab). This prospective, randomized, double-blind study compared the safety profiles of the two cetuximab formulations. Patients with previously untreated locoregionally recurrent and/or metastatic SCCHN were randomly assigned to receive the same dose of US commercial cetuximab (Arm A) or BI-manufactured cetuximab (Arm B), each in combination with cisplatin or carboplatin plus 5-FU. The primary outcome was all-grade, all-cause treatment-emergent adverse events (TEAEs). The majority of patients experienced ≥ 1 TEAE, regardless of causality (Arm A: 75/77 patients, 97.4%; Arm B: 68/71 patients, 95.8%). TEAEs with the highest incidence included nausea, fatigue, and hypomagnesemia in both arms. The absolute risk difference between the two arms for patients experiencing at least one adverse event (AE) was 0.029 (p = 0.281, 95% confidence interval [CI]: -0.024, 0.082) for AEs regardless of causality and 0.005 (p = 0.915, 95% CI: -0.092, 0.103) for AEs possibly related to study drug. There were no significant differences between the two arms in the incidence of acneiform rash, cardiac events, infusion reactions, or hypomagnesemia. Overall survival, progression-free survival, and overall response rates were similar in the two arms. There were no clinically meaningful differences in safety between US commercial cetuximab and BI-manufactured cetuximab in combination with platinum-based therapy with 5-FU in patients with locoregionally recurrent and/or metastatic SCCHN. The use of US commercial cetuximab in this combination chemotherapy regimen did not result in any unexpected safety signals. The

  4. 替莫唑胺联合方案与拓扑替康顺铂方案治疗肺癌脑转移的对比研究%Comparision about Temozolomide Based Chemotherapy and Topotecan/Cisplatin Regimen in the Treatment of Brain Metastatms from Non-Small-Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)



    目的 比较替莫唑胺联合方案与拓扑替康顺铂方案对非小细胞肺癌脑转移的治疗效果.方法 选择136例合并脑转移的非小细胞肺癌(non-small lung cancer,NSCLC)患者接受治疗,其中替莫唑胺联合方案组66例,拓扑替康顺铂方案组70例.结果 替莫唑胺组完全缓解(CR)4例,部分缓解(PR)28例,总有效率48.5%,中位生存期10.1个月;拓扑替康组CR 6例,PR 26例,总有效率45.7%,中位生存期9.2个月.两组有效率及生存期差异均无统计学意义(P>0.05).不良反应主要为骨髓抑制,两组比较差异无统计学意义(P>0.05).结论 替莫唑胺联合方案治疗肺癌脑转移疗效肯定,其近期疗效和长期生存率与拓扑替康顺铂方案组相似,耐受性较好.%Objective To compare the clinical efficacy of Temozolomide based chemotherapy and Topotecan/Cisplatin regimen in the treatment of brain metastasis from non-small-cell lung cancer. Methods A total of 136 NSCLC patients with brain metastasis from non-small-cell lung cancer were included ;66 patients received Temozolomide based chemotherapy and 70 patients received Topotecan/Cisplatin regimen. Results The overall response rate was 48. 5% in group of Temozolomide based chemotherapy, with 4 complete response (CR) and 28 partial response (PR) ,and 45. 7% in the Topotecan/Cisplatin group with 6 CR and 26 PR( P > 0. 05 ) . The median duration of survival was 10. 1 months in group of Temozolomide based chemotherapy versus 9.2 months in Topotecan/Cisplatin group (P>0. 05). The main toxicity was myelosuppression. Conclusion Temozolomide based chemotherapy was a highly active regimen for treatment of brain metastasis from non-small-cell lung cancer; there was no difference in the effectiveness and toxicity versus Topotecan/Cisplatin Regimen.

  5. Long term outcome of localized aggressive non-Hodgkin lymphoma treated with a short weekly chemotherapy regimen (doxorubicin, cyclophosphamide, bleomycin, vincristine, and prednisone) and involved field radiotherapy: result of a Gruppo Italiano Multiregionale per lo Studio dei Linfomi e Leucenie (GIMURELL) study. (United States)

    Cabras, Maria Giuseppina; Mamusa, Angela Maria; Vitolo, Umberto; Freilone R, Roberto; Dessalvi, Paolo; Orsucci, Lorella; Tonso, Anna; Levis, Alessandro; Liberati, Marina; Lay, Giancarlo; Angelucci, Emanuele


    Recently, management of limited stage diffuse large cell lymphoma (DLCL) is trending toward a low intensity chemotherapy approach. Since 1993 we have used a brief weekly (6 weeks) chemotherapy scheme (Doxorubicin, Cyclophosphamide, Bleomycin, Vincristine, and Prednisone = ACOP-B) followed by involved field radiotherapy in 207 consecutive patients with well defined localized DLCL without age limit (median 57 years, range 18-85). Treatment was completed as designed in 183 of 207 patients (88%). One hundred and ninety-nine patients (96%) achieved complete remission. At a median follow-up of 66 months 170 patients are alive (82%), 168 of them free of disease. Twenty-nine patients experienced relapse after achieving a complete remission. Kaplan-Meier, risk of relapse was 24% after 13 years. Thirty (14.5%) patients have died, 14 (6.8%) due to lymphoma progression, one due to regimen toxicity and 15 (7.2%) from other causes while remaining in complete remission. The probability of overall survival and event free survival at 13 years was 78% (95% CI 70-87%) and 63% (95% CI 50-75), respectively. Crude rate of secondary malignancy was 5.26 /1000 person-years. The ACOP-B regimen plus involved field radiotherapy is well tolerated both short and long term and is an effective chemotherapy scheme for very well defined limited stage aggressive non-Hodgkin lymphomas in all age categories.

  6. Efficacy of Induction Chemotherapy on Patients with High-risk Myelodysplastic Syndrome or MDS-transformed Acute Myeloid Leukemia with CHG Regimen and the Comparison with Regimen%含羟基喜树碱的预激方案诱导治疗高危骨髓增生异常综合征及骨髓增生异常综合征转化的急性髓系白血病的疗效观察

    Institute of Scientific and Technical Information of China (English)



    Objective To observe the efficacy and side effects of low - density regimen CHG ( Hydroxy camptothecin, Cytarabine, and granulocyte colony - stimulating factor ) as a priming induction regimen in the treatment of patients with high -risk myelodysplasia syndrome ( MDS ) or MDS - transformed acute myeloid leukemia ( AML ), and to compare the results with those of CAG regimen ( Aclacimomycin, Cytarabine and granulocyte colony - stimulating factor ). Methods Patients with high - risk MDS or MDS - transformed AML who had not undergone chemotherapy were divided into the CHG group ( n = 32; CHG regimen as induction therapy ) and the CAG group ( n = 29; CAG regimen as induction therapy ). The efficacy and side effects after one course of chemotherapy were observed and compared between the two regimens. Results After one course of treatment, the total effective rate of the CHG group was 68. 8% , with 14 patients achieving complete remission ( CR ), 7 partial remission ( PR ), and 1 with hematological response; while the total effective rate of the CAG group was 72. 4% , with 12 patients achieving CR, 6 PR and 3 with hematological response. No significant difference was found between the two groups in rate of CR, total effective rate, and side effects ( P >0. 05 ). During follow - up, 3 out of 14 cases of the CHG group who were followed by the Harringtonine + Ara - c ( HA ) or Etoposide + Ara - c ( EA ) maintenance therapy due to cardiac arrhythmia relapsed after CR. Out of the 14 cases, 11 cases were alternately treated with HA, Aclacimomycin + Ara - c ( AA ), Topotecan + Ara - c ( TA ), Mitoxantrone + Ara - c ( MA ), and Idamycin + Ara - c ( IA ) regimens, with 7 cases relapsed within 3-16 months, 3 cases transformed into AML, and 1 case lost to follow - up. Two out of 4 cases who relapsed after more than 6 months of remission achieved CR, but relapsed afterwards. Out of the 12 cases in the CAG group who reached CR, 8 patients relapsed within 2. 6 ~ 17 months, 2

  7. 晚期食管癌不同化疗方案疗效对比%Contrastive analysis of the effects of different chemotherapy regimens in advanced esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    张正荣; 袁昕; 殷旭东; 汪竹; 童建东


    Objective To analyze efficacy and side effects of Fluorouracil, Taxane, and Platinum combinations in the treatment of advanced esophageal poisoning, and explore the best drug treatment mode. Methods A total of 97 cases of advanced or recurrent esophageal cancer from September 2009 to May 2012 in the First People's Hospital of Yangzhou City were retrospectively analyzed;patients were divided into four groups according to their regimen: 22 cases of Fluo-rouracil combined with Platinum (group A), 21 cases of Fluorouracil combined with Taxane (group B), 15 cases of Tax-ane combined with Platinum (group C) and 39 cases of three drugs (group D). The efficacy and toxicity were assessed. Results Objective response rates of group A, B, C, D were 45.5%, 42.9%, 48.7% and 53.3% respectively, there was no statistically significant difference in four groups (P>0.05). Analysis of long-term effects, four groups had no statistical-ly significant difference in PFS and OS (P > 0.05), although the three drugs scheme improved the mPFS in a certain extent. Stratified analysis for the patients with first-line treatment, there were also no significant differences between groups (P> 0.05). Chemotherapy-related toxicities were mainly myelosuppression, nausea, vomiting and constipation. Compared with group C, Incidences of diarrhea and hand-foot syndrome in group D were significantly increased (P0.05)。远期疗效分析,四组进展生存期、总生存期比较,差异均无统计学意义(P>0.05),尽管三药联合方案在一定程度上提高了中位无进展生存期,但差异无统计学意义(P>0.05)。对一线治疗患者进行分层分析,各组间差异均无统计学意义(P>0.05)。各组化疗相关毒副作用均主要为骨髓抑制、恶心呕吐及便秘,D组腹泻和手足综合征发生例数较C组明显增加(P<0.05)。结论氟尿嘧啶、紫杉类、铂类药物不同组合方案在晚期食管癌治疗中效果并无明显差异,化疗相关不良

  8. Therapeutic evaluation of cisplatin, etoposide, and bleomycin chemotherapy regimen in high-risk gestational trophoblastic neoplasia%BEP方案治疗高危型妊娠滋养细胞肿瘤的疗效及安全性评价

    Institute of Scientific and Technical Information of China (English)

    宋水勤; 张国楠


    Objective To evaluate the effectiveness and safety of combination chemotherapy with bleomycin,etoposide and cisplatin (BEP) regimen on the patients with high-risk gestational trophoblastic neoplasia (GTN).Methods Forty-two patients with high-risk GTN admitted in Sichuan Cancer Hospital between Jan.1997 and Oct.2011 were analyzed retrospectively.The International Federation of Gynecology and Obstetrics (FIGO) prognostic score of all patients was more than 7.The mean age of patients was 30.2years (range 20 -49 years).All patients were treated with more than two cycles BEP regimen and followed up to the patients' death or at the end of Feb.2012.The clinical response,toxicity and the occurrence of secondary tumors were investigated.Results Forty-two high-risk GTN patients received the total of 251courses of the BEP regimen,the average number of courses for each patient was 6.0 courses.Thirty-seven patients achieved complete remission and 5 patients showed drug-resistant.The total complete remission rate of BEP regimen was 88% ( 37/42 ).Among the complete remission patients,the total courses of BEP regimen of cases getting normal serum β-hCG level was 129 courses ( average 3.5 courses),and the total courses of cases achieving complete remission was 227 courses (average 6.1 courses ).Among the 37 complete remission patients,31 cases were treated with BEP regimen chemotherapy alone,4 patients with BEP regimen chemotherapy combined with surgical treatment (1 case had no cancer after surgery) and 2 cases with BEP regimen chemotherapy combined with radiation therapy.Therefore,the complete remission rate of BEP regimen chemotherapy alone was 74% (31/42 ).There were 5 patients who showed drug-resistance after 24 courses of BEP regimen chemotherapy (average 4.8 courses),then received etoposide,methotrexate and dactinomycin( EMA )/cyclophosphamide and vincristine sulfate ( CO ) regimen chemotherapy after drugresistance,2 cases combined with radiation therapy,1 case combined

  9. Inhibition of thioredoxin reductase but not of glutathione reductase by the major classes of alkylating and platinum-containing anticancer compounds. (United States)

    Witte, Anne-Barbara; Anestål, Karin; Jerremalm, Elin; Ehrsson, Hans; Arnér, Elias S J


    Mammalian thioredoxin reductase (TrxR) is important for cell proliferation, antioxidant defense, and redox signaling. Together with glutathione reductase (GR) it is the main enzyme providing reducing equivalents to many cellular processes. GR and TrxR are flavoproteins of the same enzyme family, but only the latter is a selenoprotein. With the active site containing selenocysteine, TrxR may catalyze reduction of a wide range of substrates, but can at the same time easily be targeted by electrophilic compounds due to the extraordinarily high reactivity of a selenolate moiety. Here we addressed the inhibition of the enzyme by major anticancer alkylating agents and platinum-containing compounds and we compared it to that of GR. We confirmed prior studies suggesting that the nitrosourea carmustine can inhibit both GR and TrxR. We next found, however, that nitrogen mustards (chlorambucil and melphalan) and alkyl sulfonates (busulfan) efficiently inhibited TrxR while these compounds, surprisingly, did not inhibit GR. Inhibitions were concentration and time dependent and apparently irreversible. Anticancer anthracyclines (daunorubicin and doxorubicin) were, in contrast to the alkylating agents, not inhibitors but poor substrates of TrxR. We also found that TrxR, but not GR, was efficiently inhibited by both cisplatin, its monohydrated complex, and oxaliplatin. Carboplatin, in contrast, could not inhibit any of the two enzymes. These findings lead us to conclude that representative compounds of the major classes of clinically used anticancer alkylating agents and most platinum compounds may easily target TrxR, but not GR. The TrxR inhibition should thereby be considered as a factor that may contribute to the cytotoxicity seen upon clinical use of these drugs.

  10. Optimizing initial chemotherapy for metastatic pancreatic cancer. (United States)

    Mantripragada, Kalyan C; Safran, Howard


    The two combination chemotherapy regimens FOLFIRINOX and gemcitabine plus nab-paclitaxel represent major breakthroughs in the management of metastatic pancreatic cancer. Both regimens showed unprecedented survival advantage in the setting of front-line therapy. However, their application for treatment of patients in the community is challenging because of significant toxicities, thus limiting potential benefits to a narrow population of patients. Modifications to the dose intensity or schedule of those regimens improve their tolerability, while likely retaining survival advantage over single-agent chemotherapy. Newer strategies to optimize these two active regimens in advanced pancreatic cancer are being explored that can help personalize treatment to individual patients.

  11. NEOSCOPE: a randomised Phase II study of induction chemotherapy followed by either oxaliplatin/capecitabine or paclitaxel/carboplatin based chemoradiation as pre-operative regimen for resectable oesophageal adenocarcinoma

    NARCIS (Netherlands)

    Mukherjee, Somnath; Hurt, Christopher N; Gwynne, Sarah; Bateman, Andrew; Gollins, Simon; Radhakrishna, Ganesh; Hawkins, Maria; Canham, Jo; Lewis, Wyn; Grabsch, Heike I; Sharma, Ricky A; Wade, Wendy; Maggs, Rhydian; Tranter, Bethan; Roberts, Ashley; Sebag-Montefiore, David; Maughan, Timothy; Griffiths, Gareth; Crosby, Tom


    BACKGROUND Both oxaliplatin/capecitabine-based chemoradiation (OXCAP-RT) and carboplatin-paclitaxel based radiation (CarPac-RT) are active regimens in oesophageal adenocarcinoma, but no randomised study has compared their efficacy and toxicity. This randomised phase II "pick a winner" trial will ide

  12. Understanding Chemotherapy (United States)

    N ational C ancer I nstitute Understanding Chemotherapy What is chemotherapy? Chemotherapy is a cancer treatment that uses drugs to destroy cancer cells. It is also called “chemo.” Today, there are ...

  13. Novel Combination Chemotherapy for Localized Ewing Sarcoma (United States)

    In this clinical trial, researchers will test whether the addition of the drug combination vincristine, topotecan, and cyclophosphamide to a standard chemotherapy regimen improves overall survival in patients with extracranial Ewing

  14. Increasing aclarubicin dose in low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) is efficacious as salvage chemotherapy for relapsed/refractory mixed-phenotype acute leukemia. (United States)

    Liu, Limin; Qu, Qi; Jiao, Wenjing; Zhang, Yanming; Li, Xiaoli; Ding, Chao; Wu, Depei


    We treated 60 relapsed/refractory mixed-phenotype acute leukemia patients (MPAL-1) with increasing the aclarubicin dose in CAG regimen (HD-CAG, cytarabine (10 mg/m(2)/12 h, days 1-14), aclarubicin (5-7 mg/m(2)/day, days 1-14), granulocyte colony-stimulating factor (200 μg/m(2)/day, days 1-14). This was compared to 64 relapsed/refractory MPAL patients (MPAL-2) treated with DOAP regimen (daunorubicin, vincristine/vindesine, cytarabine and prednisone), 113 relapsed/refractory acute myeloid leukemia (AML) patients and 78 acute lymphocytic leukemia (ALL) patients treated with HD-CAG regimen. After one course, complete remission (CR) and overall response [OR, CR+partial remission (PR)] rates for MPAL-1 exceeded MPAL-2 (CR, 61.02% vs. 28.13%, P=0.000; OR, 72.88% vs. 34.38%, P=0.000), but these data were similar to AML and ALL (P>0.05). In MPAL-1 group, CR and OR rates of T-lymphoid+myeloid immunophenotype were higher than B-lymphoid+myeloid immunophenotype (CR, 81.82% vs. 44.12%, P=0.005; OR, 90.91% vs. 58.82%, P=0.009). The overall survival at 3 years in MPAL-1, MPAL-2, AML and ALL groups were 14.2%±6.8%, 14.1%±6.4%, 17.3%±5.0% and 15.0%±5.3% (P>0.05). Side effects were similar between HD-CAG and DOAP (P>0.05). HD-CAG regimen is efficacious for relapsed/refractory MPAL, especially for T+My patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. 两种新辅助化疗方案在宫颈癌治疗中的临床应用%Clinical Application of Two Neoadjuvant Chemotherapy Regimens in the Treatment of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    王宁; 张雪英; 邵婷


    目的:探讨新辅助化疗方案在Ⅰb2~Ⅱb期宫颈癌治疗中的有效性及安全性。方法:回顾性分析2010年1月-2013年12月笔者所在医院收治的66例术前行新辅助化疗的宫颈癌患者,按化疗方案分为两组,其中采用顺铂+5-氟尿嘧啶为PF组34例,顺铂+异环磷酰胺+博莱霉素为PIB组32例,所有患者于化疗结束后14 d行宫颈癌根治术。结果:PF组化疗后肿瘤体积缩小优于PIB组,差异有统计学意义(P0.05)。结论:宫颈癌新辅助化疗能够有效控制宫颈病灶,改善手术质量,提高治疗有效率。顺铂+5-氟尿嘧啶(PF)方案肿瘤体积缩小及SCC下降均较PIB方案更理想,不良反应少,是较理想的宫颈癌新辅助化疗方案。%Objective:To explore the efficacy and safety of neoadjuvant chemotherapy in the treatment ofⅠb2~Ⅱb stage cervical cancer.Method:66 cervical cancer patients with neoadjuvant chemotherapy treatment for cervical cancer before operation in our hospital from January 2010 to December 2013 were analyzed retrospectively,according to the chemotherapy plan,they were divided into two groups,34 cases of PF group(cisplatin+5-fluorouracil),32 cases of PIB group(cisplatin+ifosfamide+bleomycin).All patients received the radical hysterectomy of cervical cancer after 14 days.Result:The tumor volume of PF group after chemotherapy was better than that of PIB group,the difference was statistically significant(P0.05).Conclusion:Cervical cancer neoadjuvant chemotherapy can effectively control cervical lesions, improve the quality of surgery, improve the treatment efficiency.Cisplatin+5-PF solution tumor volume reduction and SCC decreased compared with the PIB program more ideal, less adverse reaction,it is the ideal cervical cancer neoadjuvant chemotherapy.

  16. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia.

    LENUS (Irish Health Repository)

    Alazzam, Mo'iad


    Gestational trophoblastic neoplasia (GTN) is a highly curable group of pregnancy-related tumours; however, approximately 25% of GTN tumours will be resistant to, or will relapse after, initial chemotherapy. These resistant and relapsed lesions will require salvage chemotherapy with or without surgery. Various salvage regimens are used worldwide. It is unclear which regimens are the most effective and the least toxic.

  17. 地西他滨联合改良CAG及单倍体相合外周血淋巴细胞回输治疗老年高危恶性血液病%Clinical Efficacy of Decitabine plus Improved CAG Chemotherapy and Haplo-identical Donor Peripheral Lymphocyte Infusion Regimen on Elderly Patients with High Risk Myelodysplastic Syndrome and Acute Myeloid Leukemia

    Institute of Scientific and Technical Information of China (English)

    窦立萍; 靖琙; 王全顺; 梅俊辉; 于力


    本研究旨在观察地西他滨联合改良CAG及单倍体相合外周血淋巴细胞回输免疫治疗新方案,作为初治老年高危骨髓增生异常综合征(MDS)和急性髓系白血病(AML)的诱导缓解方案的初步疗效及其不良反应.对2012年4月至2012年7月在本院血液科应用地西他滨联合改良CAG及HLA半相合外周血淋巴细胞回输免疫治疗新方案治疗的5例老年高危MDS和AML患者进行前瞻性研究,观察完全缓解率及副反应.结果表明:5例初治老年患者治疗总有效率100%,4例达到完全缓解,1例患者达到部分缓解.既往无MDS病史患者,中性粒细胞数恢复至0.5×109/L的中位时间为15d,血小板数恢复至20×109/L的中位时间为16 d.主要副作用为IV度骨髓抑制,全部患者治疗中无新发肺部感染等严重并发症.结论:地西他滨联合改良CAG及外周血淋巴细胞回输免疫治疗新方案,治疗老年MDS和AML患者安全有效,值得进一步研究.%This study was aimed to observe the clinical efficacy and adverse effects of decitabine plus improved CAG chemotherapy and haploid-identical donor peripheral lymphocyte infusion regimen on elderly patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML).Five elderly patients with MDS and AML were treated with decitabine plus improved CAG chemotherapy and donor peripheral lymphocyte infusion regimen.Examinations on liver and renal function,electrocardiogram and bone marrow analysis were performed before and after treatment,and adverse effects were observed.The results indicated that after a course of treatment by decitabine plus improved CAG chemotherapy and haplo-identical donor peripheral lymphocyte infusion regimen,the total effective rate was 100%,and 4 patients (80%) achived complete remission,1 patient achived partial remission.The dominant clinical adverse effect was bone marrow depression,the median time of neutrophil >0.5 × 109/L and platelet >20 × 109/L was

  18. 基于Hyper-CVAD/MA方案的强化化疗后自体外周血干细胞移植治疗淋巴瘤的研究%A study of malignant lymphoma treatment using Hyper-CVAD/MA regimen-based intensive chemotherapy followed by autologous peripheral blood stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    王劲; 周旭; 刘瑜; 彭翠翠


    目的 探讨以Hyper-CVAD/MA方案为基础的大剂量强化化疗后行自体外周血干细胞移植(APBSCT)治疗恶性淋巴瘤的方法和疗效.方法 23例恶性淋巴瘤患者采用 CHOP方案常规化疗;每2~3个化疗疗程后予Hyper-CVAD/MA方案强化及利妥昔单抗治疗;APBSCT前患者接受预处理,预处理方案为NEAC (12例)、NEAM (8例)及NEAM+TBI(3例)方案;5例弥漫性大B细胞型、1例套细胞型及1例滤泡细胞型(Ⅲb级)患者于移植前加用利妥昔单抗.结果 全部患者均获造血功能重建,移植后患者达到外周血绝对中性粒细胞计数(ANC)≥0.5×109/L、血小板(PLT)≥20×109/L的时间分别为(12.8±2.5)、(16.1±4.1)d.随访45~1 092 d,15例患者无病生存,5例复发,3例死亡.患者总生存率及无病生存率分别为86.96%(20/23)及65.22%(15/23).结论 以Hyper-CVAD/MA方案为基础的大剂量强化化疗后行APBSCT治疗恶性淋巴瘤可提高患者无病生存率,安全性较好.%Objective To discuss Hyper CVAD/MA regimen based high dose intensive chemotherapy followed by autologous peripheral blood stem cell transplantation(APBSCT) for malignant lymphoma treatment and its therapeutic effect. Methods 23 pa tients with malignant lymphoma were subjected to conventional CHOP chemotherapy. After every 2 3 courses of the conventional chemotherapy, Hyper CVAD/MA regimen was employed for intension and rituximab was administrated. Preparative regimen inclu ding NEAC (12 cases) ,NEAM (8 cases) and NEAM+TBI (3 cases) was conducted before APBSCT. 5 patients with diffuse large B cell type lymphoma, 1 patient with mantle cell type lymphoma and 1 patient with follicular cell type ( Ⅲ b stage) lymphoma were treated with rituximab in addition before APBSCT. Results All patients received successful hematopoietic reconstitution. After transplantation,the duration of their peripheral blood absolute neutrophil count (ANC) achieving ≥0.5 × 109/L and the platelet (PLT) achieving≥20×109/L

  19. FLAG方案诱导化疗初治急性单核细胞白血病的临床观察%Clinical study of FLAG regimen as induction chemotherapy in the treatment of newly diagnosed acute monocytic leukemia patients

    Institute of Scientific and Technical Information of China (English)

    杨斌; 王彪; 董伟民; 曹祥山


    To primarily evaluate the clinical efficacy and adverse reaction of FLAG regimen as induction chemotherapy for newly diagnosed patients with acute monocytic leukemia(M5). Method:Ten cases of de novo adult AML M5 were treated with FLAG regimen as induction chemotherapy which included fludarabine 30 mg · m-2 · d-1 over 30 min daily for 5 days and Ara-C 1 g · m-2 · d-1 for 5 days over 4 hours starting after 4 hours after completion of daily fludarabine. G-CSF 5 μg · kg-1 · d-1 subcutaneously daily on days 0 to 5. The complete remis-sion(CR)rate and the overall response rate and adverse reactions were studied. Result: After one course of FLAG regimen as induction chemotherapy,the CR rate in 10 patients was 80%(8/10) ,the overall response rate was 90% (9/10). Myelosuppression and infections due to neutropenia were the most common adverse effects and severe non-hematologic toxicity was not observed. Conclusion:FLAG regimen achieves higher CR rate for newly patients with M5 with acceptable toxicity. It is therefore worthy of popularization as induction chemotherapy for newly diagnosed patients with M5.%目的:初步探讨FLAG方案在初治急性单核细胞白血病(M5)诱导化疗中的临床疗效和不良反应.方法:10例初治M5患者,采用FLAG方案诱导化疗,具体用法为氟达拉滨(Flud)30 mg·m-2·d-1,持续静脉滴注30 min,第1~5天;阿糖胞苷(Ara-C)1 g·m-2·d-1,Flud结束后4h开始,持续静脉滴注4h,第1~5天;粒细胞集落刺激因子(G-CSF)5μg·kg-1·d-1,皮下注射,第0~5天.以完全缓解率(CR)和有效率及不良反应作为观察指标.结果:1个疗程FLAG方案诱导化疗患者CR率为80%,有效率为90%.化疗的不良反应主要为骨髓抑制和粒细胞缺乏所致的感染,未见严重的非血液系统不良反应.结论:FLAG方案诱导化疗初治急性单核细胞白血病患者具有较高的CR率,不良反应可耐受.

  20. Cancer Chemotherapy (United States)

    ... controlled way. Cancer cells keep growing without control. Chemotherapy is drug therapy for cancer. It works by killing the cancer ... It depends on the type and amount of chemotherapy you get and how your body reacts. Some ...

  1. Classifying insulin regimens

    DEFF Research Database (Denmark)

    Neu, A; Lange, K; Barrett, T


    Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1...... diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin...... variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides...

  2. Second-line chemotherapy with bleomycin, methotrexate, and vinorelbine (BMV) for patients with squamous cell carcinoma of the head, neck and esophagus (SCC-HN&E) pretreated with a cisplatin-containing regimen: a phase II study. (United States)

    Moroni, M; Giannetta, L; Gelosa, G; Secondino, S; Chillura, G; Colombo, E; Siena, S


    We evaluated the toxicity and activity of bleomycin, methotrexate and vinorelbine (BMV) combination chemotherapy in cisplatin-pretreated patients with squamous cell carcinoma of the head, neck and esophagus (SCC-HN&E) with the aim of identifying a second-line therapy combination and schedule that might offer an improved therapeutic index. BMV (bleomycin 15 I.U., total dose, methotrexate 30 mg/m2, and vinorelbine 30 mg/m2) was administered intravenously every 2 weeks until disease progression, to 26 consecutive patients. Clinical and CT-scan evaluations revealed 7 partial responses (PR) 127%, 95% confidence interval: 9.6%-44.4%], and 13 patients with stable disease (SD) [50%]. The mean progression-free survival for patients who achieved a PR or SD was 6.47 months (range 4-13 months), with 75% of these patients experiencing partial relief of symptoms, mainly pain and dysphagia. BMV, administered second-line in an outpatient setting, has activity similar to that of the taxanes, but with a more acceptable toxicity profile including an absence of alopecia.

  3. Multicenter Phase II Study Evaluating Two Cycles of Docetaxel, Cisplatin and Cetuximab as Induction Regimen Prior to Surgery in Chemotherapy-Naive Patients with NSCLC Stage IB-IIIA (INN06-Study.

    Directory of Open Access Journals (Sweden)

    Wolfgang Hilbe

    Full Text Available Different strategies for neoadjuvant chemotherapy in patients with early stage NSCLC have already been evaluated. The aim of this study was to evaluate the tolerability and efficacy of a chemoimmunotherapy when limited to two cycles.Between 01/2007 and 03/2010 41 patients with primarily resectable NSCLC stage IB to IIIA were included. Treatment consisted of two cycles cisplatin (40 mg/m2 d1+2 and docetaxel (75 mg/m2 d1 q3 weeks, accompanied by the administration of cetuximab (400 mg/m2 d1, then 250 mg weekly. The primary endpoint was radiological response according to RECIST.40 patients were evaluable for toxicity, 39 for response. The main grade 3/4 toxicities were: neutropenia 25%, leucopenia 11%, febrile neutropenia 6%, nausea 8% and rash 8%. 20 patients achieved a partial response, 17 a stable disease, 2 were not evaluable. 37 patients (95% underwent surgery and in three of them a complete pathological response was achieved. At a median follow-up of 44.2 months, 41% of the patients had died, median progression-free survival was 22.5 months.Two cycles of cisplatin/ docetaxel/ cetuximab showed promising efficacy in the neoadjuvant treatment of early-stage NSCLC and rapid operation was possible in 95% of patients. Toxicities were manageable and as expected.EU Clinical Trials Register; Eudract-Nr: 2006-004639-31.

  4. Retrospective study on glucose metabolism disorders induced by preoperative intra-arterial infusion chemotherapy with EOF regimen in patients with gastric cancer%EOF 方案术前动脉介入化疗对胃癌患者血糖影响的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    王兆京; 陈彻; 陈志伟; 姚学权; 刘福坤


    目的:探讨胃癌患者接受EOF方案术前动脉介入化疗前后血糖水平的变化,并分析相关因素对血糖变化的影响。方法:收集2012年至2014年间92例接受EOF方案术前动脉介入化疗的胃癌患者在介入化疗前及介入化疗后24 h的空腹血糖检验结果及相关临床资料,进行回顾性分析。结果:EOF方案动脉介入化疗后患者血糖平均水平增加,与介入化疗前相比差异有统计学意义( P<0.01)。患者年龄、性别、肿瘤部位、肿瘤分期等相关因素对血糖升高的影响差异无统计学意义( P>0.05)。合并糖尿病的胃癌患者动脉介入化疗后血糖升高水平明显高于非糖尿病患者,差异有统计学意义( P<0.001)。结论:EOF方案动脉介入化疗可使胃癌患者的血糖升高,尤其是合并糖尿病的胃癌患者血糖升高尤为明显,在积极治疗原发病的同时应注意监测患者血糖并及时处理。%Objective:To explore the effects of the preoperative intra-arterial infusion chemotherapy( PAIC) with EOF regimen on blood glucose of gastric cancer patients and to find the influencing factors.Methods:92 patients with gastric cancer participated in the study; they had received PAIC from 2012 to 2014 in our hospital.The regimen consisted of EPI 50 mg · m-2 , OXA 130 mg · m-2 , and 5-FU 750 mg · m-2 .Their blood glucose was detected on schedule before and after chemotherapy; clinical factors were collected.Some changed regularity on blood glucose and the influential factors were found after chemotherapy.Results: After PAIC, patients'blood glucose was higher than before the treatment ( P0.05 ) .Gastric cancer patients with diabetes were more vulnerable to induce blood glucose rose after PAIC( P<0.001) .Conclusion:PAIC could enhance blood glucose level in gastric cancer patients, especially in patients with diabetes mellitus.In order to complete tumor chemotherapy safely and successfully, strict

  5. Curative Effect of Induction Chemotherapy for Patients with MDS-transformed Acute Myeloid Leukemia with Decitabine Combined with CHG Regimen%地西他滨联合CHG方案诱导化疗骨髓增生异常综合征转化急性髓系白血病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    易雪; 余丹; 张婷; 邹亮


    目的观察地西他滨联合CHG方案诱导化疗由骨髓增生异常综合征转化的急性髓系白血病的疗效和安全性。方法7例新确诊post MDS-AML患者接受地西他滨联合CHG方案诱导化疗。结果4例获完全缓解,1例达到部分缓解,总有效率约为71.42%(5/7)。4例患者出现郁度骨髓抑制,重度骨髓抑制发生率为57.14%(4/7)。5例并发感染,感染率71.42%(5/7),其中员例治疗无效死亡,化疗相关死亡率14.28%(1/7)。不良反应可见发热及胃肠道反应等。结论地西他滨联合CHG的诱导方案对骨髓增生异常综合征转化的急性髓系白血病有效,且有效率高,严重骨髓抑制是常见并发症,不良反应可以耐受。%Objective To evaluate the induction chemotherapy ef ect and safety of decitabine combined with CHG regime for MDS-transformed acute myeloid leukemia (post MDS-AML).Methods 7 patients with post MDS-AML were treated with decitabine combined with CHG regimen.Results 4 patients achieved complete remission,1patient achieved partial remission,total ef etive rate was 71.42%.4 patients achieved Ⅳ bone marrow depression and the incidence rate of grade 郁bone marrow depression was 57.14%(4/7).5 patients achieved infection,incidence rate of infection was 71.42%(5/7),one of the two infected patients died,which the mortality rate of the treatment 14.28%(1/7).Fever and sickness and was observed as adverse ef ect of the regimen.Conclusion The induction chemotherapy of decitabine combined with CHG regime for MDS-transformed acute myeloid leukemia (post MDS-AML) works ef ectively.The incidence of IV grade bone marrow depression happened of en,and adverse ef ect were light.

  6. 紫杉醇脂质体与紫杉醇联合铂类同步放化疗治疗宫颈癌的随机对照研究%A randomized controlled trial of two chemotherapy regimens - paclitaxel liposome combined with platinum and paclitaxel combined with platinum in concurrent chemoradiotherapy for cervical carcinoma

    Institute of Scientific and Technical Information of China (English)

    Siyuan Zeng; Ling Li; Meiling Zhong; Wei Jiang; Yun Xiao


    Objective: The aim of the study was to compare the efficacy, side effect and influence on the survival rate of two chemotherapy regimens, paclitaxel liposome combined with platinum and paclitaxel combined with platinum, in concurrent chemoradiotherapy for cervical carcinoma. Methods: The 162 cases with primary cervical carcinoma diagnosed between January 2008 and November 2009 in Jiangxi Maternal and Child Health Hospital (China) were enrolled in this randomized controlled trial. Seventy-one cases were included in paclitaxel group and 91 in paclitaxel liposome group. And the chemotherapy doses were as follows: paclitaxel liposome and paclitaxel 135 mg/m2; cisplatin 80 mg/m2 or carboplatin AUC 4-6; then repeated every 21 days for two or three times. Radical radiotherapy was given to both groups at the same time. Efficacy was evaluated according to the tumor regression six months later and follow-up was done consistently. Results: The overall response rates of paclitaxel group and paclitaxel liposome group were 90.1% and 89 % respectively (P > 0.05). The one year cumulative survival was 91.4% for paclitaxel group and 89.2% for paclitaxel liposome group (P > 0.05). The incidence rates of adverse effects such as rash, gastrointestinal toxicity, bone marrow suppression and muscle/joint pain in paclitaxel liposome group were much lower than those in paclitaxel group (P 0.05). Conclusion: Paclitaxel liposome plus platinum is a safe and effective method for staging IIa-IV cervical carcinomas. While the long-term efficacy should be further observed.

  7. 复方阿胶浆对吉西他滨联合顺铂方案发生骨髓抑制的疗效%Efficacy of donkey-hide gelatin mixture for gemcitabine and cisplatin chemotherapy regimen induced my-elosuppression

    Institute of Scientific and Technical Information of China (English)

    付雷; 付慧; 刘立青; 霍志军; 于甬华; 于金明


    Objective To investigate the effect of donkey-hide gelatin mixture on myelosuppression induced by gemcitabine and cisplatin ( GP ) chemotherapy. Methods According to the treatment, 119 patients with malignant tumor from 2011 January to 2012 June were assigned into treatment group( n=64) and control group( n=55) . Both groups received GP regime ( gemcitabine, 1g/m2 , d1 , d8;cisplatin, 20mg/m2 , d1-d8;21 days was a cycle) for chemotherapy. Only the treatment group received donkey-hide gelat-in mixture ( 20ml per time, tid) from 1-2 days before chemotherapy to one week after the end of chemotherapy. The usage of chemo-therapy of interleukin-11 ( rhIL-11 ) and recombinant human granulocyte colony stimulating factor ( rhG-CSF ) during chemotherapy were compared between two groups. The white cell counts and platelet counts before the 1st and 2nd cycle of chemotherapy, minimum values of white cell count and platelet count after 1st and 2nd cycle of chemotherapy and postponed rates caused by bone marrow suppres-sion were recorded between groups. The Response Evaluation Criteria in Solid Tumors ( RECIST) criteria ( version 1�1) was employed to evaluate the short-term effect after chemotherapy for 2 cycles. Results The usage of both rhIL-11 and rhG-CSF in treatment group were lower than those in control group ( P0�05) . The minimum values of platelet count were higher in treatment group versus control group after the 1st and 2nd cycle of chemotherapy ( P0�05) . The treatment group completed 107 cycles of chemotherapy on schedule, while the con-trol group completed 75 cycles of chemotherapy on schedule. The postponed rates of treatment group was lower than that of control group ( 16�2% vs. 32�1%, P0�05) . During the process of donkey-hide gelatin mixture, no clear discomfort and side effects were observed. Conclusion Donkey-hide gelatin mixture can relieve the myelosuppression caused by GP regimen chemotherapy and increases blood platelets count after

  8. 老年乳腺癌术后不同化疗方案疗效及安全性比较%A clinical study on curative effect and safety of three chemotherapy regimens on the treatment of breast cancer in aged pa-tients after radical mastectomy

    Institute of Scientific and Technical Information of China (English)

    张新军; 李薛鑫; 赵林; 英子伟; 谢贤鑫; 李翔; 姜大庆


    目的 探讨老年乳腺癌患者应用不同辅助化疗方案治疗的有效性和安全性. 方法 回顾性分析辽宁省肿瘤医院2003-2010年收治的Ⅰ~Ⅲ期可手术治疗的老年(≥65岁)女性乳腺癌患者的临床资料及术后5年随访资料. 按不同治疗方法分为FEC组、TC组和X组,对3组患者的临床疗效和生存率进行对照分析. 结果 本研究患者共466例,其中,术后接受FEC方案者145例,TC方案者192例,X方案者129例. 3组患者的5年无复发生存率( RFS)分别为51%、60. 4%、35. 7%;总生存率( OS)分别为63. 4%、64. 1%、51. 9%. TC组患者的PFS明显高于FEC组及X组,差异均有统计学意义( P0. 05 ). 中性粒细胞减少更多发生在TC组( 66. 1%)和FEC组( 51. 7%) ,明显高于X组的1. 6%(P0. 05 ) . Reduction of neutrophile granulocyte was more frequent in TC ( 66. 1%) and FEC (51. 7%) groups,when compared to X group (1. 6%),and there was also statistical difference between TC and FEC groups (P<0. 05). Vomiting and heart function failing were more common in patients of FEC group,and hand-foot syndrome in X group. Conclusion FEC and TC regimens have equivalent efficacy for the chemotherapy treatment of patients with breast cancer after surger-y,which were better than X regimens. Adverse drug reactions could be observed in all three regimens.

  9. Clinical Observation of Aprepitant Triple Therapy on Prevention of Nausea and Vomiting Caused by Anthracycline Combined Cyclophosphamide Chemotherapy Regimen for Breast Cancer%阿瑞匹坦三联用药预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果观察

    Institute of Scientific and Technical Information of China (English)

    童雅兰; 韩涛; 宋树玺; 郑振东; 屈淑贤; 邱佳宁; 刘兆喆; 郭放; 谢晓冬


    Objective To investigate the effect of combined therapy consisting of aprepitant, tropisetron and dexam-ethasone in prevention of nausea and vomiting induced by breast cancer chemotherapy based on anthracycline and cyclophos-phamide. Methods A total of 62 cases of breast cancer collected from Oncology Department in General Hospital of Shenyang Military Area Command during January 2014 and June 2015 were selected, and those patients all underwent chemotherapy consisting of anthracycline (epirubicin or doxorubicin) combined cyclophosphamide and they were divided into experimental group ( n=31 ) and control group ( n =31 ) by CINV ( chemotherapy-induced nausea and vomiting ) regimen. The control group was given tropisetron and dexamethasone combined regimen in prevention of CINV while the experimental group was added with aprepitant based on the drug used by the control group. The effect and adverse reaction of two groups in acute phase (0-24 h) and delay period (24-120 h) on preventing nausea and vomiting were observed. Results The complete re-sponse rate and the control rate of acute phase had no statistical difference between the two groups (Z=-1. 579, P=0. 114);however, for the delayed vomiting, the complete response rate and control rate of the experimental group were higher than that of the control group and there was significant statistical difference (Z=-2. 196, P=0. 028). Adverse reactions were mild and tolerable with no significant differences between the 2 groups (P>0. 05). Conclusion The combined therapy of aprepitant is definitely effective for the delayed vomiting induced by anthracycline combined cyclophosphamide chemotherapy regimen of breast cancer, and the toxic reaction is tolerable.%目的:评估阿瑞匹坦、托烷司琼、地塞米松三联方案预防乳腺癌蒽环类药物联合环磷酰胺化疗致恶心呕吐的效果及安全性。方法选择2014年1月—2015年6月沈阳军区总医院肿瘤科收治的接收蒽环类药物(表柔

  10. Role of chemotherapy in Hodgkin's lymphoma. (United States)

    Seam, Pamela; Janik, John E; Longo, Dan L; Devita, Vincent T


    The development of curative chemotherapy regimens for the treatment of Hodgkin's lymphoma (HL) is one of the true success stories in oncology. Most patients diagnosed with HL today can be cured. The major task remaining before us is curing as many patients as possible with their initial therapeutic approach while minimizing the acute toxicities and limiting the lifetime risks of important secondary events such as cardiovascular complications and secondary malignancies. In the 40 years since DeVita et al. developed the mechlorethamine, vincristine, procarbazine, and prednisone chemotherapy regimen, we have learned a great deal about risk stratification to minimize treatment-related toxicity. Positron emission tomography may further assist us in reducing radiation treatment without compromising cures. This review will discuss the development of the chemotherapy regimens used in the management of early and advanced stage HL and the advantages and disadvantages of their use in combination with radiation therapy.

  11. Clinical Analysis of Two Chemotherapy Regimens for Patients with Extensive Small-cell Lung Cancer%两种方案治疗广泛期小细胞肺癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    张容榕; 林琳; 刘爱学; 冯天举


    Objective: To compare and analyze the efficacy and safety of two different treatment schema in previ-ously untreated extensive small-cell lung cancer. Methods:Seventy cases of patients with extensive small-cell lung cancer treated in the Oncology Department of our hospital from January 2010 to January 2013 were randomly assigned into irinote-can group( IP group,35 cases) and VP-16 group( EP group,35 cases) by random number table . Patients in IP group were treated with irinotecan and cisplatin(IP)and in EP group were treated with VP-16 and cisplatin(EP). The treatment re-sponse was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) (version 1. 1). Patients were assessed for toxicity according to WHO criteria for adverse events. Results:The objective response rates( RR) of IP group and EP group were 74. 28% and 71. 42%,respectively(P>0. 05). The median progression-free survival(PFS) for IP group and EP group were 4. 3 and 3. 7 months respectively(P>0. 05). The overall survival(OS) for IP group and EP group was 9. 3 and 8. 9 months,respectively(P>0. 05). The common adverse effects of IP group inclucled neutropenia(54. 29%),throm-bocytopenia(14. 29%),anemia(25. 71%),diarrhea(22. 86%)and nausea(71. 43%). The common adverse effects of EP group included neutropenia(80. 0%),thrombocytopenia(60. 0%),anemia(54. 29%),diarrhea(2. 86%)and nausea(74. 29%) . Conclusion:The study shows that there is no significant difference with the efficacy and survival of IP and EP regi-men as the first-line therapy for extensive small-cell lung cancer and the adverse effects are tolerant.%目的:比较两种不同化疗方案治疗广泛期小细胞肺癌的临床疗效及毒副反应。方法:回顾性分析2010年1月至2013年1月,我院肿瘤科住院治疗的70例广泛期小细胞肺癌患者的临床资料,分为伊立替康( IP)组和VP-16(EP)组,每组各35例患者,其中伊立替康组患者采用伊立替康联合顺铂方案化疗, VP-16组患者采用VP-16

  12. Effect of mFOLFOX4 chemotherapy regimen on nutritional status and immune function in patients with gastrointestinal neoplasms%术后mFOLFOX4化疗方案对胃肠道肿瘤患者营养状况及免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    石俊霞; 高立栋; 郭敏; 霍胜霞


    疗期胃肠道肿瘤患者营养不良的发生率,且对免疫功能有明显的抑制作用,应加强围化疗期胃肠道肿瘤患者的营养补充,合理搭配膳食,并增强患者免疫功能,预防感染等相关并发症.%Objective To observe the effect of mFOLFOX4 chemotherapy regimen on nutritional status and immune function in patients with gastrointestinal neoplasms.Methods Totally 45 patients with gastrointestinal neoplasms receiving mFOLFOX4 chemotherapy regimen from May 2012 to February 2014 were collected.After 6 cycles of chemotherapy,the patient-generated subjective global assessment (PG-SGA) score,nutritional risk screening (NRS-2002) score,anthropometric and laboratory detection were applied to assess the nutrition situation;the T cell subsets (CD4+,CD8+,CD4+/CD8+) in the peripheral blood were measured to evaluate the immune function.The with the PG-SGA score as the nutritional index,respectively.The complications after chemotherapy and average hospitalization time were observed.Results Before chemotherapy,there were 18 cases (40.0%) of good nutrition,20 cases (44.4%) of mild to moderate malnutrition and 7 cases (15.6%) of severe malnutrition;after chemotherapy,there were 5 cases (11.1%) of good nutrition,30 cases (66.7%) of mild to moderate malnutrition and 10 cases (22.2%) of severe malnutrition.The proportion of malnutrition after chemotherapy was significantly higher compared with that before treatment (P < 0.01).The proportion of patients with nutritional risk after chemotherapy was significantly increased compared with that before treatment [66.7% (30/45) vs 42.2% (19/45),P < 0.05].After chemotherapy,the hemoglobin,prealbumin,albumin and body mass index were significantly reduced [(112 ±21) g/L vs (121 ±23) g/L,(226 ±93) mg/L vs (248 ± 107) mg/L,(35 ± 8) g/L vs (39 ± 8) g/L,(22 ± 3) kg/m2 vs (23 ± 3) kg/m2] (P < 0.05);PG-SGA and NRS-2002 scores had no significant changes after chemotherapy [(6 ± 2) scores vs

  13. Triple negative breast cancer: adjuvant chemotherapy effect on survival

    National Research Council Canada - National Science Library

    Steponaviciene, L; Lachej-Mikeroviene, N; Smailyte, G; Aleknavicius, E; Meskauskas, R; Didziapetriene, J


    Purpose: The purpose of this study was to evaluate the overall survival of patients with triple negative breast cancer and the impact of different adjuvant chemotherapy regimens on survival.Material/Methods...

  14. Clinical observation of neoadjuvant chemotherapy with paclitaxel administered weekly combined with epirubicin and cyclophosphamide regimen in triple-negative breast cancer%三阴性乳腺癌表柔比星和环磷酰胺联合紫杉醇周疗新辅助化疗临床观察

    Institute of Scientific and Technical Information of China (English)

    王丽娜; 张崇建; 李连方; 王甲彬; 崔树德


    目的 观察表柔比星和环磷酰胺联合紫杉醇周疗在三阴性乳腺癌(triple-negative breast cancer,TNBC)新辅助化疗中的疗效和安全性.方法 2010-01-01-2012-10-31河南省肿瘤医院经空芯针活检结合免疫组化检查诊断为TNBC患者67例,术前接受紫杉醇80 mg/m2(静脉滴入,d1、d8和d15)、表柔比星75 mg/m2(静脉滴入,d1)和环磷酰胺600mg/m2(静脉推注,d1)化疗,21d为1个周期,共4个周期.根据RECIST实体瘤疗效评价标准及术后病理组织学检查评价疗效,按照WHO抗癌药物不良反应分度标准评价不良反应.结果 总有效率为91.0%,临床完全缓解(cCR)43.3%(29/67),部分缓解(PR)47.7%(32/67),疾病稳定(SD)9.0%(6/67),无疾病进展(PD)病例;病理完全缓解(pCR)率为41.8%(28/67).Ⅲ~Ⅳ度中性粒细胞减少发生率为28.4%(19/67),2例(3.0%)出现中性粒细胞减少性发热.Ⅲ~Ⅳ度贫血、血小板减少、恶心呕吐、腹泻及口腔黏膜炎的发生率分别为14.9%(10/67)、3.0%(2/67)、7.5%(5/67)、4.5%(3/67)和4.5%(3/67).治疗期间未发生严重心脏毒性病例.3年无病生存率和总生存率分别为73.6%和88.9%.结论 表柔比星和环磷酰胺联合紫杉醇周疗用于TNBC的新辅助化疗,近期疗效较好,不良反应可耐受.%OBJECTIVE To evaluate the efficacy and safety of neoadjuvant chemotherapy with paclitaxel administered weekly combined with epirubicin and cyclophosphamide regimen in triple-negative breast cancer(TNBC).MEDTH-ODS From January 1,2010 to October 31,2012,67 patients with TNBC confirmed by core needle biopsy combined with immunohistochemistry were treated with neoadjuvant chemotherapy,the regimen containing paclitaxel 80 mg/m2 (ivgtt d1,d8,d1s) and epirubicin 75 mg/m2 (ivgtt d1) and cyclophosphamide 600 mg/mz (iv d1),administered every 3 weeks for 4 cycles before surgery.Standard RECIST guidelines were used to evaluate clinical and pathological response.Toxicity was evaluated at every

  15. Chemotherapy e-prescribing: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Elsaid KA


    Full Text Available Khaled A Elsaid,1,2 Steven Garguilo,1 Christine M Collins2 1Department of Pharmaceutical Sciences, School of Pharmacy, MCPHS University, Boston, MA, 2Pharmacy Services, Rhode Island Hospital, Providence, RI, USA Abstract: Chemotherapy drugs are characterized by low therapeutic indices and significant toxicities at clinically prescribed doses, raising serious issues of drug safety. The safety of the chemotherapy medication use process is further challenged by regimen complexity and need to tailor treatment to patient status. Errors that occur during chemotherapy prescribing are associated with serious and life-threatening outcomes. Computerized provider order entry (CPOE systems were shown to reduce overall medication errors in ambulatory and inpatient settings. The adoption of chemotherapy CPOE is lagging due to financial cost and cultural and technological challenges. Institutions that adopted infusional or oral chemotherapy electronic prescribing modified existing CPOE systems to allow chemotherapy prescribing, implemented chemotherapy-specific CPOE systems, or developed home-grown chemotherapy electronic prescribing programs. Implementation of chemotherapy electronic prescribing was associated with a significant reduction in the risk of prescribing errors, most significantly dose calculation and adjustment errors. In certain cases, implementation of chemotherapy CPOE was shown to improve the chemotherapy use process. The implementation of chemotherapy CPOE may increase the risk of new types of errors, especially if processes are not redesigned and adapted to CPOE. Organizations aiming to implement chemotherapy CPOE should pursue a multidisciplinary approach engaging all stakeholders to guide system selection and implementation. Following implementation, organizations should develop and use a risk assessment process to identify and evaluate unanticipated consequences and CPOE-generated errors. The results of these analyses should serve to

  16. Comparison of Postoperative Survival and Quality of Life among Primary Bladder Cancer Patients Received Different Chemotherapy Regimens%不同化疗方案治疗原发性膀胱癌术后患者生存期与生活质量的比较

    Institute of Scientific and Technical Information of China (English)

    贾书雷; 杨东; 贾巍伟; 刘东


    Objective To observe the postoperative survival and quality of life in patients with primary bladder cancer receiving different chemotherapy regimens.Methods A total of 116 patients who met the inclusion criteria were randomized into two groups ( 58 cases each ), with the observation group underwent a long - term postoperative infusion chemotherapy regimen and the control group underwent a short - term infusion chemotherapy.The drugs were diluted to 50 mL with distilled water and in-travesical chemotherapy was performed after emptying the bladder with the drugs retained for 60 minutes.The patients were told to change the position every 15 minutes.Clinical efficacy, survival, adverse effects and quality of life improvement were compared between the two groups.Results Clinical efficacy between the two groups showed significant differences ( P < 0.05 ).Five -year survival rate was 48.3% for the observation group and 22.4% for the control group ( P <0.05 ).Quality of life score between the both groups showed no significant differences ( P > 0.05 ) before treatment; quality of life score between the both groups showed significant differences ( P < 0.05 ) after treatment.Hematologic toxicity and gastrointestinal reactions, represented by leukopenia, thrombocytopenia, anemia, nausea, vomiting, liver dysfunction, renal dysfunction, peripheral nerve toxicity, and alopecia, were the main side effects for both groups.Incidence of leukopenia, anemia recurrence, and peripheral nerve toxicity were higher in the control group than the observation group ( P < 0.05 ).Conclusion The modified long - term infusion chemotherapy can improve the clinical efficacy, quality of life, as well as survival status of the patients.%目的 探讨不同化疗方案治疗原发性膀胱癌术后患者对其生存期与生活质量的影响.方法 将符合纳入标准的116例原发性膀胱癌患者随机分为观察组、对照组,每组58例.观察组于术后行改良长期灌注

  17. Pharmacogenetics and Pharmacokinetics in high-dose alkylating chemotherapy

    NARCIS (Netherlands)

    Ekhart, G.C. (Corine)


    High-dose chemotherapy in combination with peripheral blood progenitor cell transplantation has been developed as a possible curative treatment modality in several solid tumours. A frequently used high-dose regimen in the Netherlands is the CTC regimen, which is a 4-day course of cyclophosphamide, t

  18. Comparison of two different chemotherapy regimens for concurrent chemoradiotherapy in stage Ⅰb2 to Ⅳ a squamous cell carcinoma of the uterine cervix%两种同步放化疗方案治疗Ⅰb2~Ⅳa期子宫颈鳞癌的临床分析

    Institute of Scientific and Technical Information of China (English)

    李小凡; 李永恒; 高雨农; 李彩莉; 岳海振; 徐刚; 李东明; 苏星


    目的 比较分析Ⅰ b2~Ⅳa期宫颈鳞癌患者同步放化疗中两种含铂化疗方案的疗效和安全性.方法 回顾性分析2007年11月至2011年11月北京大学肿瘤医院收治的接受同步放化疗的宫颈鳞癌患者共146例的临床病理资料,根据同步放化疗中化疗方案的不同分为两组:铂类单药每周方案化疗(单药化疗组)59例,氟尿嘧啶+铂类联合3周方案化疗(联合方案组)87例.治疗结束3个月后进行评效,比较两组患者的近期疗效、生存率和毒性反应发生情况.结果 单药化疗组和联合方案组患者的有效率分别为97%(57/59)、93%(81/87),两组比较,差异无统计学意义(P=0.249).单药化疗组、联合方案组患者的5年总生存率分别为61.2%和69.5%,5年无进展生存率分别为43.3%和24.4%,5年局部复发率分别为11.8%和9.8%,5年远处转移率分别为29.4%和38.7%,分别比较,差异均无统计学意义(P>0.05).毒性反应发生情况:联合方案组的消化道毒性反应(恶心、呕吐)发生率明显高于单药化疗组[分别为78%(68/87)、51% (30/59),P<0.01],且其贫血较单药化疗组更常见[贫血发生率分别为53% (46/87)、25% (15/59),P=0.019];但急性和晚期放射性直肠炎、膀胱炎及其他常见毒性反应的发生率比较,差异无统计学意义(P>0.05).结论 两种同步放化疗方案的疗效相当,铂类单药每周方案的毒性反应发生率明显低于含铂的3周联合方案.%Objective To compare the clinical efficacy and safety of two chemotherapy regimens for concurrent chemoradiotherapy in patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix.Methods Between November 2007 and November 2011,146 patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix who received concurrent chemoradiotherapy in Peking University Cancer Hospital were analyzed.All cases were divided into two groups according to the

  19. 老年乳腺癌患者应用非蒽环类辅助化疗方案的安全性及耐受性临床研究%Safety and tolerance of non-anthracyclin regimen adjuvant chemotherapy in elderly breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    韩颖; 李俏; 李青; 徐兵河; 张频; 袁芃; 王佳玉; 马飞; 蔡瑞刚; 樊英


    younger. The aim of this study was to investigate the safety and tolerance with non-anthracyclin regimen as adjuvant chemotherapy in elderly breast cancer patients. Methods:From Nov. 2008 to Jan. 2012, 56 patients (≥65 years) after surgical excision were enrolled into this study. The patients were divided into two groups:TC and PC groups. Each patient received 4 or 6 cycles of chemotherapy of PC (175 and 600 mg/m2, respectively;n=21) or TC (75 and 600 mg/m2, respectively;n=35), administered intravenously every 3 weeks, as adjuvant chemotherapy. Radiation therapy (as indicated) and endocrine therapy, for patients with hormone receptor-positive disease, were administered after completion of chemotherapy. Results: In this study, 50 patients completed chemotherapy as plan, the proportion of two groups were above 90%. After a median follow-up of 33 months, the median disease-free survival(DFS) and overall survival(OS) were not reached. The relapse-free rate and survival rate were 89.5%and 100%in the PC regime group, which were 90.3%and 96.8%in the TC regime group. Major toxicities included:neutropenia, leucopenia, alopecia, nausea, vomiting and various degree of peripheral neuropathy. The incidence of gradeⅢ-Ⅳneutropenia was 76.2%in PC group vs 48.6%in TC group (P=0.044). The most common cause for withdrawing from treatment was to be unable to tolerate the adverse effects. Conclusion:Adjuvant chemotherapy with paclitaxel and cyclophosphamide is safe, tolerable and promising for elderly breast cancer patients.

  20. Chemotherapy of ovarian cancer in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Tiffany A. Troso-Sandoval; Stuart M. Lichtman


    Epithelial ovarian cancer is primarily a disease of older women. Advanced age is risk factor for decreased survival. Optimal surgery and the safe and effective administration of chemotherapy are essential for prolonged progression-free and overall survival (OS). In this article, the available regimens in both the primary treatment and relapsed setting are reviewed.

  1. Possible surrogate marker for an effective dose-dense chemotherapy in treating ovarian cancer

    Directory of Open Access Journals (Sweden)

    Chueh-Yi Huang


    Conclusion: Lower PLR or lower NLR had better treatment response for dose-dense chemotherapy and are possible markers for representing treatment response in dose-dense chemotherapy. For a clinician, this is useful for timing when to switch to another chemotherapy regimen.

  2. Management of HIV Infection in Patients With Cancer Receiving Chemotherapy (United States)

    Mayer, Kenneth H.; Torres, Harrys A.; Mulanovich, Victor


    The optimal antiretroviral therapy (ART) regimen for human immunodeficiency virus (HIV)–infected patients with cancer remains unknown, as clinical trials are lacking and published data are insufficient to guide recommendations. When concomitant use of chemotherapy and ART is anticipated, overlap of toxic effects and drug–drug interactions between chemotherapy and ART may alter the optimal choice of ART. Prospective studies are urgently needed to further define the toxic effects of combined chemotherapy and ART in HIV-positive cancer patients. Such studies should aid the development of guidelines for treatment of this population. For now, clinicians should individualize decisions regarding treatment of HIV according to clinical and laboratory findings, cancer treatment plan (chemotherapy, radiotherapy, or surgery), liver or renal disease, potential adverse drug effects (eg, rash, gastrointestinal intolerance, bone marrow suppression), and patient preference. This review focuses on what infectious disease specialists need to know to select the most appropriate ART regimens for patients receiving chemotherapy. PMID:24642555

  3. Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified According to the Retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin (United States)


    median survival after systemic 5-Fluorouracil/Leucovorin ( 5FU /L) based chemotherapy for PC of colorectal cancer can, under the best of circumstances...type of systemic chemotherapy regimen; no chemotherapy (best supportive care), 5-Fluorouracil/Leucovorin ( 5FU /L), or modern chemotherapy...Eighty-three patients (50%) had no chemotherapy treatment and received best supportive care only. Forty-two patients (25%) received 5FU /L chemotherapy

  4. Progress in systemic chemotherapy of primary breast cancer: an overview. (United States)

    Hortobagyi, G N


    Substantial progress has been made in the multidisciplinary management of primary breast cancer during the last 30 years. Adjuvant chemotherapy has been shown to significantly reduce the annual risk of cancer recurrence and mortality, and these effects persist even 15 years after diagnosis. Combination chemotherapy is superior to single-agent therapy and anthracycline-containing regimens. Those that combine an anthracycline with 5-fluorouracil and cyclophosphamide are more effective than regimens without an anthracycline. Six cycles of a single regimen appear to provide optimal benefit. Dose reductions below the standard range are associated with inferior results. Dose increases that require growth factor or hematopoietic stem cell support are under investigation; at this time, the existing results provide no compelling reason to use this strategy outside a clinical trial. Regimens using fixed crossover designs with two non-cross-resistant regimens are being evaluated. The addition of a taxane to anthracycline-containing regimens is currently under intense scrutiny, and preliminary analysis of the first three clinical trials has shown encouraging, albeit not compelling, results. For patients with estrogen receptor-positive breast cancer, the sequential administration of chemotherapy and 5 years of tamoxifen therapy provides additive benefits. No compelling evidence exists to combine ovarian ablation with chemotherapy. Most side effects and toxic effects are self-limited, although premature menopause requires monitoring and preventive interventions to preserve bone mineral density. The small risk of acute leukemia is of concern, and additional research to develop safer regimens is clearly indicated. The overall effect of optimal local/regional treatment combined with an anthracycline-containing adjuvant chemotherapy and a taxane (and, for patients with estrogen receptor-positive tumors, 5 years of tamoxifen therapy) is a greater than 50% reduction in annual risks of

  5. Adjuvant chemotherapy in early breast cancer

    DEFF Research Database (Denmark)

    Ejlertsen, Bent


    % of patients aged 40 or younger in 77B had regular menses throughout chemotherapy, the corresponding percentage was 37 in 82B and 47 in 89B. The DBCG in collaboration with a Swedish and a Dutch centre participating in the DBCG trial 89B compared CMF with ovarian ablation in premenopausal high-risk breast...... are not clinically useful by themselves as other chemotherapy regimens have been more efficacious, and knowledge is still lacking regarding the benefits from adding ovarian suppression to chemotherapy plus tamoxifen. The results from the DBCG 77B and 82C are in accordance with other large adjuvant trials...... adjuvant trials demonstrated that patients with either TOP2A or centromere 17 aberrations, but not with HER2 amplification, benefit from anthracycline-containing adjuvant chemotherapy. Anthracyclins have additional distinct biological mechanisms; and results from the DBCG 89D suggested that tumours...

  6. Congenital sacrococcygeal PNET and chemotherapy

    Directory of Open Access Journals (Sweden)

    Colin Patrick Hawkes


    Full Text Available We present the case of a congenital localised sacrococcygeal primitive neuroectodermal tumor treated aggressively with surgical resection and modified age-appropriate adjuvant chemotherapy. The conventional combination chemotherapy of vincristine, adriamycin, cyclophosphamide, ifosfamide and etoposide was modified to a regimen including vincristine, adriamicin, cyclophosphamide and actinomycin in order to minimise the predicted toxicity in this age group. Adjuvant "induction" chemotherapy commenced at 4 weeks of age and consisted of four cycles of vincristine, adriamycin and cyclophosphamide at 50%, 75%, 75% and 100% of recommended doses (vincristine 0.05 mg/kg, adriamycin 0.83 mg/kg daily × 2, cyclophosphamide 40 mg/kg at 3-weekly intervals. This was followed by four cycles of "maintenance" chemotherapy with vincristine (0.025 mg/kg, actinomycin (0.025 mg/kg and cyclophosphamide (36 mg/kg at full recommended doses. Cardioxane at a dose of 16.6 mg/kg was infused immediately prior to the adriamycin. Our patient is thriving at 19 months out from end of treatment.

  7. Effect of Neoadjuvant CAF Regimen on the Expression of BCSG1 in Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    LIU Wei; ZHANG Xianghong; ZHANG Zhigang; WANG Xiaoling; WANG Junling; YAN Xia


    Objective: To evaluate the efficacy of neoadjuvant chemotherapy and explore a sensitive and objective way in the evaluation of neoadjuvant chemotherapy, the pathological changes and BCSG1 expression were studied by pathological and immunohistochemical method in breast cancer patients with CAF neoadjuvant chemotherapy (Cyclophosphamide, Adriamycin and Fluorouracil, CAF) and those without at the same period. Methods: Specimens were obtained from 34 breast cancer patients receiving neoadjuvant CAF regimen chemotherapy (CAF group) and 110 breast cancer patients not receiving neoadjuvant chemotherapy (control group). The BCSG1 expression was detected by SP immunohistochemistry.Correlation between BCSG1 expression and pathological response to CAF neoadjuvant chemotherapy was analyzed. Results: Overall response rate to neoadjuvant chemotherapy was 79.4%. The strong cytoplasm expression of BCSG1 was significantly lower in CAF group than in control group (29.4% vs. 64.5%,P<0.01). In CAF group, the positive cytoplasm expression in partial response (PR) (grade Ⅱ) cases was significantly lower than that in no response (NR) (grade Ⅲ) cases (P=0.002). Conclusion: Neoadjuvant chemotherapy of CAF regimen could decrease the nuclear expression of BSCG1 in breast cancer.

  8. Successful treatment with pemetrexed, Carboplatin, and bevacizumab for platinum-resistant adenocarcinoma of the lung. (United States)

    Wada, Sae; Fujimoto, Nobukazu; Gemba, Kenichi; Asano, Michiko; Fuchimoto, Yasuko; Ono, Katsuichiro; Ozaki, Shinji; Kishimoto, Takumi


    WE PRESENT TWO CASES OF RELAPSED ADENOCARCINOMA OF THE LUNG: a 50-year-old male and a 67-year-old male. Both patients had previously been treated with platinum-containing systemic chemotherapy. In both cases, significant clinical efficacy was demonstrated with combination chemotherapy consisting of pemetrexed, carboplatin, and bevacizumab as salvage treatment. Adverse events were mild. This regimen might be a viable therapeutic option even after heavy treatment such as platinum-containing chemotherapy, especially for patients with preserved organ function and good performance status.

  9. Successful Treatment with Pemetrexed, Carboplatin, and Bevacizumab for Platinum-Resistant Adenocarcinoma of the Lung

    Directory of Open Access Journals (Sweden)

    Sae Wada


    Full Text Available We present two cases of relapsed adenocarcinoma of the lung: a 50-year-old male and a 67-year-old male. Both patients had previously been treated with platinum-containing systemic chemotherapy. In both cases, significant clinical efficacy was demonstrated with combination chemotherapy consisting of pemetrexed, carboplatin, and bevacizumab as salvage treatment. Adverse events were mild. This regimen might be a viable therapeutic option even after heavy treatment such as platinum-containing chemotherapy, especially for patients with preserved organ function and good performance status.

  10. The impact of recent chemotherapy innovation on the longevity of myeloma patients in the U.S. and international evidence

    DEFF Research Database (Denmark)

    Lichtenberg, Frank R.; Hostenkamp, Gisela

    expectancy was due to the increase in the number of chemotherapy regimens now preferred by specialists, and that the cost per U.S. life-year gained from post-1997 chemotherapy innovation did not exceed $45,551. We also investigate the impact of chemotherapy innovation on the myeloma mortality rate using...

  11. Types of chemotherapy (United States)

    ... Types of chemotherapy To use the sharing features on this page, ... or on cancer cells. How Doctors Choose Your Chemotherapy The type and dose of chemotherapy your doctor ...

  12. Chemotherapy for Thyroid Cancer (United States)

    ... Type and Stage Thyroid Cancer Treating Thyroid Cancer Chemotherapy for Thyroid Cancer Chemotherapy (chemo) uses anti-cancer drugs that are injected ... vein or muscle, or are taken by mouth. Chemotherapy is systemic therapy, which means that the drug ...

  13. Chemotherapy for Testicular Cancer (United States)

    ... Type and Stage Testicular Cancer Treating Testicular Cancer Chemotherapy for Testicular Cancer Chemotherapy (chemo) is the use of drugs to treat ... that is only in the testicle. Doctors give chemotherapy in cycles, with each period of treatment followed ...

  14. Side Effects of Chemotherapy (United States)

    ... Jacket Fashion Show Contact Us Side Effects of Chemotherapy Each of the chemotherapy drugs available today works in a slightly different ... few rules of thumb when it comes to chemotherapy that should always be kept in mind. Ignore ...

  15. Chemotherapy and Your Mouth (United States)

    ... Treatment and Oral Health > Chemotherapy and Your Mouth Chemotherapy and Your Mouth Main Content Are You Being ... Problems Too? Remember Are You Being Treated With Chemotherapy for Cancer? If so, this booklet can help ...

  16. Efficacy and safety of oxaliplatin chemotherapy programs as adjuvant treatment in colorectal cancer after surgery

    Institute of Scientific and Technical Information of China (English)



    Objective To compare the efficacy and safety of 5-fluorouracil and calcium folinatc combined with oxaliplatin(FOLFOX) program with capecitabine regimen combined oxaliplatin(XELOX) program as adjuvant chemotherapy in advanced colorectal cancer after surgery.

  17. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk


    Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

  18. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk


    Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.

  19. First-line chemotherapy in low-risk gestational trophoblastic neoplasia.

    LENUS (Irish Health Repository)

    Alazzam, Mo'iad


    This is an update of a Cochrane review that was first published in Issue 1, 2009. Gestational trophoblastic neoplasia (GTN) is a rare but curable disease arising in the fetal chorion during pregnancy. Most women with low-risk GTN will be cured by evacuation of the uterus with or without single-agent chemotherapy. However, chemotherapy regimens vary between treatment centres worldwide and the comparable benefits and risks of these different regimens are unclear.

  20. Feasibility of alternating induction and maintenance chemotherapy in pancreatic cancer


    Hann, Alexander; Bohle, Wolfram; Egger, Jan; Zoller, Wolfram


    Chemotherapy regimens for pancreatic ductal adenocarcinoma (PDAC) have changed since the introduction of FOLFIRINOX. Due to toxicity, dosage and number of applied cycles are limited. In analogy to chemotherapy strategies in colon cancer we used a scheme of induction, maintenance and re-induction therapy in PDAC to alleviate such toxicities and increase the number of applied cycles. Here we report first experiences with this approach. Data of all patients who received FOLFIRINOX for metastatic...

  1. Prospective study of long-term impact of adjuvant high-dose and conventional-dose chemotherapy on health-related quality of life

    NARCIS (Netherlands)

    Buijs, C.; Rodenhuis, S.; Seynaeve, C.M.; van Hoesel, Q.G.; van der Wall, E.; Smit, W.J.; Nooij, M.A.; Voest, E.; Hupperets, P.; TenVergert, E.M.; van Tinteren, H.; Willemse, P.H.; Mourits, M.J.; Aaronson, N.K.; Post, W.J.; de Vries, E.G.


    Purpose To evaluate and compare health-related quality of life (HRQOL) after conventional- and high-dose adjuvant chemotherapy in patients with high-risk breast cancer. Patients and Methods Patients were randomly assigned to either a conventional or high-dose chemotherapy regimen; both regimens were

  2. Outcomes of Patients With Burkitt Lymphoma Older Than Age 40 Treated With Intensive Chemotherapeutic Regimens

    NARCIS (Netherlands)

    Kelly, Jennifer L.; Toothaker, Stephen R.; Ciminello, Lauren; Hoelzer, Dieter; Holte, Harald; LaCasce, Ann S.; Mead, Graham; Thomas, Deborah; Van Imhoff, Gustaaf W.; Kahl, Brad S.; Cheson, Bruce D.; Magrath, Ian T.; Fisher, Richard I.; Friedberg, Jonathan W.


    Burkitt lymphoma is a highly curable disorder when treated with modern intensive chemotherapy regimens. The majority of adult patients with Burkitt lymphoma in the United States are over age 40 years. Older patients have historically been underrepresented in published clinical trials of modern inten

  3. Outcomes of CAG Regimen for Refractory Biphenotypic Acute Leukemia Patients

    Institute of Scientific and Technical Information of China (English)

    Guang-sheng He; Xiang Zhang; De-pei Wu; Ai-ning Sun; Zheng-ming Jin; Hui-ying Qiu; Miao Miao; Xiao-wen Tang; Zheng-zheng Fu; Yue Han


    Objective To evaluated the efficiency of low-dose cytosine arabinoside plus aclarubicin with concurrent administration of granulocyte colony-stimulating factor(CAG)regimen for refractory biphenotypic acute leukemia(BAL).Methods We treated 5 refractory BAL patients by CAG regimen(10 mg·m 2 cytosine arabinoside subcutaneously administrated every 12 hours,day 1-14;5-7 mg·m2 aclarubicin intravenously administrated daily,day 1-8;and concurrently used 200 μg.m-2·d-1 granulocyte colony-stimulating factor subcutaneously)from November 2002 to April 2007.The efficacy of the regimen was evaluated by response rate,and the side effects were also measured.Results The complete remission rate was 80% ,median duration of absolute neutrophil count<5.0×108/L and platelet count<2.0×1010/L was day 13 and day 1,respectively;and the infection rate was low(Ⅲ-Ⅳ infection rate,20.00% ).Conclusion CAG regimen as remission induction chemotherapy for BAL patients is effective with a high remission rate and low toxicity.

  4. Incidence of Chemotherapy-Induced Amenorrhea After Adjuvant Chemotherapy With Taxane and Anthracyclines in Young Patients With Breast Cancer



    Background Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. Methods In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departmen...

  5. Role of Chemotherapy and Mechanisms of Resistance to Chemotherapy in Metastatic Castration-Resistant Prostate Cancer (United States)

    Lohiya, Vipin; Aragon-Ching, Jeanny B.; Sonpavde, Guru


    Chemotherapy using the taxanes, docetaxel and cabazitaxel, remains an important therapeutic option in metastatic castration-resistant prostate cancer (CRPC). However, despite the survival benefits afforded by these agents, the survival increments are modest and resistance occurs universally. Efforts to overcome resistance to docetaxel by combining with biologic agents have heretofore been unsuccessful. Indeed, resistance to these taxanes is also associated with cross-resistance to the antiandrogen drugs, abiraterone and enzalutamide. Here, we discuss the various mechanisms of resistance to chemotherapy in metastatic CRPC and the potential role of emerging regimens and agents in varying clinical phases of development.

  6. Results of scalp cooling during anthracycline containing chemotherapy depend on scalp skin temperature

    NARCIS (Netherlands)

    Komen, M.M.; Smorenburg, C.H.; Nortier, J.W.; Ploeg, T. van der; Hurk, C.J. van den; Hoeven, J.J. van der


    OBJECTIVES: The success of scalp cooling in preventing or reducing chemotherapy induced alopecia (CIA) is highly variable between patients undergoing similar chemotherapy regimens. A decrease of the scalp skin temperature seems to be an important factor, but data on the optimum temperature reached

  7. Our experiment in postoperative adjuvant chemotherapy of endometrial carcinoma. In comparison with radiotherapy on prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Kaichiro; Abe, Kunio; Obata, Koushiro; Inoue, Yoshiki; Hoshiai, Hiroshi [Kinki Univ., Osaka-Sayama (Japan). School of Medicine


    To evaluate the usefulness chemotherapy for postoperative adjuvant therapy, authors compared with chemoradiotherapy and the prognosis was analyzed. Patients were 171 cases of endometrial carcinoma which underwent surgery between January 1976 and December 1993. They were accurately determined the surgical stages. In chemoradiotherapy group, patients received irradiation on whole-pelvis or para-aortic lymph nodes after chemotherapy. In the IIIc stage patients, who received combined therapy with chemotherapy (CP or CAP regimen) and radiotherapy, the prognosis was significantly better than those by the chemotherapy alone. The five-year survival rate was 90.9% in chemoradiotherapy group and 50.0% in chemotherapy alone group. The trial on the regimen of chemotherapy and the use of new anti-cancer drugs will be required. (K.H.)

  8. ATP-binding cassette transporters in tumor endothelial cells and resistance to metronomic chemotherapy. (United States)

    Hida, Kyoko; Kikuchi, Hiroshi; Maishi, Nako; Hida, Yasuhiro


    Drug resistance is a major problem in anticancer therapy. ATP-binding cassette (ABC) transporters have a role in the multidrug resistance. A new regimen of chemotherapy has been proposed, called "metronomic chemotherapy". Metronomic chemotherapy is the frequent, regular administration of drug doses designed to maintain low, but active, concentrations of chemotherapeutic drugs over prolonged periods of time, without causing serious toxicities. Metronomic chemotherapy regimens were developed to optimize the antitumor efficacy of agents that target the tumor vasculature instead of tumor cells, and to reduce toxicity of antineoplastic drugs [1]. Nevertheless, recent studies revealed that ABC transporters are expressed at a higher level in the endothelium in the tumor. To avoid resistance to metronomic anti-angiogenic chemotherapy, ABC transporter inhibition of tumor endothelial cells may be a promising strategy. In this mini-review, we discuss the possible mechanism of resistance to metronomic chemotherapy from the viewpoint of tumor endothelial cell biology, focusing on ABC transporters.

  9. Adjuvant chemotherapy for early-stage cervical cancer. (United States)

    Asano, Hiroshi; Todo, Yukiharu; Watari, Hidemichi


    The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery (RS) has not yet been established, and radiation therapy (RT) or concurrent chemoradiotherapy (CCRT) is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life (QOL) or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival (OS) with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin (TP) regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group (GOG), had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial (RCT) of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable

  10. Radiation Plus Chemotherapy in Early-Stage Hodgkin Lymphoma (United States)

    Adding radiation therapy to chemotherapy may improve outcomes in patients with early-stage Hodgkin lymphoma, according to a paper published in the Cochrane Database of Systematic Reviews in February 2011, but the long-term effects of this regimen are not

  11. Osteonecrosis in patients with testicular tumours treated with chemotherapy.

    NARCIS (Netherlands)

    Berkmortel, F. van den; Wit, R. de; Rooy, J.W.J. de; Mulder, P.H.M. de


    The role of antiemetics is invaluable in allowing cancer patients to complete, otherwise possibly intolerable, chemotherapy. In the Perugia Consensus Conference it was decided that the recommended antiemetic regimen in the prevention of acute emesis induced by a single high, low and repeated doses o

  12. History of chemotherapy of leprosy. (United States)

    Noordeen, Shaik K


    Chemotherapy of leprosy over the past 70 years has passed through several phases, from sulfones, to clofazimine, and to highly bactericidal drugs like rifampicin. The use particularly of the more potent drugs in effective combinations and the development of standard multidrug therapy regimens have made a huge difference in the successful treatment of leprosy as well as in reducing tremendously the prevalence of leprosy globally. A major contributing factor to development of better drugs and drug combinations has been the introduction of the mouse footpad model to evaluate the in vivo activity of drugs against Mycobacterium leprae. The World Health Organization has recommended multidrug therapy, which has been used to treat more than 15 million patients in the last 30 years and has set an excellent record with regard to its very high rate of cure, very low occurrence of relapse, and very rare occurrence of drug resistance.

  13. Myoepithelial Carcinoma of the Breast Treated with Surgery and Chemotherapy

    Directory of Open Access Journals (Sweden)

    Yumi Endo


    Full Text Available Myoepithelial carcinoma (malignant myoepithelioma of the breast is a rare tumor, for which only a limited number of reports have been published. Most of the reports emphasized diagnosis and pathology but not biological behavior and treatment. We report a 61-year-old patient with breast myoepithelial carcinoma who developed locoregional and distant metastases and received many chemotherapy regimens. She presented with an elastic hard mass of the left breast. Breast conserving surgery was performed as part of both diagnosis and treatment. From the results of histological and immunohistochemical examinations, this case was considered to be a myoepithelial carcinoma. Fifteen months after the completion of adjuvant radiotherapy, distant metastasis of the left parasternal lymph node metastasis developed. She was treated by further excision and received a total of four regimens of chemotherapy including a combination of doxorubicin and cyclophosphamide. She received chemotherapy for 20 months after the diagnosis of metastasis.

  14. Chemotherapy Less Toxic to the Heart May Be Option for Some Women with HER2-Positive Breast Cancer (United States)

    A nonanthracycline-containing chemotherapy regimen combined with the targeted therapy trastuzumab may be an option for some women with HER2-positive breast cancer, according to results from the BCIRG-006 trial.

  15. Chemotherapy (For Parents) (United States)

    ... Getting Involved Teaching Kids to Be Smart About Social Media Chemotherapy KidsHealth ... and Where Chemo Is Given Common Side Effects of Chemotherapy Common Side Effects (continued) Common Side ...

  16. Chemotherapy | (United States)

    Chemotherapy works by killing cancer cells, but healthy cells get attacked too. Damage to healthy cells can cause uncomfortable side effects. Use this action deck to get information on common chemotherapy side effects and learn how to manage them.

  17. Uterine/Endometrial Cancer: Chemotherapy (United States)

    ... Types of Gynecologic Cancers Uterine/Endometrial Cancer Chemotherapy Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for endometrial cancer is usually given intravenously (injected ...

  18. Second-line Chemotherapy and Its Survival Analysis of 181 Patients with
Extensive-stage Small Cell Lung Cancer in a Single Institute

    Directory of Open Access Journals (Sweden)

    Manjiao MA


    Full Text Available Background and objective Small cell lung cancer (SCLC is the most malignant neuroendocrine tumor and sensitive to chemotherapy and radiotherapy. However, most patients who receive first-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. Currently, the standard first-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen while the standard second-line chemotherapy regimen is open to debate. The aim of this study is to analysis the prognostic factors of second-line chemotherapy in extensive-stage SCLC and to compare the differences of objective response rate, side effects and survival among different second-line chemotherapy regimens. Methods 181 patients who were diagnosed as extensive-stage SCLC and received second-line chemotherapy were collected. χ2 test was used to analysis the differences of enumeration data and between different groups. Kaplan-Meier method was used to calculate the overall survival (OS and progression-free survival (PFS. Univariate analysis and Cox regression analysis were used to detect the prognostic factors. Objective response rate was evaluated by RECIST criteria and side effects were evaluated by WHO criteria. Results The patients who received second-line chemotherapy can be divided into 6 groups, namly group A (CE/EP regimen 27 cases, group B (regimens containing TPT 44 cases, group C (regimens containing CPT-11 33 cases, group D (regimens containing TAX/DXL 20 cases, group E (regimens containing IFO 28 cases and group F (other regimens 29 cases. The median OS in second-line chemotherapy as 7.0 months and was relevant with smoking history (P=0.004, ECOG PS (P<0.001, liver metastasis (P=0.019 and bone metastasis (P=0.028 independently. The median PFS in second-line chemotherapy as 3.0 months and was relevant with smoking history (P=0.034, ECOG PS (P=0.011 and bone metastasis (P=0.005. The response rate among six regimens was

  19. Clinical overview of metronomic chemotherapy in breast cancer. (United States)

    Munzone, Elisabetta; Colleoni, Marco


    Over 15 years ago, low-dose metronomic chemotherapy was shown to induce disease control in patients with advanced-stage breast cancer with a lower incidence of adverse events compared with conventional maximum tolerated dose chemotherapy. Good response rates have been seen in heavily pre-treated patients for whom limited treatment options are available. Most patients prefer oral therapy and metronomic chemotherapy is a convenient alternative in patients with advanced-stage disease in which minimal toxicity and good tumour control are the overall aims of treatment. The addition of metronomic protocols to standard neoadjuvant chemotherapy regimens has produced promising pathological complete response rates. Ongoing trials including the SYSUCC-001 trial in patients with triple-negative breast cancer and the IBCSG 22-00 trial that is assessing a cyclophosphamide-methotrexate maintenance regimen after standard adjuvant therapy in hormone receptor-negative disease, will clarify the value of adding this approach to conventional therapies. The low cost associated with metronomic chemotherapy represents an opportunity for the utilization of this treatment option, especially in developing countries, and poses a challenge for the launch of large trials sponsored by industry. Using breast cancer as the principal example, we discuss the key clinical advances in this area, including new trial design, appropriate patient and end point selection, as well as the evolving rationale for metronomic chemotherapy combinations.

  20. [History of cancer and chemotherapy before chemotherapy]. (United States)

    Bonnichon, Philippe; Berger, J P; Bonni, N; Fontaine, M; Pion-Graff, J


    Chemotherapy stands today for cancer. In 1909, Paul Ehrlich (1854-1915) advocates the use of arsphenamine by infusion. So, he is considered as the father of chemotherapy. In fact, the first to have thought through chemotherapy was Sir Christopher Wren (1632-1723). In 1676, ideas and experiments on animals had sufficiently progressed to allow Michel Ettmuller (1644-1683) to publish the first edition of his book and several others were printed until 1753. In this book, he describes the first intravenous treatment, it sets the first indications, dosages and different products which can be used. However this method has been forgotten until the late 19th century.

  1. Toxicity Reducing and Efficacy Enhancing Effect of Sodium Cantharidinate Vitamin B6 Injection on GP Chemotherapy Regimen in Treatment of Advanced Non-Small Cell Lung Carcinoma%斑蝥酸钠维生素B6注射液对GP方案治疗晚期非小细胞肺癌减毒增效作用观察

    Institute of Scientific and Technical Information of China (English)

    曹晶杰; 宋一雪; 蒋潮涌


    Objective To observe the efficacy and the influence on the immune function and analgesic effect of Sodium Cantharidinate and Vitamin B6 Injection in treating advanced non-small cell lung carcinoma (NSCLC) patients combined with GP chemotherapy. Methods Totally 79 patients with advanced NSCLC were randomly divided into the observation group and the control group. The observation group accepted GP chemotherapy plus Sodium Cantharidinate and Vitamin B6 Injection, and the control group was treated with GP chemotherapy. After 2 cycles of chemotherapy, the efficacy was evaluated, cellular immune function index and analgesic effect were observed. Results The objective response rate (RR) of the treatment group was 72.50%(29/40), and the control group was 48.72%(19/39). There was no significant difference between the two groups (P>0.05). After 2 cycles of treatment, the ratio of CD3+, CD4+, CD8+, CD4+/CD8+ and NK in the observation group were higher than the control group, with significant differences (P<0.05). The pain relief rate in the observation group was 75.00%(30/40), and it was 51.28%(20/39) in the control group, the difference was significant between the two groups (P<0.05). Conclusion Sodium Cantharidinate and Vitamin B6 Injection combined with GP chemotherapy can improve the short-term effect rate and the cellular immune function. It can also relieve the pain and improve the guality of life of patients with advanced NSCLC.%目的观察斑蝥酸钠维生素B6注射液对接受GP方案(吉西他滨+顺铂)治疗的晚期非小细胞肺癌(NSCLC)患者临床疗效、免疫功能及止痛效果的影响。方法将79例晚期NSCLC患者分为观察组和对照组,2组患者均给予GP方案化疗,同时观察组予斑蝥酸钠维生素B6注射液治疗,疗程为2个周期。评价2组近期疗效,对比免疫功能,并评估止痛效果。结果观察组的客观缓解率为72.50%(29/40),对照组为48.72%(19/39),差异有统计学意义(P<0.05)

  2. Personalized chemotherapy selection for breast cancer using gene expression profiles (United States)

    Yu, Kaixian; Sang, Qing-Xiang Amy; Lung, Pei-Yau; Tan, Winston; Lively, Ty; Sheffield, Cedric; Bou-Dargham, Mayassa J.; Liu, Jun S.; Zhang, Jinfeng


    Choosing the optimal chemotherapy regimen is still an unmet medical need for breast cancer patients. In this study, we reanalyzed data from seven independent data sets with totally 1079 breast cancer patients. The patients were treated with three different types of commonly used neoadjuvant chemotherapies: anthracycline alone, anthracycline plus paclitaxel, and anthracycline plus docetaxel. We developed random forest models with variable selection using both genetic and clinical variables to predict the response of a patient using pCR (pathological complete response) as the measure of response. The models were then used to reassign an optimal regimen to each patient to maximize the chance of pCR. An independent validation was performed where each independent study was left out during model building and later used for validation. The expected pCR rates of our method are significantly higher than the rates of the best treatments for all the seven independent studies. A validation study on 21 breast cancer cell lines showed that our prediction agrees with their drug-sensitivity profiles. In conclusion, the new strategy, called PRES (Personalized REgimen Selection), may significantly increase response rates for breast cancer patients, especially those with HER2 and ER negative tumors, who will receive one of the widely-accepted chemotherapy regimens. PMID:28256629

  3. Neoadjuvant chemotherapy for invasive bladder cancer. (United States)

    Sonpavde, Guru; Sternberg, Cora N


    Neoadjuvant cisplatin-based combination chemotherapy is an established standard for resectable muscle-invasive bladder cancer, a disease with a pattern of predominantly distant and early recurrences. Pathologic complete remission appears to be an intermediate surrogate for survival when employing combination chemotherapy. Moreover, baseline host and tumor tissue studies may enable the discovery of biomarkers predictive of activity. The neoadjuvant setting also provides a window of opportunity to evaluate novel biologic agents or rational combinations of biologic agents to obtain a signal of biologic activity. The residual tumor after neoadjuvant therapy may be exploited to study the mechanism of action and resistance. Cisplatin-ineligible patients warrant the evaluation of tolerable neoadjuvant regimens. Given that bladder cancer is characterized by initial localized presentation in the vast majority of cases, the paradigm of neoadjuvant therapy may expedite the development of novel systemic agents.

  4. Sequential Metastatic Breast Cancer Chemotherapy:Should the Median be the Message?

    Directory of Open Access Journals (Sweden)

    Su Yon eJung


    Full Text Available Background: Counseling and anticipatory guidance of the expected course of treatment for women newly diagnosed with metastatic breast cancer (MBC are difficult due to multiple factors influencing survival following metastatic breast cancer therapy. In order to better tailor counseling at the onset and through the duration of metastatic breast cancer we used non-clinical trial data to better characterize real life experience of sequential metastatic breast cancer treatment. We examined the following aims:1. What demographic and tumor characteristics are predictive of survival in metastatic breast cancer?2. What is the median duration of each sequential chemotherapy regimen and subsequent survival of women following each sequence of chemotherapy regimen in metastatic breast cancer?Methods: Retrospective study included 792 women diagnosed from January 1999 through December 2009 at the University of Pittsburgh Cancer Institute Breast Cancer Program.Results: Median duration of sequential chemotherapy regimen and median survival from completion of sequence of chemotherapy regimens were relatively short with a wide range of treatment duration and survival. Characteristics for poor survival included hormone status, human epidermal growth factor receptor-2 (HER 2/neu status, and increased number and type of metastatic sites. Women who took more than the second sequential chemotherapy regimens had no more than median 3 months of treatment duration and 6 months survival from treatment termination.Discussion: Median clinical response and survival shorten with sequential chemotherapy regimen but with wide ranges. The rare clinical response of the minority should not set the standard for treatment expectations. All cancer clinicians, including oncology nurses, must ensure that patients are receiving tailored counseling regarding their specific risks and benefits for sequential metastatic breast cancer chemotherapy.

  5. Effective chemotherapy induce apoptosis in vivo in patients with leukemia

    Institute of Scientific and Technical Information of China (English)

    岑溪南; 朱平; 虞积仁; 石永进; 马明信


    Objective To investigate apoptosis in vivo in patients with leukemia at different stages of the first cycle of chemotherapy.Methods We detected apoptosis of HL-60 cells and peripheral blood leukemia cells in 17 patients at different stages, using in situ terminal deoxynucleotidyl transferase (TdT) fluorescence measurement and DNA electrophoresis. Results When HL-60 cells were incubated with 0.02 mg/L harringtonine for 0 to 48 hours, agarose gel electrophoresis showed that DNA ladder patterns became evident only at 12 hour into the treatment. In situ TdT assay showed that apoptotic cells occurred after one hour of the treatment. Apoptotic cells were few (0-3.3%) before chemotherapy, but increased substantially (11.4%-87.5%) during chemotherapy in patients with complete remission (CR) or partial remission (PR). Apoptotic cells were few (0-6.1%) during chemotherapy in ten patients with no remission (NR). DNA ladder cannot be detected by agarose gel electrophoresis either before, during or after chemotherapy. Wilcoxon signed rank test shows: P=0.0012<0.01, apoptotic cells during chemotherapy were present in greater quantity than prior to chemotherapy. Wilcoxon rank sum test shows: P=0.0011<0.01, with the median of apoptotic cells during chemotherapy in patients with CR or PR more than with NR.Conclusions TdT assay can be used to detect apoptotic cells earlier and more sensitively than DNA agarose gel electrophoresis. In situ TdT assay is useful to detect apoptosis in vivo in the initial phase of chemotherapy for immediate modification of the chemotherapy regimen, whereas electrophoretic analysis is not sensitive enough to detect apoptotic cell in vivo. Where the median of apoptotic cells during chemotherapy in patients with CR or PR were greater than with NR, only effective drug therapy could induce apoptosis.

  6. Role of myeloid growth factors in chemotherapy induced neutropenia

    Directory of Open Access Journals (Sweden)

    Ravinutala Srinath Bharadwaj


    Full Text Available Neutropenia is a major dose limiting toxicity of many chemo therapeutic regimens. Haemopoietic colony - stimulating factors (CSFs have been shown to reduce the duration and severity of chemotherapy induced neutropenia (CIN and risk of febrile neutropenia. Supportive care with myeloid growth factors improve chemotherapy delivery by minimizing chemotherapy dose reductions or treatment delays by enabling the delivery of full dose chemotherapy (dose dense in short time intervals. The goal of this article is to give comprehensive review of current literature regarding medical practice guidelines and risk assessment models for appropriate use of myeloid growth factors and management of febrile neutropenia. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1715-1721

  7. Systemic chemotherapy for metastatic breast cancer

    Institute of Scientific and Technical Information of China (English)

    Yannan Zhao; Biyun Wang


    Breast cancer is the leading cause of cancer among women worldwide and the most common cancer in China. Many factors influence the treatment strategy for metastatic breast cancer (MBC). Chemotherapy should be administered to patients with hormone receptor-negative tumors, symptomatic visceral metastasis, and a short disease-free interval. Sequential single-agent chemotherapy has similar efficacy as combination agents in terms of overall survival and quality of life. Anthracyclines are the cornerstone of first-line treatment for MBC, and taxanes represent the second treatment option after resistance. When progression or intolerable toxicity occurs after optimal treatment, the alternative treatments include capecitabine, vinorel-bine, and gemcitabine. Ixabepilone and eribulin are relatively new effective single agents. A combination of cytotoxic agents for patients with rapid clinical progression can further improve the overall response rate and time to progression compared to single-agent treatment. For patients with MBC who were pretreated with anthracyclines in the neoadjuvant/adjuvant setting, a taxane-containing regimen such as docetaxel plus capecitabine or gemcitabine plus paclitaxel should be administered. Platinum-based therapies such as cisplatin or carboplatin have a role in the treatment of triple-negative breast cancer. Meanwhile, the efficacy of the addition of targeted drugs such as iniparib, bevacizumab, and cetuximab to chemotherapy remains unproven. Maintenance chemotherapy is routinely recommended in clinical practice at present. Patients who were previously treated with paclitaxel and gemcitabine have better progression-free and overall survival with maintenance chemotherapy according to a Korean phase Ⅲ clinical trial. Sequential maintenance treatment with capecitabine monotherapy after capecitabine-based combination chemotherapy (X-based X) appears favorable based on a series of domestic studies.

  8. Sedation regimens for gastrointestinal endoscopy. (United States)

    Moon, Sung-Hoon


    Sedation allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces a patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. Sedation is therefore considered by many endoscopists to be an essential component of gastrointestinal endoscopy. Endoscopic sedation by nonanesthesiologists is a worldwide practice and has been proven effective and safe. Moderate sedation/analgesia is generally accepted as an appropriate target for sedation by nonanesthesiologists. This focused review describes the general principles of endoscopic sedation, the detailed pharmacology of sedatives and analgesics (focused on midazolam, propofol, meperidine, and fentanyl), and the multiple regimens available for use in actual practice.

  9. Adjuvant chemotherapy for advanced endometrial cancer. (United States)

    Galaal, Khadra; Al Moundhri, Mansour; Bryant, Andrew; Lopes, Alberto D; Lawrie, Theresa A


    Approximately 13% of women diagnosed with endometrial cancer present with advanced stage disease (International Federation of Gynecology and Obstetrics (FIGO) stage III/IV). The standard treatment of advanced endometrial cancer consists of cytoreductive surgery followed by radiation therapy, or chemotherapy, or both. There is currently little agreement about which adjuvant treatment is the safest and most effective. To evaluate the effectiveness and safety of adjuvant chemotherapy compared with radiotherapy or chemoradiation, and to determine which chemotherapy agents are most effective in women presenting with advanced endometrial cancer (FIGO stage III/IV). We searched the Cochrane Gynaecological Cancer Collaborative Review Group's Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 10 2013), MEDLINE and EMBASE up to November 2013. Also we searched electronic clinical trial registries for ongoing trials. Randomised controlled trials (RCTs) of adjuvant chemotherapy compared with radiotherapy or chemoradiation in women with FIGO stage III and IV endometrial cancer. Two review authors selected trials, extracted data, and assessed trials for risk of bias. Where necessary, we contacted trial investigators for relevant, unpublished data. We pooled data using the random-effects model in Review Manager (RevMan) software. We included four multicentre RCTs involving 1269 women with primary FIGO stage III/IV endometrial cancer. We considered the trials to be at low to moderate risk of bias. All participants received primary cytoreductive surgery. Two trials, evaluating 620 women (83% stage III, 17% stage IV), compared adjuvant chemotherapy with adjuvant radiotherapy; one trial evaluating 552 women (88% stage III, 12% stage IV) compared two chemotherapy regimens (cisplatin/doxorubicin/paclitaxel (CDP) versus cisplatin/doxorubicin (CD) treatment) in women who had all undergone adjuvant radiotherapy; and one trial contributed no data

  10. Triple negative breast cancer: adjuvant chemotherapy effect on survival. (United States)

    Steponaviciene, L; Lachej-Mikeroviene, N; Smailyte, G; Aleknavicius, E; Meskauskas, R; Didziapetriene, J


    The purpose of this study was to evaluate the overall survival of patients with triple negative breast cancer and the impact of different adjuvant chemotherapy regimens on survival. The study group consisted of 99 breast cancer patients with immunohistochemically confirmed triple negative breast cancer. The impact of various factors as well as the impact of different chemotherapy regimens on survival was evaluated. The overall survival of breast cancer patients was 97.0% (95% CI 90.9-99.0), 84.9% (95% CI 76.1-90.6) and 66.5% (95% CI 55.5-75.3) 10, 30 and 60 months after diagnosis, respectively. Univariate analysis demonstrated that the following were significant risk factors for breast cancer patients survival: patient's age, stage of disease, tumour size, lymph node status, type of surgery and chemotherapy. Better survival was related to younger patients' age, smaller tumour size, lower stage of disease, no lymph nodes involvement. Survival rates were higher among patients who received adjuvant chemotherapy and underwent quadrantectomy. In the multivariate statistical analysis the significant independent prognostic variables influencing survival were lymph node status and adjuvant chemotherapy. Survival rates of the patients, who received adjuvant anthracycline containing chemotherapy were higher, than those in non-anthracycline containing treatment group, but the difference was not statistically significant. Patients who had lymph node status N2-3 and those who did not receive adjuvant chemotherapy showed worse prognosis and survival than other patients. The impact of chemotherapy type (anthracycline containing or non-anthracycline containing) on patients survival was not statistically significant.

  11. Pathobiology of cancer chemotherapy-induced peripheral neuropathy (CIPN

    Directory of Open Access Journals (Sweden)

    Yaqin eHan


    Full Text Available Chemotherapy induced peripheral neuropathy (CIPN is a type of neuropathic pain that is a major dose-limiting side-effect of potentially curative cancer chemotherapy treatment regimens that develops in a ‘stocking and glove’ distribution. When pain is severe, a change to less effective chemotherapy agents may be required, or patients may choose to discontinue treatment. Medications used to alleviate CIPN often lack efficacy and/or have unacceptable side-effects. Hence the unmet medical need for novel analgesics for relief of this painful condition has driven establishment of rodent models of CIPN. New insights on the pathobiology of CIPN gained using these models are discussed in this review. These include mitochondrial dysfunction and oxidative stress that are implicated as key mechanisms in the development of CIPN. Associated structural changes in peripheral nerves include neuronopathy, axonopathy and/or myelinopathy, especially intra-epidermal nerve fiber (IENF degeneration. In patients with CIPN, loss of heat sensitivity is a hallmark symptom due to preferential damage to myelinated primary afferent sensory nerve fibers in the presence or absence of demyelination. The pathobiology of CIPN is complex as cancer chemotherapy treatment regimens frequently involve drug combinations. Adding to this complexity, there are also subtle differences in the pathobiological consequences of commonly used cancer chemotherapy drugs, viz platinum compounds, taxanes, vincristine, bortezomib, thalidomide and ixabepilone, on peripheral nerves.

  12. Progress in adjuvant chemotherapy for breast cancer: an overview. (United States)

    Anampa, Jesus; Makower, Della; Sparano, Joseph A


    Breast cancer is the most common cause of cancer and cancer death worldwide. Although most patients present with localized breast cancer and may be rendered disease-free with local therapy, distant recurrence is common and is the primary cause of death from the disease. Adjuvant systemic therapies are effective in reducing the risk of distant and local recurrence, including endocrine therapy, anti-HER2 therapy, and chemotherapy, even in patients at low risk of recurrence. The widespread use of adjuvant systemic therapy has contributed to reduced breast cancer mortality rates. Adjuvant cytotoxic chemotherapy regimens have evolved from single alkylating agents to polychemotherapy regimens incorporating anthracyclines and/or taxanes. This review summarizes key milestones in the evolution of adjuvant systemic therapy in general, and adjuvant chemotherapy in particular. Although adjuvant treatments are routinely guided by predictive factors for endocrine therapy (hormone receptor expression) and anti-HER2 therapy (HER2 overexpression), predicting benefit from chemotherapy has been more challenging. Randomized studies are now in progress utilizing multiparameter gene expression assays that may more accurately select patients most likely to benefit from adjuvant chemotherapy.

  13. Present situation and development of chemotherapy of nasopharyngeal carcinoma%鼻咽癌化疗现状及进展

    Institute of Scientific and Technical Information of China (English)

    冼献清; 谢民强; 江刚


    Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy,concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.

  14. Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy. (United States)

    França, Monique Sedlmaier; Usón Junior, Pedro Luiz Serrano; Antunes, Yuri Philippe Pimentel Vieira; Prado, Bernard Lobato; Donnarumma, Carlos del Cistia; Mutão, Taciana Sousa; Rodrigues, Heloisa Veasey; Giglio, Auro del


    To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.

  15. Rituximab and new regimens for indolent lymphoma: a brief update from 2012 ASCO Annual Meeting

    Directory of Open Access Journals (Sweden)

    Zhao Jiangning


    Full Text Available Abstract Indolent lymphoma (IL, the second most common lymphoma, remains incurable with chemotherapy alone. While R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone remains the standard frontline regimen for diffuse Large B –cell lymphoma, the optimal chemotherapy regimen for frontline therapy of advanced IL remains uncertain. FCR (fludarabine, cyclophosphamide, rituximab has been shown to be better than fludarabine alone and fludarabine plus cyclophosphamide for IL. In FOLL05 trial, R-CHOP was compared with R-CVP (cyclophosphamide, vincristine, prednisone and R-FM (fludarabine, mitoxantrone. The study showed that R-CHOP appears to have the best risk-benefit ratio for IL. The StiL NHL1 trial showed that BR (bendamustine, rituximab has longer progression free survival and is better tolerated than R-CHOP. Long-term complications with secondary malignancies between the two regimens appear to be comparable. In this review, new combination regimens reported at 2012 ASCO annual meeting were evaluated for frontline and salvage therapy of indolent lymphoma.

  16. Clinical Application and Evaluation of Pharmacogenomics in Tumor Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Feng Jifeng


    In the treatment of tumor patients, how to select the chemotherapy regimen with better efifcacy, less toxicity and expense is a difficult problem that perplexes clinical doctors for a long time. Pharmacogenetics is to study the influence of genetic factors on pharmacokinetics, whereas pharmacogenomics is to study the relationship between various gene mutations and drug efifcacy and safety. With molecular biology developing, pharmacogenetics and pharmacogenomics are considered to be essential in the reduction of adverse reactions, improvement of efficacy and realization of individualized treatment. In this article, the clinical application and evaluation of pharmacogenomics in tumor chemotherapy were primarily investigated.

  17. Drug Cocktail Optimization in Chemotherapy of Cancer (United States)

    Preissner, Saskia; Dunkel, Mathias; Hoffmann, Michael F.; Preissner, Sarah C.; Genov, Nikolai; Rong, Wen Wei; Preissner, Robert; Seeger, Karlheinz


    Background In general, drug metabolism has to be considered to avoid adverse effects and ineffective therapy. In particular, chemotherapeutic drug cocktails strain drug metabolizing enzymes especially the cytochrome P450 family (CYP). Furthermore, a number of important chemotherapeutic drugs such as cyclophosphamide, ifosfamide, tamoxifen or procarbazine are administered as prodrugs and have to be activated by CYP. Therefore, the genetic variability of these enzymes should be taken into account to design appropriate therapeutic regimens to avoid inadequate drug administration, toxicity and inefficiency. Objective The aim of this work was to find drug interactions and to avoid side effects or ineffective therapy in chemotherapy. Data sources and methods Information on drug administration in the therapy of leukemia and their drug metabolism was collected from scientific literature and various web resources. We carried out an automated textmining approach. Abstracts of PubMed were filtered for relevant articles using specific keywords. Abstracts were automatically screened for antineoplastic drugs and their synonyms in combination with a set of human CYPs in title or abstract. Results We present a comprehensive analysis of over 100 common cancer treatment regimens regarding drug-drug interactions and present alternatives avoiding CYP overload. Typical concomitant medication, e.g. antiemetics or antibiotics is a preferred subject to improvement. A webtool, which allows drug cocktail optimization was developed and is publicly available on PMID:23236419

  18. Drug cocktail optimization in chemotherapy of cancer.

    Directory of Open Access Journals (Sweden)

    Saskia Preissner

    Full Text Available BACKGROUND: In general, drug metabolism has to be considered to avoid adverse effects and ineffective therapy. In particular, chemotherapeutic drug cocktails strain drug metabolizing enzymes especially the cytochrome P450 family (CYP. Furthermore, a number of important chemotherapeutic drugs such as cyclophosphamide, ifosfamide, tamoxifen or procarbazine are administered as prodrugs and have to be activated by CYP. Therefore, the genetic variability of these enzymes should be taken into account to design appropriate therapeutic regimens to avoid inadequate drug administration, toxicity and inefficiency. OBJECTIVE: The aim of this work was to find drug interactions and to avoid side effects or ineffective therapy in chemotherapy. DATA SOURCES AND METHODS: Information on drug administration in the therapy of leukemia and their drug metabolism was collected from scientific literature and various web resources. We carried out an automated textmining approach. Abstracts of PubMed were filtered for relevant articles using specific keywords. Abstracts were automatically screened for antineoplastic drugs and their synonyms in combination with a set of human CYPs in title or abstract. RESULTS: We present a comprehensive analysis of over 100 common cancer treatment regimens regarding drug-drug interactions and present alternatives avoiding CYP overload. Typical concomitant medication, e.g. antiemetics or antibiotics is a preferred subject to improvement. A webtool, which allows drug cocktail optimization was developed and is publicly available on

  19. Adjuvant chemotherapy for endometrial cancer after hysterectomy (United States)

    Johnson, Nick; Bryant, Andrew; Miles, Tracie; Hogberg, Thomas; Cornes, Paul


    Background Endometrial adenocarcinoma (womb cancer) is a malignant growth of the lining (endometrium) of the womb (uterus). It is distinct from sarcomas (tumours of the uterine muscle). Survival depends the risk of microscopic metastases after surgery. Adjuvant (postoperative) chemotherapy improves survival from some other adenocarcinomas, and there is evidence that endometrial cancer is sensitive to cytotoxic therapy. This systematic review examines the effect of chemotherapy on survival after hysterectomy for endometrial cancer. Objectives To assess efficacy of adjuvant (postoperative) chemotherapy for endometrial cancer. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2010, Issue 3), MEDLINE and EMBASE up to August 2010, registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Randomised controlled trials (RCTs) comparing adjuvant chemotherapy with any other adjuvant treatment or no other treatment. Data collection and analysis We used a random-effects meta-analysis to assess hazard ratios (HR) for overall and progression-free survival and risk ratios (RR) to compare death rates and site of initial relapse. Main results Five RCTs compared no additional treatment with additional chemotherapy after hysterectomy and radiotherapy. Four trials compared platinum based combination chemotherapy directly with radiotherapy. Indiscriminate pooling of survival data from 2197 women shows a significant overall survival advantage from adjuvant chemotherapy (RR (95% CI) = 0.88 (0.79 to 0.99)). Sensitivity analysis focused on trials of modern platinum based chemotherapy regimens and found the relative risk of death to be 0.85 ((0.76 to 0.96); number needed to treat for an additional beneficial outcome (NNT) = 25; absolute risk reduction = 4% (1% to 8%)). The HR for overall survival is 0.74 (0.64 to 0.89), significantly

  20. Extravasation of chemotherapy

    DEFF Research Database (Denmark)

    Langer, Seppo W


    Extravasation of chemotherapy is a feared complication of anticancer therapy. The accidental leakage of cytostatic agents into the perivascular tissues may have devastating short-term and long-term consequences for patients. In recent years, the increased focus on chemotherapy extravasation has led...

  1. Chemotherapy for Soft Tissue Sarcomas (United States)

    ... Stage Soft Tissue Sarcoma Treating Soft Tissue Sarcomas Chemotherapy for Soft Tissue Sarcomas Chemotherapy (chemo) is the use of drugs given into ... Depending on the type and stage of sarcoma, chemotherapy may be given as the main treatment or ...

  2. Thrombosis of abdominal aorta during cisplatin-based chemotherapy of testicular seminoma - a case report

    Directory of Open Access Journals (Sweden)

    Gehrckens Ralf


    Full Text Available Abstract Background Vascular complications occurring during cisplatin-based chemotherapy of germ cell tumours are inadequately recognized to date. Case Presentation A 49 year old man with advanced seminoma underwent two courses of chemotherapy according to the PEB regimen. Upon restaging, two thrombotic deposits were noted in the descending part of the thoracic aorta and in the infrarenal abdominal aorta, respectively. Although thrombotic plaques caused aortic occlusion of about 30%, no clinical signs of malperfusion of limbs were registered. The patient was placed on anticoagulant therapy. Six months after completion of chemotherapy, thrombotic deposits had completely resolved. In the absence of other predisposing factors, it must be assumed that cisplatin-based chemotherapy represented a strong stimulus for arterial thrombosis in the aorta. Conclusions This is the first case of endo-aortic thrombosis during chemotherapy for testicular germ cell cancer. Providers of chemotherapy must be aware of arterial thrombosis even in young patients with testicular cancer.

  3. [Loco-regional chemotherapy at the outpatient clinic for gastric cancer patients with home enteral nutrition]. (United States)

    Maruyama, Michio; Nagahama, Takeshi; Sugano, Norihide; Satoh, Eigo; Maruyama, Shouji; Tanami, Hideo; Chiba, Tetsuma; Murakata, Ayano; Mitsuhashi, Yosuke; Uehira, Daisuke; Akazawa, Naoya; Suzuki, Keiichirou


    In over the 10 years from 2000-2010, 21 gastric cancer patients received loco-regional chemotherapy with home enteral nutrition (HEN) at an outpatient clinic because of insufficient oral intake. These loco-regional chemotherapy regimens consisted of 5 intra-aortic chemotherapies, 4 hepato-arterial infusions and 12 intra-peritoneal chemotherapies. Five out of 8 cases that had measurable lesions showed PR, and 3 cases revealed PD. The patients received HEN with peptide central formula, 400-1,200 kcal/day in night time. The average duration of HEN was 12.9 months. The post-operative nutritional management was needed for continuation and securing of outpatient chemotherapy. The author reported an experience of the outpatient loco-regional chemotherapy with HEN for the gastric cancer patients who could not eat a sufficient volume of food.

  4. Changes in Pathological Complete Response Rates after Neoadjuvant Chemotherapy for Breast Carcinoma over Five Years



    Historically, neoadjuvant chemotherapy (NACT) was extrapolated from adjuvant regimens. Dual HER2 blockade and the introduction of carboplatin for triple negative breast cancers (TNBC) emerged by December 2013 and have improved pathological complete response (pCR) rates. The objective of this study was to assess the pCR rates before and after the introduction of these new neoadjuvant regimens. Materials and Methods. Stage I–III breast cancer patients who received NACT were analyzed for rates o...

  5. The impacts of a pharmacist-managed outpatient clinic and chemotherapy-directed electronic order sets for monitoring oral chemotherapy. (United States)

    Battis, Brandon; Clifford, Linda; Huq, Mostaqul; Pejoro, Edrick; Mambourg, Scott


    Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve. A collaborative agreement was reached among oncology pharmacists, a pharmacy resident, two oncologists, and a physician assistant to establish a pharmacist-managed oral chemotherapy monitoring clinic at the VA Sierra Nevada Healthcare System. Drug-specific electronic order sets for prescribing and lab monitoring were created for initiating new drug therapy and prescription renewal. The order sets were created to be provider-centric, minimizing clicks needed to order necessary medications and lab monitoring. A standard progress note template was developed for documenting interventions made by the clinic. Patients new to an oral chemotherapy regimen were first counseled by an oncology pharmacist. The patients were then enrolled into the oral chemotherapy monitoring clinic for subsequent follow up and pharmacist interventions. Further, patients lacking monitoring or missing provider appointments were captured through a Clinical Dashboard developed by the US Department of Veterans Affairs (VA) Regional Office (VISN21) using SQL Server Reporting Services. Between September 2014 and April 2015, a total of 68 patients on different oral chemotherapy agents were enrolled into the clinic. Out of the 68 patients enrolled into the oral chemotherapy monitoring clinic, 31 patients (45

  6. The impact of recent chemotherapy innovation on the longevity of myeloma patients

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela; Lichtenberg, Frank R.


    patients using both time-series US data and longitudinal data on 38 countries.We estimate that almost two-thirds (0.99 years) of the 1997-2005 increase in the life expectancy of American myeloma patients was due to an increase in the number of chemotherapy regimens now preferred by specialists. Based...... during the period 2002-2012. Countries that had larger increases in the number of chemotherapy regimens now preferred by specialists had larger subsequent declines in myeloma mortality rates, controlling for myeloma incidence. The (marginal) effect on the mortality rate of one additional preferred...

  7. The Role of Chemotherapy in Hodgkin’s Lymphoma


    Seam, Pamela; Janik, John E.; Longo, Dan L; DeVita, Vincent T.


    The development of curative chemotherapy regimens for the treatment of Hodgkin’s lymphoma is one of the true success stories in oncology. Most patients diagnosed with Hodgkin’s lymphoma today can be cured. The major task remaining before us is curing as many patients as possible with their initial therapeutic approach while minimizing the acute toxicities and limiting the lifetime risks of important secondary events such as cardiovascular complications and secondary malignancies. In the 40 ye...

  8. [An approach to ambulant cancer chemotherapy by the pharmaceutical department system]. (United States)

    Atsumi, Sachie; Iwasa, Masahiro; Konomi, Ginko; Watanabe, Masayuki


    In recent years, cancer chemotherapy has been switching from hospital treatment to ambulant treatment. In such a situation, pharmacists are required to carry out their work unfailingly and smoothly in checking chemotherapy regimens, admixtures of drugs and providing information, for example. At Tokai University Hachioji Hospital, we have been trying to computerize a regimen-check, quantitative calculations for admixtures of anticancer drugs and the comment-input function of the pharmaceutical department so that our work will be more efficient and precise. The regimen-check system receives automatically, the patients' own data and the information of injection prescriptions and of the clinical laboratory from the Hospital Information System. Then pharmacists put the information to the regimen master file for recording in order to manage dosages, the accumulated dose and dose schedule. Also by registering the amount of dissolution of each anticancer drug beforehand, the quantitative calculation system makes it possible to automatically convert dosages on electronic medical charts to a liquid measure needed for the admixtures of drugs and to print the information on the prescription of injections. Additionally, the comment-input function makes it possible to print information on injections such as chemical information needed for regimen-checks and doctors' answers to questions about prescriptions. The pharmaceutical department system enables pharmacists to check regimens accurately and quickly to calculate the precise quantity for admixtures of drugs and to share information among pharmacists. The system has also contributed to the efficiency and medical safety of the ambulant cancer chemotherapy.

  9. Clinical observation of intrathecal chemotherapy combined with concurrent radiotherapy for leptomeningeal metastases from malignant solid tumors

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the efficacy and safety of intrathecal chemotherapy combined with concurrent radiotherapy in patients with leptomeningeal metastases from solid tumors.Methods The clinical and follow-up data of 29 patients with leptomeningeal metastases frommalignant solid tumor who had intrathecal chemotherapy combined with concurrent radiotherapy were retrospectively analyzed.The treatment regimen was that 12.5-15.0 mg of methotrexate intrathecal injection once a week for 8

  10. A single center experience: post-transplantation adjuvant chemotherapy impacts the prognosis of hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Wu Junyi; Sun Hongcheng; Han Zhongbo; Peng Zhihai


    Background The aim of this research was to investigate the impact of post-transplantation adjuvant chemotherapy in the prevention of tumor recurrence and metastasis for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation.Methods A total of 117 patients with HCC exceeding the Milan criteria who had undergone orthotopic liver transplantation (OLT) from August 2002 to February 2009 were enrolled and retrospectively analyzed.The patients were divided into four groups according to chemotherapy regimens and the impact of different chemotherapy regimens on survival,disease-free survival,and adverse effects were compared.Results One year survival rates for the gemicitabine,conventional chemotherapy,oxaliplatin plus capecitabine and the best supportive care (BSC) group were 87.5%,84.2%,81.6%,and 67.5%.The 3-year survival rates were 48.1%,25.9%,31.6%,and 33.7%,respectively for the four groups.One year disease free survival rates for the four groups were 69.8%,47.4%,53.8%,and 45.7% respectively.And 3-year disease free survival rates were 43.2%,23.7%,23.6%,and 25.1% for the four groups.Stratification analysis showed that the gemcitabine regimen and conventional chemotherapy could significantly improve the survival rate and disease free survival rate for HCC patients who had major vascular invasion and/or microvascular invasion after liver transplantation compared with BSC group.Conclusions For HCC patients beyond Milan criteria,especially who had vascular invasion and/or micorvascular invasion,post-transplantation adjuvant chemotherapy can significantly improve survival.Gemcitabine is a proper regimen for postoperative adjuvant chemotherapy.Conventional chemotherapy can also benefit patients,but the adverse effects are not satisfactory.

  11. Gemcitabine Based Combination Regimens for Treatment of Refractory Advanced Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    CHE Li; DI Li-jun; SONG Guo-hong; JIA Jun; YU Jing; WANG Xiao-li; ZHU Yu-lin; JIANG Han-fang; LIANG Xu


    Objective:Anthracycline and taxane are the standard agents in combined chemotherapy of advanced breast cancer.However,when these agents based chemotherapy is failure,the selection of salvage regimen is still of problem.Gemcitabine,an active agent in both lung cancer and pancreas cancer,is demonstrated effective in breast caner.But there have been relatively less data of gemcitabine in anthracycline and/or taxane-resistant breast cancer.Therefore we employe this study to explore the efficacy and safety of gemcitabine based combination regimen in this population.Methods:From May 2002 to March 2006,28 patients with measurable lesion of advanced metastatic breast cancer who were resistant to prior anthracycline and taxane based chemotherapy were enrolled.Patients were treated with gemcitabine based combination chemotherapy with a median cycles of 3(range 2-6).Results:The overall response rate was 28.6%(8/28),with 1 CR(Complete response 3.5%)and 7 PRs(Partial response 25%).Stable disease was seen in 8 patients(28.6%)while disease progressed in 12 patiens(42.8%).The median time to progression was 4.5 m(range,2-23 m).The main toxicity included bone marrow depression,alopecia,mucositis and peripheral neurotoxicity.The grade 3 to 4 clinical adverse effect was leukopenia in 5 cases(17.9%)and thrombocytopenia in 8 cases(30%).Conclusion:Gemcitabine based combination regimens is feasible in anthracycline and taxane-resistant advanced breast cancer.The clinical response and TTP is acceptable with limited toxicity pattern.

  12. Recombinant human thrombopoietin in myelosuppressive chemotherapy. (United States)

    Vadhan-Raj, S


    Recombinant human thrombopoietin (rhTPO) is a full-length glycosylated molecule that has been under evaluation in the setting of chemotherapy-induced myelosuppression. It has been shown to be a potent stimulator of platelet production in cancer patients when administered prior to chemotherapy. The peak platelet response to a single dose of rhTPO is observed around day 12, and is accompanied by a significant increase in the number of mature megakaryocytes in bone marrow. Consistent with this biologic effect, rhTPO administered postchemotherapy has been shown to be effective in attenuating severe thrombocytopenia induced by carboplatin, which produces a late platelet nadir. Early clinical experience with a regimen that produces an early nadir, however, such as AI (doxorubicin [Adriamycin] and ifosfamide [Ifex]), suggests that administration of rhTPO both prior to and following chemotherapy might be important to reduce thrombocytopenia severity. Treatment with rhTPO in these clinical trials has been well tolerated with a favorable safety profile. Randomized clinical trials have been initiated to determine further the importance of schedule in the prevention and treatment of severe thrombocytopenia in cancer patients.

  13. Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol--EASE

    DEFF Research Database (Denmark)

    Grunberg, Steven; Chua, Daniel; Maru, Anish;


    Addition of aprepitant, a neurokinin-1 receptor antagonist (NK1RA), to an ondansetron and dexamethasone regimen improves prevention of chemotherapy-induced nausea/vomiting (CINV), particularly during the delayed phase (DP; 25 to 120 hours). Therefore, recommended antiemetic regimens include multi...

  14. Review of the efficacy of individualized chemotherapy selected by in vitro drug sensitivity testing for patients with cancer. (United States)

    Cortazar, P; Johnson, B E


    The purpose of this study is to review the potential efficacy of individualized chemotherapy selected by in vitro drug sensitivity testing (DST) compared with empiric regimens for patients with cancer. MEDLINE and CANCERLIT were searched for articles published (in English) about prospective clinical trials in which patients were treated with chemotherapy that was selected with the use of in vitro DST. We identified 12 prospective studies that examined the benefit of chemotherapy selected by DST. Five hundred six patients (33%) were treated with chemotherapy that was selected with the use of in vitro DST. The mean response rate for patients treated with in vitro-selected therapy was 27% (range, 10% to 100%; n = 12 studies) compared with 18% (range, 0% to 100%; n = 7 studies) for patients treated with empiric therapy. Five studies (only one randomized) evaluated the impact of chemotherapy selected by in vitro DST on patient survival. Three studies showed that survival was 1 to 4 months longer for the 238 patients treated with empiric chemotherapy compared with that of the 65 patients treated with chemotherapy that was selected by in vitro testing. Two nonrandomized studies showed that survival was 4 or 19 months longer for 27 patients treated with chemotherapy selected by in vitro testing compared with that of 80 patients who were treated with empiric chemotherapy. Only one third of patients entered in prospective trials of in vitro DST were actually treated with an in vitro best regimen. The response rates seem to be better with in vitro selected chemotherapy regimens than with empiric regimens, but the impact on survival has not been adequately addressed.


    Directory of Open Access Journals (Sweden)

    E. N. Bochanova


    Full Text Available A complex system of hemostasis regulation, insufficient data on drugs pharmacokinetics, multiple factors effecting treatment, including patient’s adherence to therapy, that can lead to the need for the dosage regimen specification are presented.

  16. Neurotoxicity of cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Miyoung Yang; Changjong Moon


    There is accumulating clinical evidence that chemotherapeutic agents induce neurological side effects, including memory deficits and mood disorders, in cancer patients who have undergone chemotherapeutic treatments. This review focuses on chemotherapy-induced neurodegeneration and hippocampal dysfunctions and related mechanisms as measured by in vivo and in vitro approaches. These investigations are helpful in determining how best to further explore the causal mechanisms of chemotherapy-induced neurological side effects and in providing direction for the future development of novel optimized chemotherapeutic agents.

  17. Paclitaxel-Based Chemotherapy for Advanced Pancreatic Cancer after Gemcitabine-Based Therapy Failure: A Case Series of 5 Patients

    Directory of Open Access Journals (Sweden)

    Hisato Igarashi


    Full Text Available Background/Objectives: Gemcitabine (GEM is a gold-standard chemotherapy agent for advanced pancreatic cancer. Because of the malignant character of the disease, nearly all patients show disease progression despite treatment with GEM-based chemotherapy; therefore, second-line chemotherapy may be beneficial for these patients. We report a retrospective analysis of 5 patients with advanced pancreatic cancer, treated with a paclitaxel-containing regimen as second-, third- or fourth-line chemotherapy after various therapies, such as a GEM-based regimen, S-1 regimen, and chemoradiation. We retrospectively analyzed the efficacy and adverse events, and evaluated the paclitaxel-containing regimens. A review of the literature is also discussed. Results: The median overall survival from the start of salvage therapy was 10.7 months. The disease control rate of the paclitaxel-containing regimen according to RECIST criteria was 60%, including complete response in 0 patients, partial response in 3, and stable disease in 2. Two patients had malignant ascites at the start of this salvage therapy, and in both of them the ascites and clinical complaints improved. Grade 3 and 4 hematological adverse events were observed in 2 patients and 1 patient, respectively. Conclusion: Salvage paclitaxel-based therapy could be beneficial to advanced pancreatic cancer patients who maintain good performance status after several chemotherapy failures.

  18. Chemotherapy for Melanoma. (United States)

    Wilson, Melissa A; Schuchter, Lynn M


    Prior to the recent therapeutic advances, chemotherapy was the mainstay of treatment options for advanced-stage melanoma. A number of studies have investigated various chemotherapy combinations in order to expand on the clinical responses achieved with single-agent dacarbazine, but these have not demonstrated an improvement in overall survival. Similar objective responses were observed with the combination of carboplatin and paclitaxel as were seen with single-agent dacarbazine. The combination of chemotherapy and immunotherapy, known as biochemo-therapy, has shown high clinical responses; however, biochemo-therapy has not been shown to improve overall survival and resulted in increased toxicities. In contrast, palliation and long-term responses have been observed with localized treatment with isolated limb perfusion or infusion in limb-isolated disease. Although new, improved therapeutic options exist for first-line management of advanced-stage melanoma, chemotherapy may still be important in the palliative treatment of refractory, progressive, and relapsed melanoma. We review the various chemotherapy options available for use in the treatment and palliation of advanced-stage melanoma, discuss the important clinical trials supporting the treatment recommendations, and focus on the clinical circumstances in which treatment with chemotherapy is useful.

  19. Intensive induction chemotherapy with C-BOP/BEP for intermediate- and poor-risk metastatic germ cell tumours (EORTC trial 30948).

    NARCIS (Netherlands)

    Fossa, S.D.; Paluchowska, B.; Horwich, A.; Kaiser, G.; Mulder, P.H.M. de; Koriakine, O.; Oosterom, A.T. van; Prijck, L. de; Collette, L.; Wit, R. de


    New chemotherapy regimens are continuously explored in patients with high-risk malignant germ cell tumours (MGCTs). This multicentre phase II trial assessed the efficacy and toxicity of C-BOP/BEP chemotherapy in intermediate and poor prognosis MGCT (IGCCCG criteria). C-BOP/BEP treatment consisted of

  20. Rituximab and escalated chemotherapy in elderly patients with aggressive diffuse large-cell lymphoma: a controlled clinical trial. (United States)

    Avilés, Agustin; Nambo, María Jesus; Castañeda, Claudia; Cleto, Sergio; Neri, Natividad; Murillo, Edgar; Huerta-Guzmán, Judith; Contreras, Margarita


    The treatment of elderly patients with aggressive malignant lymphoma has not been defined. The addition of rituximab to conventional chemotherapy has been reported to improve the outcome, but most patients have good prognostic factors (performance status < 2, no severe associated diseases, low or low-intermediate clinical risk). Thus, we developed a combined regimen, including escalated doses of anthracycline and rituximab. The endpoint was to improve event-free survival (EFS) and overall survival. Two hundred and four (204) patients were randomly assigned to receive an escalated chemotherapy regimen (CEOP) with escalated dose of epirubicin, compared to the same regimen and addition of rituximab. All patients had poor prognostic factors: high- or high-intermediate clinical risk, poor performance status, bulky disease, and more than 2 with extranodal involvement. In an intent-to-treat analysis, all patients were evaluable for efficacy and toxicity. The complete response rates were similar in both arms: 74% in chemotherapy and 78% in the rituximab + chemotherapy program. EFS and overall survival were similar: 77% and 84%, respectively, in combined chemotherapy and 75% and 81% in the rituximab-chemotherapy regimen. Toxicity was mild and well tolerated. In elderly patients with diffuse large-cell lymphoma and poor prognostic factors, rituximab did not improve their outcome.

  1. Common toxicities and objective response rate in metastatic colorectal cancer patients treated with irinotecan based regimens

    Institute of Scientific and Technical Information of China (English)

    Liu Huang; Xin Liao; Qianqian Yu; Qiang Fu; Kai Qin; Huanlei Wu; Lihong Zhang; Xianglin Yuan


    Objective: The aim of our study was to investigate if common toxicities are correlated to objective response rate (ORR) in metastatic colorectal cancer (mCRC) patients treated by irinotecan based regimens. Methods: Univariate and multivariate logistic regression analyses were performed to evaluate correlations between common toxicities and binary ORR in 106 mCRC patients from a prospective cohort treated with irinotecan based regimens. Results: The most frequent severe toxicities (Grade 3/4) were as follows: neutropenia (27.4%), diarrhea (16.9%), leucopenia (12.6%), vomiting (3.2%) and thrombocytopenia (2.1%). Thrombocytosis was observed in 25 (26.3%) patients. ORR was 25.3%. Thrombocytopenia (P = 0.014), line of chemotherapy (P = 0.028) and thrombocytosis (P = 0.033) were correlated with ORR in univariate analysis. In multivariate analysis, thrombocytopenia (odds ratio [OR] = 8.600, 95% confidence interval [CI] = 1.705–43.385, P = 0.009) and first line chemotherapy (OR = 5.155, 95% CI = 1.153–23.256, P = 0.032) positively related to ORR. Conclusion: Throm-bocytopenia may be an indicator of ORR in mCRC patients treated by irinotecan plus 5-fluorouracil/capecitabine. Evidence is not strong enough to prove that irinotecan based regimens-induced diarrhea, leucopenia, neutropenia or vomiting is associ-ated with ORR.

  2. Effect of Brucea Javanica Oil Emulsion Combined with GP Regimen on the Immune Function of Patients with Advanced Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Zhang Yu; Yu Like; Xia Ning


    Objective:To observe the effect of Brucea javanica oil emulsion combined with chemotherapy on the immune function of patients with advanced non-small cell lung cancer (NSCLC). Methods:One hundred and fifty-six patients with NSCLC were randomly divided into treatment group (n=82) treated with Brucea javanica oil emulsion combined with GP regimen chemotherapy and control group (n=74) only with GP regimen chemotherapy. The cellular immunity (CD3+, CD4+, CD8+, CD16+CD56+) and humoral immunity (IgG, IgA, IgM, C3, C4) before and after chemotherapy were tested by lfow cytometry (FCM) and biochemical method, respectively. The inlfuences of two treatment methods on the immune function were compared, and clinical efifcacy was evaluated. Results:The remission rates (RRs) were respectively 40.3% and 36.5% in treatment group and control group, without statistical difference (P>0.05). Compared with chemotherapy before, the cellular immune function after chemotherapy decreased in control group (P<0.05),whereas the levels of CD3+, CD4+, CD4+/CD8+ and CD16+CD56+increased signiifcantly in treatment group (P<0.05 orP<0.01). After chemotherapy, the cellular immune function in treatment group was obviously superior to that in control group, whereas there was no statistical signiifcance by comparison to humoral immune indexes between two groups. Conclusion:With similar efifcacy to control group, Brucea javanica oil emulsion combined with GP regimen chemotherapy can improve the cellular immune function of patients with advanced NSCLC and protect the chemotherapy-induced cellular immune function from damage to a certain extent.

  3. Hepatic Sinusoidal Obstruction Syndrome Induced by Non-transplant Chemotherapy for Non-Hodgkin Lymphoma (United States)

    Sakumura, Miho; Tajiri, Kazuto; Miwa, Shigeharu; Nagata, Kohei; Kawai, Kengo; Miyazono, Takayoshi; Arita, Kotaro; Wada, Akinori; Murakami, Jun; Sugiyama, Toshiro


    Hepatic sinusoidal obstruction syndrome (SOS), a serious complication that mainly occurs after hematopoietic-stem cell transplantation (HSCT), is caused by damage to the sinusoidal endothelial cells after the obstruction of the sinusoid. Recently, hepatic SOS was reported to occur after non-HSCT chemotherapies. This report describes a patient who experienced hepatic SOS after non-HSCT chemotherapy for non-Hodgkin lymphoma. A liver biopsy showed the slight dilatation of the hepatic sinusoid, which may be indicative of hepatic SOS. Hepatic SOS should be included in the differential diagnosis of patients with severe liver injury following the administration of chemotherapy regimens that are toxic to the vascular endothelial cells. PMID:28202860

  4. Dramatic Response of a Case ofRecurrent Basal Cell Carcinoma toSystemic Chemotherapy

    Directory of Open Access Journals (Sweden)

    Mohammad Mohammadianpanah


    Full Text Available Basal cell carcinoma (BCC is the most common cancer among humans, and the standard treatment is surgery. Other modalities are reserved as a second line of treatment. Topical chemotherapy may be used in primary BCC. Systemic chemotherapy has no role in the primary treatment of BCC, although it may be efficacious in metastatic cases. We report the case of a patient with persistent recurrent BCC following multiple surgeries and radiotherapy, who achieved a dramatic response with a cisplatinand 5-flourouracil chemotherapy regimen.

  5. Comparative Study of L-Asparaginase-Based LOP Regimen Over CHOP Regimen Before Radiotherapy for Stage IIE Extranodal Nasal Type NK/T Cell Lymphoma: A Study of 2 Centers. (United States)

    Huang, Limin; Yuan, Bin; Wu, Haixia; Chu, Hongliang; Liu, Yayun; Wu, Shuang; Li, Hong; Lu, He; Chen, Hui


    In this study we evaluated the efficacy of an L-asparaginase-based LOP (L-asparaginase, vincristine, and dexamethasone) regimen in extranodal Natural Killer (NK)/T-cell lymphoma (ENKTL) patients in the Guizhou province of China. Forty-eight patients were treated with the LOP (L-asparaginase, vincristine and dexamethasone) regimen chemotherapy (CT) and 32 patients with the CHOP (cyclophosphamide, tetrahydropyanyl adriamycin, vincristine, and prednisone) regimen. These patients then received involved-field radiotherapy (RT) with the doses of DT = 49-59 Gy. A significant improvement of clinical end points with the LOP regimen was noticed compared with the CHOP regimen: 33 (68.8%) versus 16 (50.0%) for complete responses; 10 (20.8%) versus 5 (15.6%) for partial responses. There were statistical differences in objective response rates (43 [89.6%] for LOP vs. 21 [65.6%] for CHOP; P = .009), 3 years of overall survival (42 [87.5%] for LOP vs. 20 [62.5%] for CHOP; P = .006) and progression-free survival (32 [79.2%] for LOP vs. 16 [50.0%] for CHOP; P = .007). The results showed that the LOP regimen is safe and much more efficient than the CHOP regimen for stage IIE ENKTL patients. They indicate that the LOP regimen is a satisfying alternative protocol among the other L-asparaginase-based regimens reported so far, such as SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide), GELOX (gemcitabine, oxaliplatin, and L-asparaginase), CHOP-L, and sandwich (CT, then RT, then CT). Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Cytomegalovirus enterocolitis in a patient with diffuse large B-cell lymphoma after chemotherapy with rituximab

    Institute of Scientific and Technical Information of China (English)

    Jason Seewoodhary


    Rituximab has been associated with the development of cytomegalovirus enterocolitis in immunosuppressed patients. A 51-year-old patient with diffuse large B-cell lymphoma who received a conditioning chemotherapy regimen (RCVP and RICE) consisting of rituximab before bone marrow transplantation went on to develop cytomegalovirus enterocolitis. This supports evidence from previously described cases that rituximab may be associated with cytomegalovirus enterocolitis.

  7. ERP amplitude and latency in breast cancer survivors treated with adjuvant chemotherapy

    NARCIS (Netherlands)

    Kreukels, B.P.C.; Hamburger, H.L.; de Ruiter, M.B.; van Dam, F.S.A.M.; Ridderinkhof, K.R.; Boogerd, W.; Schagen, S.B.


    Objective: Neurocognitive problems that were observed in a number of breast cancer survivors treated with adjuvant chemotherapy initiated a series of EEG studies to examine the neurophysiological basis of these deficits. The aim of the present study was to examine the effects of various regimens of

  8. Outcome of combination chemotherapy in extensive stage small-cell lung cancer

    DEFF Research Database (Denmark)

    Lassen, U N; Hirsch, F R; Osterlind, K


    During the past two decades many different treatment regimens of combination chemotherapy have been applied in extensive stage small-cell lung cancer (SCLC). This study was carried out to identify whether these modifications have resulted in an improved overall survival for extensive stage during...

  9. Treatment outcome in performance status 2 advanced NSCLC patients administered platinum-based combination chemotherapy

    DEFF Research Database (Denmark)

    Helbekkmo, Nina; Aasebø, Ulf; Sundstrøm, Stein H


    BACKGROUND: There is no consensus regarding chemotherapy to patients with advanced NSCLC (ANSCLC) and performance status (PS) 2. Using data from a national multicenter study comparing two third-generation carboplatin-based regimens in ANSCLC patients, we evaluated the outcome of PS 2 patients...

  10. Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting. (United States)

    Aziz, Fahad


    Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. The discovery of several NK1 receptor antagonists is a big revolution to dealt this problem. NK1 receptor antagonists prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). These agents act centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, these agents help improve patients' daily living and their ability to complete multiple cycles of chemotherapy. They are effective for both moderately and highly emetogenic chemotherapy regimens. Their use might be associated with increased infection rates; however, additional appraisal of specific data from RCTs is needed.

  11. Peritoneal carcinomatosis from ovarian cancer: chemosensitivity test and tissue markers as predictors of response to chemotherapy

    Directory of Open Access Journals (Sweden)

    Turci Livia


    Full Text Available Abstract Background Platinum-based regimens are the treatments of choice in ovarian cancer, which remains the leading cause of death from gynecological malignancies in the Western world. The aim of the present study was to compare the advantages and limits of a conventional chemosensitivity test with those of new biomolecular markers in predicting response to platinum regimens in a series of patients with peritoneal carcinomatosis from ovarian cancer. Methods Fresh surgical biopsy specimens were obtained from 30 patients with primary or recurrent peritoneal carcinomatosis from ovarian cancer. ERCC1, GSTP1, MGMT, XPD, and BRCA1 gene expression levels were determined by Real-Time RT-PCR. An in vitro chemosensitivity test was used to define a sensitivity or resistance profile to the drugs used to treat each patient. Results MGMT and XPD expression was directly and significantly related to resistance to platinum-containing treatment (p = 0.036 and p = 0.043, respectively. Significant predictivity in terms of sensitivity and resistance was observed for MGMT expression (75.0% and 72.5%, respectively; p = 0.03, while high predictivity of resistance (90.9% but very low predictivity of sensitivity (37.5% (p = 0.06 were observed for XPD. The best overall and significant predictivity was observed for chemosensitivity test results (85.7% sensitivity and 91.3% resistance; p = 0.0003. Conclusions The in vitro assay showed a consistency with results observed in vivo in 27 out of the 30 patients analyzed. Sensitivity and resistance profiles of different drugs used in vivo would therefore seem to be better defined by the in vitro chemosensitivity test than by expression levels of markers.

  12. Combination Chemotherapy for Influenza

    Directory of Open Access Journals (Sweden)

    Robert G. Webster


    Full Text Available The emergence of pandemic H1N1 influenza viruses in April 2009 and the continuous evolution of highly pathogenic H5N1 influenza viruses underscore the urgency of novel approaches to chemotherapy for human influenza infection. Anti-influenza drugs are currently limited to the neuraminidase inhibitors (oseltamivir and zanamivir and to M2 ion channel blockers (amantadine and rimantadine, although resistance to the latter class develops rapidly. Potential targets for the development of new anti-influenza agents include the viral polymerase (and endonuclease, the hemagglutinin, and the non-structural protein NS1. The limitations of monotherapy and the emergence of drug-resistant variants make combination chemotherapy the logical therapeutic option. Here we review the experimental data on combination chemotherapy with currently available agents and the development of new agents and therapy targets.

  13. Lactate dehydrogenase B is associated with the response to neoadjuvant chemotherapy in oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Wenyi Sun

    Full Text Available Oral squamous cell carcinoma (OSCC comprises a subset of head and neck squamous cell carcinoma (HNSCC with poor therapeutic outcomes and high glycolytic dependency. Neoadjuvant chemotherapy regimens of docetaxel, cisplatin and 5-fluorouracil (TPF are currently accepted as standard regimens for HNSCC patients with a high risk of distant metastatic spread. However, the antitumor outcomes of TPF neoadjuvant chemotherapy in HNSCC remain controversial. This study investigated the role of lactate dehydrogenase B (LDHB, a key glycolytic enzyme catalyzing the inter-conversion between pyruvate and lactate, in determining chemotherapy response and prognosis in OSCC patients. We discovered that a high protein level of LDHB in OSCC patients was associated with a poor response to TPF regimen chemotherapy as well as poor overall survival and disease-free survival. Our in-depth study revealed that high LDHB expression conferred resistance to taxol but not 5-fluorouracil or cisplatin. LDHB deletion sensitized OSCC cell lines to taxol, whereas the introduction of LDHB decreased sensitivity to taxol treatment. Taxol induced a pronounced impact on LDHB-down-regulated OSCC cells in terms of apoptosis, G2/M phase cell cycle arrest and energy metabolism. In conclusion, our study highlighted the critical role of LDHB in OSCC and proposed that LDHB could be used as a biomarker for the stratification of patients for TPF neoadjuvant chemotherapy and the determination of prognosis in OSCC patients.

  14. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013 (United States)

    Xu, Hairong; Xu, Lanfang; Page, John H; Cannavale, Kim; Sattayapiwat, Olivia; Rodriguez, Roberto; Chao, Chun


    Purpose The purpose of this study was to evaluate and characterize the risk of anemia during the course of chemotherapy among patients with five common types of solid tumors. Patients and methods Patients diagnosed with incident cancers of breast, lung, colon/rectum, stomach, and ovary who received chemotherapy were identified from Kaiser Permanente Southern California Health Plan (2010–2012). All clinical data were collected from the health plan’s electronic medical records. Incidence proportions of patients developing anemia and 95% confidence intervals were calculated overall and by anemia severity and type, as well as by stage at cancer diagnosis, and by chemotherapy regimen and cycle. Results A total of 4,426 patients who received chemotherapy were included. Across cancers, 3,962 (89.5%) patients developed anemia during the course of chemotherapy (normocytic 85%, macrocytic 10%, microcytic 5%; normochromic 47%, hyperchromic 44%, hypochromic 9%). The anemia grades were distributed as follows: 58% were grade 1, 34% grade 2, 8% grade 3, and anemia ranged from 26.3% in colorectal cancer patients to 59.2% in ovarian cancer patients. Incidence of grade 2+ anemia increased from 29% in stage I to 49% in stage IV. Incidence of grade 2+ anemia varied from 18.2% in breast cancer patients treated with cyclophosphamide + docetaxel regimen to 59.7% in patients with ovarian cancer receiving carboplatin + paclitaxel regimen. Conclusion The incidence of moderate-to-severe anemia (hemoglobin anemia was greater in patients with distant metastasis. PMID:27186078

  15. Prophylactic antibiotic regimens in tumour surgery (PARITY)

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hettwer, Werner H; Grum-Schwensen, Tomas


    -day regimen of post-operative antibiotics, in comparison to a 24-hour regimen, decreases surgical site infections in patients undergoing endoprosthetic reconstruction for lower extremity primary bone tumours. METHODS: We performed a pilot international multi-centre RCT. We used central randomisation......% at one year (the remainder with partial data or pending queries). In total, 18 participants missed at least one dose of antibiotics or placebo post-operatively, but 93% of all post-operative doses were administered per protocol. CONCLUSIONS: It is feasible to conduct a definitive multi-centre RCT of post-operative...... to conceal treatment allocation and sham antibiotics to blind participants, surgeons, and data collectors. We determined feasibility by measuring patient enrolment, completeness of follow-up, and protocol deviations for the antibiotic regimens. RESULTS: We screened 96 patients and enrolled 60 participants...

  16. Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. (United States)

    Hashiguchi, Yasunori; Kasai, Mari; Fukuda, Takeshi; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki


    Chemotherapy-induced neutropenia is a common complication in cancer treatment. In this study, we investigated chemotherapy-induced neutropenia that was recently detected in all patients with gynecologic malignancy. Between January 2009 and December 2011, we examined cases of chemotherapy-induced neutropenia reported in our hospital. We analyzed the incidence and clinical features of chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. During the study period, we administered over 1614 infusions (29 regimens) to 291 patients. The median age of the patients was 60 years (range 24-84 years). Chemotherapy-induced neutropenia occurred in 147 (50.5%) patients over 378 (23.4%) chemotherapy cycles. Febrile neutropenia occurred in 20 (6.9%) patients over 25 (1.5%) cycles. The mean duration of neutropenia and fever was 3.6 days (range 1-12 days) and 3.4 days (range 1-9 days), respectively. The source of fever was unexplained by examination or cultures in 14 (56.0%) cycles. There were two cases of neutropenia-related death. Chemotherapy-induced neutropenia was associated with older age (over 70 years) (PFebrile neutropenia was associated with poor performance status (Pneutropenia nor febrile neutropenia was associated with bone marrow metastases or previous radiotherapy. By identifying risk factors for febrile neutropenia, such as performance status, no previous chemotherapy, disseminated disease, and distant metastatic disease, the safe management of chemotherapy-induced neutropenia may be possible in patients with gynecologic malignancy.

  17. [Adjuvant chemotherapy in colon cancer. About 119 cases]. (United States)

    Yaich, Asma; Khanfir, Afef; Bayrouti, Mohamed Issam; Frikha, Mounir


    colon cancer is a public health problem worldwide and in Tunisia. The prognosis of patients with unresectable colorectal cancer varies according to the stage. The indication for adjuvant chemotherapy is well established in the colon cancer stage III, while it remains a matter of controversy for stage II. The aim of this work is to identify the epidemiological and anatomoclinical assess therapeutic outcomes in terms of overall survival of patients with high-risk stage II and stage III colon cancer treated with surgery and adjuvant chemotherapy. DS: It's a retrospective study based on 119 patients with colon adenocarcinoma from 1996 to 2010. This patients suffering from colon cancer classified stage II and III having them all radical surgery and adjuvant chemotherapy. The average age of our patients was 53 years. The surgery was performed in an emergency situation in 53 patients (44%). Stages II and III, respectively, were observed in 47% and 53% of cases. Three regimens of chemotherapy were used: protocol FUFOL (50%), followed by FOLFOX (34%) and the protocol LV5FU2 (16%). Overall survival of patients all stages combined was 73.4% at 5 years. Stage III of the TNM classification (p = 0.03) and the number of cycles of chemotherapy colon cancer is improving thanks to recent advances that have enabled the integration of new cytogenetic factors in the therapeutic decision.

  18. Metronomic Chemotherapy: Low Dose Less Toxicity Anticancer Strategy

    Directory of Open Access Journals (Sweden)

    Anjan Khadka


    Full Text Available Metronomic chemotherapy is the frequent administration of chemotherapy drugs at doses below the maximum tolerated dose and with no prolonged drug‑free break. It thus achieves a sustained low blood level of the drug without significant toxic side‑effects. Metronomic therapy leads to sustained plasma concentration of the drug without significant toxic side‑effects and hence there is reduced need for supportive therapy. However in case of conventional therapy toxicity is a concern. Metronomic chemotherapy exerts both direct and indirect effects on tumor cells and their microenvironment. It can inhibit tumor angiogenesis, stimulate anticancer immune response and also induces tumor dormancy. Optimizing a metronomic anticancer therapy is still a challenging task. New strategies are being developed to combine metronomic chemotherapy with conventional chemotherapy, radiotherapy and/or targeted therapy. An important disadvantage of this type of regimen is the empiricism in finding the optimal ‘low‑dose’ and in monitoring therapeutic efficacy during the course of treatment.

  19. Partial remission of acute myeloid leukemia complicating multiple myeloma following COAP chemotherapy: A case report. (United States)

    Shen, Man; Sun, Wan-Jun; Huang, Zhong-Xia; Zhang, Jia-Jia; An, Na; Li, Xin


    A 77-year-old male was admitted to hospital after complaining of fever and a cough for three days. A diagnosis of multiple myeloma was confirmed following M protein identification and a bone marrow biopsy. The patient received chemotherapy regimens of bortezomib plus dexamethasone, cyclophosphamide, thalidomide and dexamethasone, and thalidomide and dexamethasone, and was prescribed thalidomide (100 mg/d) to be taken orally for maintenance therapy. After a further two years the patient was subsequently diagnosed with acute myeloid leukemia. Chemotherapy regimens of cytarabine, aclacinomycin and daunorubicin, homoharringtonine and etoposide, and mitoxantrone and cytarabine resulted in no remission. Partial remission was obtained with a course of ifosfamide, vindesine, cytarabine and prednisone chemotherapy. This therapy may be an alternative treatment for secondary leukemia, particularly in elderly patients.

  20. Systemic Chemotherapy for Progression of Brain Metastases in Extensive-Stage Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Nagla Abdel Karim


    Full Text Available Lung cancer is the most common cause of cancer related mortality in men and women. Approximately 15% of lung cancers are small cell type. Chemotherapy and radiation are the mainstay treatments. Currently, the standard chemotherapy regimen includes platinum/etoposide. For extensive small cell lung cancer, irinotecan and cisplatin have also been used. Patients with relapsed small cell lung cancer have a very poor prognosis, and the morbidity increases with brain metastases. Approximately 10%–14% of small cell lung cancer patients exhibit brain metastases at the time of diagnosis, which increases to 50%–80% as the disease progresses. Mean survival with brain metastases is reported to be less than six months, thus calling for improved regimens. Here we present a case series of patients treated with irinotecan for progressive brain metastases in small cell lung cancer, which serves as a reminder of the role of systemic chemotherapy in this setting.

  1. Platinum-Based Chemotherapy for Variant Castrate-Resistant Prostate Cancer (United States)

    Aparicio, Ana M.; Harzstark, Andrea L.; Corn, Paul G.; Wen, Sijin; Araujo, John C.; Tu, Shi-Ming; Pagliaro, Lance C.; Kim, Jeri; Millikan, Randall E.; Ryan, Charles J.; Tannir, Nizar M.; Zurita, Amado J.; Mathew, Paul; Arap, Wadih; Troncoso, Patricia; Thall, Peter F.; Logothetis, Christopher J.


    Purpose Clinical features characteristic of small-cell prostate carcinoma (SCPC), (““anaplastic””) often emerge during the progression of prostate cancer. We sought to determine the efficacy of platinum-based chemotherapy in patients meeting at least one of seven prospectively defined “anaplastic” clinical criteria, including exclusive visceral or predominantly lytic bone metastases, bulky tumor masses, low PSA levels relative to tumor burden or short response to androgen deprivation therapy. Experimental Design A 120-patient phase II trial of frontline carboplatin and docetaxel (CD) and second-line etoposide and cisplatin (EP) was designed to provide reliable clinical response estimates under a Bayesian probability model with early stopping rules in place for futility and toxicity. Results Seventy-four of 113 (65.4%) and 24 of 71 (33.8%) were progression free after 4 cycles of CD and EP, respectively. Median overall survival (OS) was 16 months (95% CI, 13.6-19.0 months). Of the 7 “anaplastic” criteria, bulky tumor mass was significantly associated with poor outcome. Lactic acid dehydrogenase (LDH) strongly predicted for OS and rapid progression. Serum carcinoembryonic antigen (CEA) concentration strongly predicted OS but not rapid progression. Neuroendocrine markers did not predict outcome or response to therapy. Conclusion Our findings support the hypothesis that patients with “anaplastic” prostate cancer are a recognizable subset characterized by a high response rate of short duration to platinum-containing chemotherapies, similar to SCPC. Our results suggest that CEA is useful for selecting therapy in men with CRPC and consolidative therapies to bulky high-grade tumor masses should be considered in this patient population. PMID:23649003

  2. ATLAS: Randomized, Double-Blind, Placebo-Controlled, Phase IIIB Trial Comparing Bevacizumab Therapy With or Without Erlotinib, After Completion of Chemotherapy, With Bevacizumab for First-Line Treatment of Advanced Non–Small-Cell Lung Cancer

    National Research Council Canada - National Science Library

    Bruce E. Johnson; Fairooz Kabbinavar; Louis Fehrenbacher; John Hainsworth; Saifuddin Kasubhai; Bruce Kressel; Chin-Yu Lin; Thomas Marsland; Taral Patel; Jonathan Polikoff; Mark Rubin; Leonard White; James Chih-Hsin Yang; Chris Bowden; Vincent Miller


    This phase III trial was performed to assess the potential benefit of adding maintenance erlotinib to bevacizumab after a first-line chemotherapy regimen with bevacizumab for advanced non-small-cell lung cancer (NSCLC...

  3. The clinical research of elemene emulsion combined with F0LF0X4 regimen in the treatment of advanced gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yanzhi Bi; Dongxiang Zeng; Yang Ling


    Objective: The aim of this study was to observe the effects and adverse reactions of elemene emulsion added to the chemotherapy in the treatment of advanced gastric carcinoma (AGC). Methods: Forty-nine patients were divided randomly into two groups, elemene emulsion group (25 cases, treated with chemotherapy and elemene emulsion) and chemotherapy group (24 cases, treated with chemotherapy only). All patients received chemotherapy. The clinical effects and adverse reactions were evaluated after four cycles. Results: The response rate (RR) were 60% in elemene emulsion group and 41.7% in chemotherapy group respectively (P < 0.05). The median time to progression and overall survival in elemene emulsion group and in chemotherapy group were 7.1 months and 11.0 months vs 5.2 months and 9.3 months (P < 0.05). A lower rate of neutropenia, nausea, vomiting and diarrhea occurred in elemene emulsion group compared with chemotherapy group (P < 0.05), and there was significant difference in the elevation of life quality as well (48% vs 25%; P < 0.05). Conclusion: Elemene emulsion in combination with FOLFOX4 regimen can improve the efficacy, decrease the incidence of side effects of chemotherapy and elevate the life quality and prolong the survival time in AGC.

  4. Cost-effectiveness of chemotherapy for sputum smear-positive pulmonary tuberculosis in Malawi, Mozambique and Tanzania. (United States)

    de Jonghe, E; Murray, C J; Chum, H J; Nyangulu, D S; Salomao, A; Styblo, K


    The cost-effectiveness of chemotherapy for pulmonary sputum smear-positive tuberculosis was examined in the national tuberculosis control programmes of Malawi, Mozambique and Tanzania. In these three programmes, routine cure rates have exceeded 80 per cent. Average, average incremental and marginal unit costs for standard, short-course and retreatment regimens with and without hospitalization have been measured. The average incremental cost per year of life saved through chemotherapy ranged from US $0.90-3.10. In all conditions, short-course chemotherapy is preferable to standard 12-month chemotherapy. When hospitalization during the intensive phase of chemotherapy increases the cure rate by 10-15 percentage points, it can be relatively cost-effective. Analysing the cost-effectiveness of short-course and standard chemotherapy, where the depth of the margin of benefit is different, illustrates some of the dangers of simplistic use of cost-effectiveness ratios.

  5. Is there any advantage to combined trastuzumab and chemotherapy in perioperative setting her 2neu positive localized gastric adenocarcinoma?

    Directory of Open Access Journals (Sweden)

    Albouzidi Abderrahmane


    Full Text Available Abstract We report here a 44-year-old Moroccan man with resectable gastric adenocarcinoma with overexpression of human epidermal growth factor receptor 2 (HER2 by immunohistochemistry who was treated with trastuzumab in combination with chemotherapy in perioperative setting. He received 3 cycles of neoadjuvant chemotherapy consisting of trastuzumab, oxaliplatin, and capecitabine. Afterwards, he received total gastrectomy with extended D2 lymphadenectomy without spleno-pancreatectomy. A pathologic complete response was obtained with a combination of trastuzumab and oxaliplatin and capecitabine. He received 3 more cycles of trastuzumab containing regimen postoperatively. We conclude that resectable gastric carcinoma with overexpression of the c-erbB-2 protein should ideally be managed with perioperative combination of trastuzumab with chemotherapy. Further research to evaluate trastuzumab in combination with chemotherapy regimens in the perioperative and adjuvant setting is urgently needed.

  6. Chemotherapy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Javier Sastre; Jose Angel García-Saenz; Eduardo Díaz-Rubio


    Metastatic gastric cancer remains a non-curative disease.Palliative chemotherapy has been demonstrated to prolong survival without quality of life compromise. Many single-agents and combinations have been confirmed to be active in the treatment of metastatic disease. Objective response rates ranged from 10-30% for single-agent therapy and 30-60% for polychemotherapy. Results of phase Ⅱ and Ⅲ studies are reviewed in this paper as well as the potential efficacy of new drugs. For patients with localized disease, the role of adjuvant and neoadjuvant chemotherapy and radiation therapy is discussed.Most studies on adjuvant chemotherapy failed to demonstrate a survival advantage, and therefore, it is not considered as standard treatment in most centres. Adjuvant immunochemotherapy has been developed fundamentally in Korea and Japan. A meta-analysis of phase Ⅲ trials with OK-432 suggested that immunochemotherapy may improve survival of patients with curatively resected gastric cancer. Based on the results of US Intergroup 0116study, postoperative chemoradiation has been Accepted as standard care in patients with resected gastric cancer in North America. However, the results are somewhat confounded by the fact that patients underwent less than a recommended D1 lymph node dissection and the pattern of recurrence suggested a positive effect derived from local radiotherapy without any effect on micrometastatic disease.Neoadjuvant chemotherapy or chemoradiation therapy remains experimental, but several phase Ⅱstudies are showing promising results. Phase Ⅲ trials are needed.

  7. Chemotherapy of herpesvirus infections. (United States)

    Jawetz, E


    Herpesviruses commonly produce lesions that come to the attention of physicians. Many different chemicals are known to suppress the growth of herpesviruses in vitro, but only a few of these have found application in clinical practice. A critical assessment of the place of some of these forms of chemotherapy was briefly presented.

  8. Intravenous and intramuscular magnesium sulphate regimens in ...

    African Journals Online (AJOL)


    Sep 3, 1993 ... Pritchard' and a continuous intravenous (IV) infusion described by Zuspan! ... in the treatment of severe pre-eclampsia with the IM regimen of ..... people under the age of 50 years and more men died than women. In 40% of ...

  9. Sensitivity of Interstitial combined Chemotherapy against Glioma

    Institute of Scientific and Technical Information of China (English)

    WANG Ming-sheng; LIN Jian-ying; ZHOU Guo-sheng; ZHANG Xin-zhong


    Objective To investigate the inhibitory effects of combination chemotherapy of Carboplatin(CBP) ,Teniposide (Vm-26) ,Methasquin(MTX),and Nimodipine(NIM) on glioma,and to explore the sensitivity of glioma cells to different treatment regimens so as to provide some clues for clinical usage of interstitial combination chemotherapy. Methods MTT assay and 3H-TdR incorporation assay were performed to evaluate the inhibitory effects upon the proliferation of glioma cells,and to compare the sensitivity of glioma cells to administration of CBP,Vm-26, MTX, and NIM with that of the administration of CBP + NIM, Vm-26 + NIM, MTX + NIM, CBP + Vm-26 + MTX, or CBP + Vm-26 + MTX + NIM respectively. Results The inhibition rate of CBP + Vm-26 + MTX + NIM combination administration against glioma cells was 96.64%,which was higher than that of CBP + NIM (69.03%), Vm-26 + NIM (71.53%), MTX + NIM (52. 75% ), CBP + Vm-26 + MTX(78.59%)(P<0.01),and the dosage of CBP,Vm-26,and MTX was declined to 1/10 ~ 1/100 that of respective use of CBP,Vm-26,and MTX. Conclusions The curative effects of combination administration of CBP,Vm-26, MTX, and NIM was much better than that of respective administration,suggesting a higher inhibition rate and a lower dosage use.

  10. Effects of Traditional Chinese Medicine on Chemotherapy-Induced Myelosuppression and Febrile Neutropenia in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Huan Tian


    Full Text Available Title. Chemotherapy-induced myelosuppression lowers the quality of life in breast cancer patients and causes many complications. Traditional Chinese Medicine (TCM is a widely used complementary and alternative medicine therapies. Objective. To study whether TCM can reduce the incidence of chemotherapy-induced leukopenia, neutropenia, and febrile neutropenia (FN in breast cancer patients. Methods. The data were analyzed retrospectively between patients who received TCM treatment (group 1, n=453 and patients who did not receive TCM treatment (group 2, n=359. Significant risk factors associated with the occurrence of chemotherapy-induced leukopenia, neutropenia, and FN were identified using multivariate analysis. Propensity score-matched patients were analyzed to adjust for any baseline differences. Results. Group 1 patients had a significantly lower rate of chemotherapy-induced severe leukopenia, neutropenia, and FN, compared with group 2 (43% versus 71%, P<0.0001, 72% versus 78%, P=0.005, 6% versus 24%, P<0.0001, resp.. Multivariate analysis revealed that chemotherapy regimens containing anthracyclines combined with paclitaxel or docetaxel were the most significant predictor. Subgroup analysis indicated that TCM treatment showed benefit in relieving chemotherapy-induced leukopenia and FN in most chemotherapy regimens. Conclusions. TCM treatment could lower the risk of severe chemotherapy-induced leukopenia, neutropenia, and FN in breast cancer patients.

  11. Influence of rmhTNF on the Chemotherapy Treatment of Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)


    The efficacy and safety of the recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy vs chemotherapy alone in the treatment of patients with small cell lung cancer (SCLC) were evaluated in this study. The selected 37 patients with SCLC were divided into experimental group (n = 18) and control group (n = 19). Bothgroups were subjected to EP regimen. While in the experimental group, a regimen of 4 × 106 U/m2 rmhTNF intramuscular injection was given once a day from the 1st to 7th day and 11th to 17th day on the chemotherapy cycle.Twenty-one days were as a chemotherapy cycle and all patients received treatment with 2 cycles.The response rate was 83.3 % (15/18) in the experimental group and 63.2 % (12/19) in the control group respectively (P<0.05). The KPS score after treatment was 78.4±9.6 in the experimental group and 71.2±9.7 in the control group with the difference being significant (P<0.05).No severe adverse effects occurred in the two groups. It was concluded that the curative effectiveness of the rmhTNF combined with chemotherapy in the treatment of SCLC was more satisfactory than chemotherapy alone. The former could obviously improve the quality of life of the patients with SCLC.

  12. Efficacy and safety analysis of chemotherapy for advanced colitis-associated colorectal cancer in Japan. (United States)

    Nio, Kenta; Higashi, Daijiro; Kumagai, Hozumi; Arita, Shuji; Shirakawa, Tsuyoshi; Nakashima, Koji; Shibata, Yoshihiro; Esaki, Motohiro; Manabe, Tatsuya; Nagai, Shuntaro; Ueki, Takashi; Nakano, Michitaka; Ariyama, Hiroshi; Kusaba, Hitoshi; Hirahashi, Minako; Oda, Yoshinao; Esaki, Taito; Mitsugi, Kenji; Futami, Kitaro; Akashi, Koichi; Baba, Eishi


    Chemotherapy for advanced colitis-associated colorectal cancer (CAC) has been insufficiently evaluated. The goal of this study was to clarify the efficacy and safety of chemotherapy for CAC in Japan. CAC patients who were treated with chemotherapy between 2005 and 2015 were retrospectively examined. Twenty-nine patients (median age, 48 years; 23 men) were assessed. Eighteen patients had ulcerative colitis, and 11 had Crohn's disease. Three ulcerative colitis and four Crohn's disease patients were in the active disease phase. Primary tumors were located in the rectum/anus (n=16), the left colon (n=9), or the right colon (n=4). Palliative or adjuvant chemotherapy was performed in 13 and 16 patients, respectively. First-line palliative chemotherapy regimens were as follows: fluorouracil, leucovorin, and oxaliplatin (FOLFOX; n=6), FOLFOX+bevacizumab (n=3), and others (n=4). Adjuvant chemotherapy regimens were S-1 (n=7), oxaliplatin-based (n=4) and others (n=5). In palliative chemotherapy, the objective response rate was 15%, and the median progression-free survival and overall survival were 182 and 315 days, respectively. In adjuvant chemotherapy, the 5-year relapse-free survival rate was 78%. Grade 3/4 adverse events (AEs) were observed in 16 patients (55%). Active and remission inflammatory bowel disease patients suffered grade 3/4 nonhematological AEs at an incidence of 71 and 23%, respectively (Pchemotherapy for CAC exhibited sufficient efficacy, whereas modest efficacy was shown for palliative chemotherapy for CAC. AEs, particularly nonhematological AEs, were closely associated with disease activity of colitis.

  13. Coming to your senses: detecting taste and smell alterations in chemotherapy patients. A systematic review. (United States)

    Gamper, Eva-Maria; Zabernigg, August; Wintner, Lisa Maria; Giesinger, Johannes Maria; Oberguggenberger, Anne; Kemmler, Georg; Sperner-Unterweger, Barbara; Holzner, Bernhard


    Taste alterations (TAs) and smell alterations (SAs) are frequently observed, yet understudied side effects in chemotherapy patients, considerably affecting patients' quality of life. This review provides a systematic evaluation of the literature on TAs and SAs in cancer chemotherapy patients and discloses understudied research questions. A systematic methodology based on the PRISMA guidelines was applied to identify original research articles with TAs and SAs as primary outcomes in chemotherapy patients. MEDLINE and Embase were searched using Medical Subject Heading and free-text terms. Study extraction and evaluation were done by three reviewers using predefined criteria. The search revealed 22 eligible studies, including three randomized controlled trials. Different measurement approaches were identified, with a clear trend toward self-report measures during the past decade. The methodological quality of the included studies varied, especially reports on SAs, which were inconsistent and hard to interpret. Regarding TAs, there is evidence that taste thresholds increase during chemotherapy. Qualitative changes, for example, metallic taste, are frequent but cannot be attributed to specific chemotherapy regimens. There are large research gaps regarding TAs and SAs in different patient populations and the impact of different chemotherapy regimens. Adequate management strategies are rare. Current research results do not allow firm conclusions concerning the occurrence, severity, and quality of TAs and SAs under different chemotherapy regimens. Patient information on TAs and SAs, therefore, largely is based on the clinician's experience. In the palliative care setting, TAs and SAs need further investigation in the light of their importance in preventing food-related problems and maintaining a reasonable quality of life. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  14. Intermittent Versus Daily Pulmonary Tuberculosis Treatment Regimens: A Meta-Analysis (United States)

    Kasozi, Samuel; Clark, Justin; Doi, Suhail A. R.


    Background Several systematic reviews suggest that intermittent pulmonary tuberculosis (TB) chemotherapy is effective, but intensity (daily versus intermittent) and duration of rifampicin use (intensive phase only versus both phases) have not been distinguished. In addition, the various outcomes (success, failure, relapse, and default) have only selectively been evaluated. Methods We conducted a meta-analysis of proportions using all four outcomes as multi-category proportions to examine the effectiveness of WHO category 1 TB treatment regimens. Database searches of studies reporting treatment outcomes of HIV negative subjects were included and stratified by intensity of therapy and duration of rifampicin therapy. Using a bias-adjusted statistical model, we pooled proportions of the four treatment outcome categories using a method that handles multi-category proportions. Results A total of 27 studies comprising of 48 data sets with 10,624 participants were studied. Overall, treatment success was similar among patients treated with intermittent (I/I) (88%) (95% CI, 81–92) and daily (D/D) (90%) (95% CI, 84–95) regimens. Default was significantly less with I/I (0%) (95% CI, 0–2) compared to D/D regimens (5%) (95% CI, 1–9). Nevertheless, I/I relapse rates (7%) (95% CI, 3–11) were higher than D/D relapse rates (1%) (95% CI, 0–3). Conclusion Treatment regimens that are offered completely intermittently versus completely daily are associated with a trade-off between treatment relapse and treatment default. There is a possibility that I/I regimens can be improved by increasing treatment duration, and this needs to be urgently addressed by future studies. PMID:26056374

  15. Efficacy and Toxicity of Low-Dose versus Conventional-Dose Chemotherapy for Malignant Tumors: a Meta-Analysis of 6 Randomized Controlled Trials (United States)

    Xie, Xianhe; Wu, Yupeng; Luo, Shuimei; Yang, Haitao; Li, Lina; Zhou, Sijing; Shen, Ruifen; Lin, Heng


    Low-dose chemotherapy has emerged as a new strategy for control of cancer. However, there is a controversy as to whether low-dose chemotherapy is an effective way to manage many human malignancies. To shed light on this controversy, we performed a meta-analysis of relative merits between low-dose and conventional-dose chemotherapy in different carcinomas. Studies published before February 29, 2016 were reviewed for the meta-analysis and selected according to defined criteria. The effect levels of low-dose chemotherapy regarding overall survival (OS), progression-free survival (PFS) and severe adverse events (SAEs) (Grade≥3) were calculated as risk ratios (ORs) or adjusted hazard ratios (HRs). Six randomized controlled studies (RCTs) have provided data for low-dose chemotherapy versus conventional-dose chemotherapy for 838 cases and 833 cases, respectively. Interestingly, low-dose chemotherapy achieved the same desired potency as conventional-dose chemotherapy, with no differences in pooled ORR (RR=1.00, 95%CI [0.89, 1.13]; (P=0.97), OS (HR=1.07, 95%CI [0.90, 1.26]; P=0.44) and PFS (HR=1.02, 95%CI [0.84, 1.23]; P=0.87) values. Furthermore, pooled data for common SAEs showed that, compared with conventional-dose chemotherapy regimen, low-dose chemotherapy regimen resulted in significant less mucositis (Plow-dose chemotherapy may play an important role in achieving the same desired potency as conventional-dose chemotherapy in managing malignant tumors. Moreover, low-dose regimen seems to possess positive advantages of lower toxicity which is a particular concern for most patients.

  16. The influence of chemotherapy on taste perception and food hedonics: a systematic review. (United States)

    Boltong, Anna; Keast, Russell


    Altered food relationships in people receiving chemotherapy are prevalent and distressing. Whether, or to what extent, taste perception and food hedonics plays in altered food relationships is unknown among people receiving chemotherapy. This two-armed systematic review addressed the question "Does chemotherapy influence taste perception and hedonic experience of food?" A systematic review was undertaken of (1) taste perception and (2) food hedonics. Search phrases used in the taste arm were: "chemotherapy AND taste", and in the food hedonics arm, "chemotherapy AND (liking OR food OR appetite OR hedonic(∗))". Databases searched were PsycINFO, PubMed, Medline, CINAHL, EMBASE and the Cochrane Library. English language, peer-reviewed publications investigating adults (>18years) receiving chemotherapy as the only cancer treatment were eligible. One hundred and sixty three papers were screened in the taste arm, of which eight (5%) met inclusion criteria. Nine hundred and seventy two papers were screened in the food hedonics arm of which 25 (3%) met inclusion criteria. Chemotherapy had variable influence on both taste sensitivity and perceived intensity of the taste qualities sweet, salty, sour and bitter. Liking of food and drink decreased after chemotherapy treatment commenced. Caffeinated foods and drinks, red meat and citrus fruits or juices were most frequently reported as aversive during chemotherapy. A reduction in appetite was reported between baseline (pre-chemotherapy) and cycles 1-3 of chemotherapy with no further worsening in latter chemotherapy cycles and an improvement after completion of chemotherapy treatment. There was a lack of consistency of results between studies due to differences in study design, chemotherapy regimen, tumor type and stage of treatment examined. These results provide insufficient evidence to suggest chemotherapy has a significant or consistent influence on taste. There is a consistent, albeit small, body of evidence indicating

  17. Combined radio- and chemotherapy for non-small cell lung cancer: systematic review of landmark studies based on acquired citations

    Directory of Open Access Journals (Sweden)

    Carsten eNieder


    Full Text Available The important role of combined chemoradiation for several groups of patients with non-small cell lung cancer (NSCLC is reflected by the large number of scientific articles published during the last 30 years. Different measures of impact and clinical relevance of published research are available, each with its own pros and cons. For this review, article citation rate was chosen. Highly cited articles were identified through systematic search of the citation database Scopus. Among the 100 most often cited articles, meta-analyses (n=5 achieved a median of 203 citations, guidelines (n=7 97, phase III trials (n=29 168, phase II trials (n=21 135, phase I trials (n=7 88, and others combined 115.5 (p=0.001. Numerous national and international cooperative groups and several single institutions were actively involved in performing often cited, high-impact trials, reflecting the fact that NSCLC is a world-wide challenge that requires research collaboration. Platinum-containing combinations have evolved into a standard of care, typically administered concurrently. The issue of radiotherapy fractionation and total dose has also been studied extensively, yet with less conclusive results. Differences in target volume definition have been addressed. However, it was not possible to test all theoretically possible combinations of radiotherapy regimens, drugs and drug doses (lower radiosensitizing doses compared to higher systemically active doses. That is why current guidelines offer physicians a choice of different, presumably equivalent treatment alternatives. This review identifies open questions and strategies for further research.

  18. Prevent Infections During Chemotherapy

    Centers for Disease Control (CDC) Podcasts


    This podcast discusses the importance of preventing infections in cancer patients who are undergoing chemotherapy. Dr. Lisa Richardson, CDC oncologist, talks about a new Web site for cancer patients and their caregivers.  Created: 10/24/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 10/24/2011.

  19. Chemotherapy of Leishmaniasis. (United States)


    NOTES 1S. KEY WORDS (Continue on reverse side linscoeawy and identiIIy by block number) LEISHMANIA LEISHMANIASIS CHEMOTHERAPY ANTILEISHMANIAL PENTOSTAM...number of compounds was supplied by WRAIR for testing on four strains of Leishmania in December 1977. Preliminary data were supplied to WRAIR by the...j_ = L. tropica major (Strain LV39 from USSR) and the New World cutaneous leishmaniasis by L. mexicana amazonensis (Strain LV78 from Brazil). The test

  20. Topoisomerase II alpha expression and the benefit of adjuvant chemotherapy for postoperative patients with non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Jie Li


    Full Text Available Abstract Background Adjuvant chemotherapy has been shown to improve survival rates of postoperative patients with non-small cell lung cancer (NSCLC. Biomarkers could help select an appropriate chemotherapy for NSCLC patients or predict the efficacy of chemotherapy. The objective of this study was to explore the possible prognostic and predictive role of topoisomerase II alpha (TopIIα expression level in postoperative NSCLC patients who received adjuvant chemotherapy. Methods Patients with stage I-III NSCLC, who underwent surgery in our hospital from January 2004 to December 2007 and who also received adjuvant chemotherapy after surgery, were analyzed in this study. Expression of TopIIα and Ki67 in paraffin-embedded tissues was detected by immunohistochemistry (IHC. The relationships between clinicopathological characteristics, chemotherapy regimens, the expression of biomarkers and disease free survival (DFS were analyzed. Results TopIIα and Ki67 were highly expressed in 22.5% and 36.4% of the 151 patients, respectively. Univariate survival analysis showed that male sex (P = 0.036, non-adenocarcinoma (P = 0.004, earlier pathological TNM stage (P = 0.001 or pathological N stage (P Conclusions High TopIIα expression was discovered to be correlated with better DFS for postoperative NSCLC patients who received adjuvant chemotherapy. The NVB-containing chemotherapy regimen was more effective than the TXT-containing regimen in improving DFS in patients with low TopIIα expression. TopIIα could be considered to be an independent prognostic biomarker of DFS in postoperative NSCLC patients who received adjuvant chemotherapy.

  1. "Rescue" regimens after Helicobacter pylori treatment failure

    Institute of Scientific and Technical Information of China (English)

    Javier P Gisbert


    Helicobacter pylori (H pylori)infection is the main cause of gastritis,gastroduodenal ulcer disease,and gastric cancer.After more than 20 years of experience in Hpylori treatment,in my opinion,the ideal regimen to treat this infection is still to be found.Currently,apart from having to know first-line eradication regimens well,we must also be prepared to face lyeatment failures.Therefore,in designing a treatment strategy we should not focus on the results of primary therapy alone,but also on the final (overall) eradication rate.The choice of a "rescue" treatment depends on which treatment is used initially.If a clarithromycinbased regimen was used initially,a subsequent metronidazole-based treatment (quadruple therapy)may be used afterwards,and then a levofloxacinbased combination would be a third "rescue" option.Alternatively,it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy,representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure,with the advantage of efficacy,simplicity and safety.In this case,a quadruple regimen may be reserved as a third-line rescue option.Finally,rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin.Even after two consecutive failures,several studies have demonstrated that H pylor/eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given.Therefore,the attitude in H pylori eradication therapy failure,even after two or more unsuccessful attempts,should be to fight and not to surrender.

  2. New Treatment Regimen for Latent Tuberculosis Infection

    Centers for Disease Control (CDC) Podcasts


    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses the December 9, 2011 CDC guidelines for the use of a new regimen for the treatment of persons with latent tuberculosis infection.  Created: 3/15/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/15/2012.

  3. Successful Chemotherapy on a Pregnant Non-Hodgkin's Lymphoma Patient

    Directory of Open Access Journals (Sweden)



    Full Text Available We report a case of a non-Hodgkin's lymphoma (NHL patient treated successfully with combination chemotherapy during pregnancy who delivered a full-term baby. A 29 year-old patient with cervical and inguinal lymphadenopathy in the 27th week of gestation was referred to our hospital. The diagnosis of lymph node biopsy was NHL (diffuse, large cell type with B-cell phenotype. Three courses of CHOP regimen (adriamycin, cyclophosphamide, vincristine and prednisolone were given before delivery. The patient has been in complete remission for three years and her baby has been in normal development. Our case supports previous reports that chemotherapy in the third trimester may be given safely on NHL patients.

  4. Recent advances of cocktail chemotherapy by combination drug delivery systems. (United States)

    Hu, Quanyin; Sun, Wujin; Wang, Chao; Gu, Zhen


    Combination chemotherapy is widely exploited for enhanced cancer treatment in the clinic. However, the traditional cocktail administration of combination regimens often suffers from varying pharmacokinetics among different drugs. The emergence of nanotechnology offers an unparalleled opportunity for developing advanced combination drug delivery strategies with the ability to encapsulate various drugs simultaneously and unify the pharmacokinetics of each drug. This review surveys the most recent advances in combination delivery of multiple small molecule chemotherapeutics using nanocarriers. The mechanisms underlying combination chemotherapy, including the synergistic, additive and potentiation effects, are also discussed with typical examples. We further highlight the sequential and site-specific co-delivery strategies, which provide new guidelines for development of programmable combination drug delivery systems. Clinical outlook and challenges are also discussed in the end.

  5. [Control of vomiting induced by antineoplastic chemotherapy in childhood]. (United States)

    Madero López, L; Pérez Jurado, L; Martín Ramos, N; Contra Gómez, T; Ruiz López, M J; Robles Cascallar, P


    Twenty four children aged 2 to 13 years who were to receive cancer chemotherapy were enrolled in a prospective study (before-after-trial) in order to evaluate the efficacy of systematic antiemetic prophylaxis. The regimen of three drugs (metilpednisolone 4 mg/Kg/dose/iv 2 doses; metodopamide 0.5 mg/Kg/dose/iv 4 doses; diphenydramine 1 mg/Kg/dose/iv 4 doses) was used. We found a significative reduction (P less than 0.001) in the incidence of vomiting and nauseousness duration when the antiemetic prophylaxis was used. There were very few and slight adverse effects secondary to antiemetic drugs: Sedation happened in 25% of chemotherapic cycles and hypotension without clinical repercussion in 15%. No patient had distonia. We conclude that systematical antiemetic protection should be used in children receiving chemotherapy. The association of metilpednisolone, metopramide and diphenhydramine is a safe and effective combination.

  6. Treatment of radiation- and chemotherapy-induced stomatitis

    Energy Technology Data Exchange (ETDEWEB)

    Carnel, S.B.; Blakeslee, D.B.; Oswald, S.G.; Barnes, M. (Fitzsimons Army Medical Center, Aurora, CO (USA))


    Severe stomatitis is a common problem encountered during either radiation therapy or chemotherapy. Most therapeutic regimens are empirical, with no scientific basis. The purpose of this study is to determine the efficacy of various topical solutions in the treatment of radiation- or chemotherapy-induced stomatitis. Eighteen patients were entered into a prospective double-blinded study to test several topical solutions: (1) viscous lidocaine with 1% cocaine; (2) dyclonine hydrochloride 1.0% (Dyclone); (3) kaolin-pectin solution, diphenhydramine plus saline (KBS); and (4) a placebo solution. Degree of pain relief, duration of relief, side effects, and palatability were evaluated. The results showed that Dyclone provided the most pain relief. Dyclone and viscous lidocaine with 1% cocaine provided the longest pain relief, which averaged 50 minutes This study provides objective data and defines useful guidelines for treatment of stomatitis.

  7. Chemotherapy in non-small cell lung cancer:opportunities for advancement

    Institute of Scientific and Technical Information of China (English)

    Mani Akhtari; Eric H Bernicker; Bin S Teh


    Locally advanced non-small cell lung cancer (NSCLC) continues to be a challenging disease to treat. With high rates of both local and distant failures, there is significant interest in finding more biologically active chemotherapy regimens that can contribute to reduce both failures. The phase III PROCLAIM trial, recently published in the Journal of Clinical Oncology entitled“PROCLAIM: randomized phase III trial of pemetrexed–cisplatin or etoposide–cisplatin plus thoracic radiation therapy followed by consolidation chemotherapy in locally advanced nonsquamous non-small-cell lung cancer”, compared two different chemotherapy regimens given concurrently with radiotherapy in patients with stage III non-squamous lung cancer: pemetrexed plus cisplatin versus cisplatin plus etoposide. Both groups received con-solidation chemotherapy. After enrolling 598 of planned 600 patients, the study was stopped early due to futility as no difference was seen in the primary end-point of overall survival. Since PROCLAIM was designed as a superiority trial, these results suggest that pemetrexed regimens do not offer a clinical advantage over standard cisplatin plus etopo-side. There are some subpopulations who might still benefit from pemetrexed, especially if clinicians are concerned about myelosuppression-related adverse events. Future trials are needed to investigate novel biologic agents and irradiation techniques that can result in more durable local and distant disease control in locally advanced NSCLC.

  8. Assessment of adherence to tuberculosis drug regimen

    Directory of Open Access Journals (Sweden)

    Khalili H.


    Full Text Available Background and the purpose of the study: Tuberculosis is curable if patients take sufficient uninterrupted therapy. Most experts acknowledge importance of patient adherence in efforts to control of the disease. This cross-sectional study was designed to evaluate the rate of compliance to anti-tuberculosis regimens by means of urine tests in newly diagnosed tuberculosis patients.Method: Investigation was carried out in Tehran University of Medical Sciences Teaching Hospitals, Tehran, IRAN. Fifty patients completed the study. The patients' urine samples were obtained at 0, 1, 2, 4 and 6 months of the study. Simple chemical methods were used to detect Isoniazid, Rifampin, and pyrazinamide, the three main drugs in tuberculosis treatment regimens. Urine tests at months of 0 and l of the study were considered as control tests.Results: After the first month, the patients' compliance was about 96%. At months of second, fourth and sixth, the whole adherence rates were 56 %, 76% and 81% respectively. Conclusion: About 30% of patients were non-compliant with treatment regimen which was more frequent than presumed; therefore detection of non-adherent patients is an essential subject in developing countries.

  9. Phase II trial of ifosfamide, fluorouracil, and folinic acid (FIFO regimen) in relapsed and refractory urothelial cancer. (United States)

    Kattan, J; Culine, S; Theodore, C; Droz, J P


    There is no known effective salvage chemotherapy for patients with refractory or relapsed urothelial tumors after methotrexate/cisplatin-based regimen. We report the results of a phase II trial with the FIFO regimen that includes from day 1 to 5: fluorouracil 350 mg/m2, folinic acid 20 mg/m2, and ifosfamide 1000 mg/m2, Q4W. Fifteen patients with metastatic measurable urothelial cancer were enrolled in this trial. Previous therapy included M-VAC regimen in 11 patients, CMV regimen in 3 patients, and both regimens in 1 patient. Thirty-one courses were delivered. Toxicity was moderate, including encephalopathy grade 2 in 2 patients and hematological toxicity grade 3 in 2 others. However, an early death occurred on day 1 in a patient who progressed rapidly and died from hepatic insufficiency after initial encephalopathy. No objective response was seen. Twelve patients progressed during FIFO therapy and 3 patients experienced a stable disease. Despite almost encouraging results of fluorouracil and ifosfamide in the literature, their combination according to our schedule is not active in urothelial cancer.

  10. Prebiotics: A Potential Treatment Strategy for the Chemotherapy-damaged Gut? (United States)

    Wang, Hanru; Geier, Mark S; Howarth, Gordon S


    Mucositis, characterized by ulcerative lesions along the alimentary tract, is a common consequence of many chemotherapy regimens. Chemotherapy negatively disrupts the intestinal microbiota, resulting in increased numbers of potentially pathogenic bacteria, such as Clostridia and Enterobacteriaceae, and decreased numbers of "beneficial" bacteria, such as Lactobacilli and Bifidobacteria. Agents capable of restoring homeostasis in the bowel microbiota could, therefore, be applicable to mucositis. Prebiotics are indigestible compounds, commonly oligosaccharides, that seek to reverse chemotherapy-induced intestinal dysbiosis through selective colonization of the intestinal microbiota by probiotic bacteria. In addition, evidence is emerging that certain prebiotics contribute to nutrient digestibility and absorption, modulate intestinal barrier function through effects on mucin expression, and also modify mucosal immune responses, possibly via inflammasome-mediated processes. This review examines the known mechanisms of prebiotic action, and explores their potential for reducing the severity of chemotherapy-induced mucositis in the intestine.

  11. Partial splenic embolization to permit continuation of systemic chemotherapy. (United States)

    Luz, Jose Hugo M; Luz, Paula M; Marchiori, Edson; Rodrigues, Leonardo A; Gouveia, Hugo R; Martin, Henrique S; Faria, Igor M; Souza, Roberto R; Gil, Roberto de Almeida; Palladino, Alexandre de M; Pimenta, Karina B; de Souza, Henrique S


    Systemic chemotherapy treatments, commonly those that comprise oxaliplatin, have been linked to the appearance of distinctive liver lesions that evolves to portal hypertension, spleen enlargement, platelets sequestration, and thrombocytopenia. This outcome can interrupt treatment or force dosage reduction, decreasing efficiency of cancer therapy. We conducted a prospective phase II study for the evaluation of partial splenic embolization in patients with thrombocytopenia that impeded systemic chemotherapy continuation. From August 2014 through July 2015, 33 patients underwent partial splenic embolization to increase platelets count and allow their return to treatment. Primary endpoint was the accomplishment of a thrombocyte level superior to 130 × 10(9) /L and the secondary endpoints were the return to chemotherapy and toxicity. Partial splenic embolization was done 36 times in 33 patients. All patients presented gastrointestinal cancer and colorectal malignancy was the commonest primary site. An average of 6.4 cycles of chemotherapy was done before splenic embolization and the most common regimen was Folfox. Mean platelet count prior to embolization was 69 × 10(9) /L. A total of 94% of patients achieved primary endpoint. All patients in need reinitiated treatment and median time to chemotherapy return was 14 days. No grade 3 or above adverse events were identified. Aiming for a 50% to 70% infarction area may be sufficient to achieve success without the complications associated with more extensive infarction. Combined with the better safety profile, partial splenic embolization is an excellent option in the management of thrombocytopenia, enabling the resumption of systemic chemotherapy with minimal procedure-related morbidity.

  12. Postoperative adjuvant radiotherapy and 5-fluorouracil chemotherapy for rectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chao, M.W.T.; Lim-Joon, M.; Wada, M. [Peter MacCallum Cancer Institute, Melbourne, VIC (Australia). Division of Radiation Oncology; Byram, D.; Vaughan, S.; McLennan, R.; Joseph, D. [Geelong Hospital, Geelong, VIC (Australia). Department of Radiation and Medical Oncology; Bell, R.; Bond, R. [St John of God Hospital, Ballarat, VIC (Australia). Department of Medical Oncology


    Postoperative combined modality therapy with radiotherapy and 5-fluorouracil (5FU) chemotherapy is an effective adjuvant approach that reduces locoregional and distant metastatic disease in patients with high-risk rectal carcinoma. However, this approach results in a treatment regimen of at least 6 months` duration. The present prospective study investigates the integration of radiotherapy and 5FU chemotherapy in a protocol designed to minimize toxicity and reduce the overall treatment time. A total of 40 patients with TNM stage 11 or 111 disease receives postoperative radiotherapy at four fractions per week with weekly 5FU bolus injections delivered on the fifth non radiotherapy day. Patients also received systemic chemotherapy with leucovorin both before and after pelvic irradiation, with the total treatment duration extending for only 18 weeks. Patients were able to complete radiotherapy in 90% of cases, while the delivery of full-dose chemotherapy was achievable in the vast majority. The incidence of haematologic and gastrointestinal toxicities requiring the cessation of treatment was acceptable. With a median follow-up of 20.9 months among surviving patients, the estimated progression-free and overall survival at 2 years were 71% and 79%, respectively. Copyright (1998) Blackwell Science Pty Ltd 15 refs., 7 tabs., 4 figs

  13. Chemotherapy or radio-chemotherapy for advanced adenocarcinoma of the oesophagus and cardiac orifice; Adenocarcinomes du bas oesophage et du cardia: quelle chimiotherapie ou chimioradiotherapie dans le traitement des recidives et des metastases

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, J.F.; Duffaud, F.; Dahan, L.; Ries, P.; Ville, E.; Laugier, R. [Centre Hospitalier Universitaire de la Timone, 13 - Marseille (France)


    Adenocarcinomas of esophagus and cardia represent in France approximately 20 to 40% of the esophagus cancers. They have a high risk to develop lymph nodes metastases and liver metastases. Currently, only 50 to 70% of patients may benefit from surgical curative resection at diagnosis, but more than 50% of them will recur. The standard of treatment of these metastatic adenocarcinomas is chemotherapy. Three large randomized comparative studies, between chemotherapy and supportive care, showed that chemotherapy significantly extends the median of survival (from 3-4 months to 10-12 months) and improves the quality of life. Currently, the combination of epirubicin-cisplatin-continuous 5FU (ECF) is the most effective regimen but it is difficult to administer and tolerate because of the long continuous 5FU infusion. In France, the most commonly used combination regimen still associates 5FU and cisplatin. New drugs (such as docetaxel, CPT11, oxaliplatin) used alone or in combination, especially with 5U, are very promising. Radio-chemotherapy is the preferred treatment for locoregional recurrences, because it improves dysphagia and enables to obtain complete tumor responses. Current results from concomitant radio-chemotherapy studies for esophagus cancer, based on 5FU alone, 5FU-cisplatin or 5FU-mitomycin, given as preoperative treatment or as exclusive treatment, support to use radio-chemotherapy for the treatment of loco-regional recurrences after surgical resection. Nevertheless, the optimal radio-chemotherapy schedule still remain to be defined (dose, duration, splitting of radiotherapy, choice of anticancer drugs). (authors)

  14. Improving adherence to medical regimens for juvenile rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Lindsley Carol B


    Full Text Available Abstract Poor adherence to medical regimens can compromise the efficacy of treatments for children and adolescents with juvenile rheumatoid arthritis (JRA. The purpose of this review is to describe medical regimens for the treatment of JRA and the rates of adherence to these regimens. We also summarize and critically the few research studies aimed at improving adherence to regimens for JRA. Finally, we summarize strategies for enhancing adherence in clinical practice.

  15. Postoperative adjuvant chemotherapy in rectal cancer operated for cure. (United States)

    Petersen, Sune Høirup; Harling, Henrik; Kirkeby, Lene Tschemerinsky; Wille-Jørgensen, Peer; Mocellin, Simone


    Colorectal cancer is one of the most common types of cancer in the Western world. Apart from surgery - which remains the mainstay of treatment for resectable primary tumours - postoperative (i.e., adjuvant) chemotherapy with 5-fluorouracil (5-FU) based regimens is now the standard treatment in Dukes' C (TNM stage III) colon tumours i.e. tumours with metastases in the regional lymph nodes but no distant metastases. In contrast, the evidence for recommendations of adjuvant therapy in rectal cancer is sparse. In Europe it is generally acknowledged that locally advanced rectal tumours receive preoperative (i.e., neoadjuvant) downstaging by radiotherapy (or chemoradiotion), whereas in the US postoperative chemoradiotion is considered the treatment of choice in all Dukes' C rectal cancers. Overall, no universal consensus exists on the adjuvant treatment of surgically resectable rectal carcinoma; moreover, no formal systematic review and meta-analysis has been so far performed on this subject. We undertook a systematic review of the scientific literature from 1975 until March 2011 in order to quantitatively summarize the available evidence regarding the impact of postoperative adjuvant chemotherapy on the survival of patients with surgically resectable rectal cancer. The outcomes of interest were overall survival (OS) and disease-free survival (DFS). CCCG standard search strategy in defined databases with the following supplementary search. 1. Rect* or colorect* - 2. Cancer or carcinom* or adenocarc* or neoplasm* or tumour - 3. Adjuv* - 4. Chemother* - 5. Postoper* Randomised controlled trials (RCT) comparing patients undergoing surgery for rectal cancer who received no adjuvant chemotherapy with those receiving any postoperative chemotherapy regimen. Two authors extracted data and a third author performed an independent search for verification. The main outcome measure was the hazard ratio (HR) between the risk of event between the treatment arm (adjuvant chemotherapy

  16. Anti-Müllerian hormone in breast cancer patients treated with chemotherapy: a retrospective evaluation of subsequent pregnancies. (United States)

    Hamy, Anne-Sophie; Porcher, Raphaël; Eskenazi, Sarah; Cuvier, Caroline; Giacchetti, Sylvie; Coussy, Florence; Hocini, Hamid; Tournant, Bertrand; Perret, Francine; Bonfils, Sylvie; Charvériat, Patrick; Lacorte, Jean-Marc; Espie, Marc


    Few studies have reported reproductive outcomes after breast cancer chemotherapy. The relationship between anti-Müllerian hormone (AMH) concentrations and the occurrence of subsequent pregnancies in women after chemotherapy for breast cancer was investigated. Women aged 18-43 years treated with chemotherapy for invasive breast cancer between May 2005 and January 2011 were retrospectively identified. Exclusion criteria were previous gonadotoxic treatment, oophorectomy or hysterectomy. Measurement of AMH took place before, during chemotherapy and at distant time points after the end of chemotherapy (4 months to 5.5 years). Seventeen out of 134 patients experienced 28 spontaneous pregnancies (median follow-up: 59 months). Neither baseline AMH (divided into quartiles) nor end-of-chemotherapy AMH (detectable versus undetectable) were significantly associated with the occurrence of pregnancy. Chemotherapy regimen with anthracyclines was associated with a greater probability of pregnancy compared with a taxane-containing regimen (hazard ratio 4.75; (95% CI 1.76 to 12.8); P = 0.002). Five-year disease-free survival and overall survival rates were 60% (95% CI: 51 to 70; relapse, n = 48) and 88% (95% CI 82 to 95; deaths, n = 21), respectively. AMH did not predict the occurrence of pregnancy. Additional studies assessing ovarian reserve and reproductive outcomes after breast cancer are required.

  17. Phase II studies of dianhydrogalactitol-based combination chemotherapy for recurrent brain tumors. (United States)

    Eagan, R T; Creagan, E T; Bisel, H F; Layton, D D; Groover, R V; Herman, R C


    The drug combinations of dianhydrogalactitol and VP-16 and dianhydrogalactitol, VP-16, and triazinate were used in patients with primary brain tumors, principally astrocytoma, recurrent following cranial irradiation. Tumor regressions were noted in 40% of patients treated with the 2-drug regimen and in 33% of patients treated with the 3-drug regimens. Regression were noted in all grades of tumor. Poor performance score on the patients' part did not seem to effect regression rates. Myelosuppression was the principal toxicity encountered. Dianhydrogalactitol-based combination chemotherapy seems as active as nitrosourea therapy and presents an alternative to nitrosourea therapy.

  18. Guidelines for the assessment of oral mucositis in adult chemotherapy, radiotherapy and haematopoietic stem cell transplant patients.

    NARCIS (Netherlands)

    Quinn, B.; Potting, C.M.J.; Stone, R.; Blijlevens, N.M.A.; Fliedner, M.; Margulies, A.; Sharp, L.


    Oral mucositis (OM) is a serious consequence of some chemotherapy and radiotherapy regimens. A number of reliable instruments are available to assess OM, but none are universally accepted. A unique collaboration of multi-disciplinary experts from Europe was formed to make recommendations on OM asses

  19. Intracavitary chemotherapy (Gliadel) for recurrent esthesioneuroblastoma: case report and review of the literature. (United States)

    Park, Michael C; Weaver, Charles E; Donahue, John E; Sampath, Prakash


    Esthesioneuroblastoma is an uncommon malignancy of the nasal vault with a treatment regimen consisting of surgical resection followed by radiotherapy for primary lesions and addition of chemotherapy for patients with advanced, recurrent or metastatic lesions. We report a case of a 39-year-old female with a history of esthesioneuroblastoma, previously treated with resection, radiation and chemotherapy, presenting with a recurrent disease that was successfully treated with re-resection and placement of Gliadel) wafers in the surgical resection cavity. The novel option of controlled-release and local delivery of a chemotherapeutic agent for treatment of recurrent esthesioneuroblastoma should be recognized and considered.

  20. Why chemotherapy can fail? (United States)

    Król, M; Pawłowski, K M; Majchrzak, K; Szyszko, K; Motyl, T


    There are many reasons that lead to failure of cancer chemotherapy. Cancer has the ability to become resistant to many different types of drugs. Increased efflux of drug, enhanced repair/increased tolerance to DNA damage, high antiapoptotic potential, decreased permeability and enzymatic deactivation allow cancer cell survive the chemotherapy. Treatment can lead to the death of most tumor cells (drug-sensitive), but some of them (drug-resistant) survive and grow again. These tumor cells may arise from stem cells. There are many studies describing human experiments with multidrug resistance, especially in breast cancer. Unfortunately, studies of canine or feline ABC super family members are not as extensive as in human or mice and they are limited to several papers describing PGP in mammary cancer, cutaneous mast cell tumors and lymphoma. Multidrug resistance is one of the most significant problems in oncology today. The involvement of many different, not fully recognized, mechanisms in multidrug resistance of cancer cells makes the development of effective methods of therapy very difficult. Understanding the mechanisms of drug resistance in cancer cells may improve the results of treatment. This review article provides a synopsis of all aspects that refer to cancer cell resistance to antitumor drugs.

  1. Nutritional intervention using nutrition care process in a malnourished patient with chemotherapy side effects. (United States)

    Lee, Hye-Ok; Lee, Jung-Joo


    In this case study, the process of nutritional diagnosis and intervention conducted at a hospital on a malnourished patient who underwent treatment for a chronic illness (chemotherapy for cancer treatment) was recorded. The patient received his first round of chemotherapy for colorectal cancer, and then a second round after the cancer metastasized to the liver. The patient was malnourished and had experienced weight loss (17% loss in the most recent 3 months) due to side effects of chemotherapy including stomatitis, nausea, and vomiting. Nutritional diagnosis and intervention via the nutrition care process were implemented through two screening rounds, and the quantity of oral intake increased from 28% to 62% of the recommended daily intake. The patient required continuous monitoring and outpatient care after hospital discharge. It is speculated that if a more active patient education and dietary regimen with respect to chemotherapy side effects had been offered after the patient's first chemotherapy cycle, it might have been possible to treat ingestion problems due to stomatitis during the second cycle of chemotherapy and prevent the weight loss. Henceforth, patients receiving chemotherapy should be educated about nutrition management methods and monitored continuously to prevent malnutrition.

  2. A case of advanced intrahepatic cholangiocarcinoma successfully treated with chemosensitivity test-guided systemic chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Kazumichi Abe; Takeru Wakatsuki; Fumiko Katsushima; Kyoko Monoe; Yukiko Kanno; Atsushi Takahashi; Junko Yokokawa; Hiromasa Ohira


    Intrahepatic cholangiocarcinoma (ICC) is a relatively rare and highly fatal neoplasm that arises from the biliary epithelium. Prognosis is generally poor and survival is limited to a few months. Here we present a case of advanced ICC successfully treated by chemosensitivity test-guided systemic chemotherapy combining S-1 and cisplatin (CDDP). A 65-year-old woman with a liver tumor was referred to our hospital on November 21, 2007. Abdominal ultrasonography and computed tomography (CT) showed low-density masses of 50 and 15 mm in diameter, respectively in segment Ⅷ of the liver and in the enlarged lymph node in the para-aorta. Ultrasonography-guided fine needle biopsy diagnosed the tumors as ICC. Since the patient was inoperable for lymph node metastasis, she underwent systemic chemotherapy with gemcitabine. Six months after initiation of chemotherapy, CT revealed ICC progression in the liver and pleural dissemination with pleural effusion. The patient was admitted to our hospital for anticancer drug sensitivity testing on June 9, 2008. Based on the sensitivity test results, we elected to administer systemic chemotherapy combining S-1 and CDDP. Two months into the second chemotherapy treatment, CT revealed a reduction of the tumors in the liver and lymph node and a decrease in pleural effusion.After eight cycles of the second chemotherapy, 17 mo after ICC diagnosis, she is alive and well with no sign of recurrence. We conclude that chemosensitivity testing may effectively determine the appropriate chemotherapy regimen for advanced ICC.

  3. Chemotherapy for Late-Stage Cancer Patients: Meta-Analysis of Complete Response Rates [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Martin L. Ashdown


    Full Text Available Complete response (CR rates reported for cytotoxic chemotherapy for late-stage cancer patients are generally low, with few exceptions, regardless of the solid cancer type or drug regimen. We investigated CR rates reported in the literature for clinical trials using chemotherapy alone, across a wide range of tumour types and chemotherapeutic regimens, to determine an overall CR rate for late-stage cancers. A total of 141 reports were located using the PubMed database. A meta-analysis was performed of reported CR from 68 chemotherapy trials (total 2732 patients using standard agents across late-stage solid cancers—a binomial model with random effects was adopted. Mean CR rates were compared for different cancer types, and for chemotherapeutic agents with different mechanisms of action, using a logistic regression. Our results showed that the CR rates for chemotherapy treatment of late-stage cancer were generally low at 7.4%, regardless of the cancer type or drug regimen used. We found no evidence that CR rates differed between different chemotherapy drug types, but amongst different cancer types small CR differences were evident, although none exceeded a mean CR rate of 11%. This remarkable concordance of CR rates regardless of cancer or therapy type remains currently unexplained, and motivates further investigation.

  4. Analysis of combination drug therapy to develop regimens with shortened duration of treatment for tuberculosis. (United States)

    Drusano, George L; Neely, Michael; Van Guilder, Michael; Schumitzky, Alan; Brown, David; Fikes, Steven; Peloquin, Charles; Louie, Arnold


    Tuberculosis remains a worldwide problem, particularly with the advent of multi-drug resistance. Shortening therapy duration for Mycobacterium tuberculosis is a major goal, requiring generation of optimal kill rate and resistance-suppression. Combination therapy is required to attain the goal of shorter therapy. Our objective was to identify a method for identifying optimal combination chemotherapy. We developed a mathematical model for attaining this end. This is accomplished by identifying drug effect interaction (synergy, additivity, antagonism) for susceptible organisms and subpopulations resistant to each drug in the combination. We studied the combination of linezolid plus rifampin in our hollow fiber infection model. We generated a fully parametric drug effect interaction mathematical model. The results were subjected to Monte Carlo simulation to extend the findings to a population of patients by accounting for between-patient variability in drug pharmacokinetics. All monotherapy allowed emergence of resistance over the first two weeks of the experiment. In combination, the interaction was additive for each population (susceptible and resistant). For a 600 mg/600 mg daily regimen of linezolid plus rifampin, we demonstrated that >50% of simulated subjects had eradicated the susceptible population by day 27 with the remaining organisms resistant to one or the other drug. Only 4% of patients had complete organism eradication by experiment end. These data strongly suggest that in order to achieve the goal of shortening therapy, the original regimen may need to be changed at one month to a regimen of two completely new agents with resistance mechanisms independent of the initial regimen. This hypothesis which arose from the analysis is immediately testable in a clinical trial.


    Directory of Open Access Journals (Sweden)

    Yu. S. Sidorenko


    Full Text Available Thirty two with the ascitic form of Stages IIIC—IV ovarian cancer underwent 1 to 3 courses of intraperitoneal multidrug therapy using a protein ascitic fluid concentrate (PAFC as a solvent of drugs (cisplatin, cyclophosphan, doxorubicin according to the CAP regimen. The induction chemotherapy allowed remission to be achieved in 78.1% of cases (against 40% with standard intraperitoneal therapy, the stan- dard volume of surgical treatment was performed in 28 (87.5% patients (21 (70% receiving the control regime; with the use of PAFC, the size of minimum residual tumour (less than 1 cm was achieved in 81.3% versus 63.3% with standard intraperitoneal chemotherapy. This treatment enables the use large-dose chemotherapy regimens that cause no severe systemic toxic reactions. The method is highly-effective, low-toxic and may be recommended for the treatment of patients with the ascitic form of Stages III—IV ovarian cancer.

  6. The potential usage of caffeic acid phenethyl ester (CAPE) against chemotherapy-induced and radiotherapy-induced toxicity. (United States)

    Akyol, Sumeyya; Ginis, Zeynep; Armutcu, Ferah; Ozturk, Gulfer; Yigitoglu, M Ramazan; Akyol, Omer


    Protection of the patients against the side effects of chemotherapy and radiotherapy regimens has attracted increasing interest of clinicians and practitioners. Caffeic acid phenethyl ester (CAPE), which is extracted from the propolis of honeybee hives as an active component, specifically inhibits nuclear factor κB at micromolar concentrations and show ability to stop 5-lipoxygenase-catalysed oxygenation of linoleic acid and arachidonic acid. CAPE has antiinflammatory, antiproliferative, antioxidant, cytostatic, antiviral, antibacterial, antifungal and antineoplastic properties. The purpose of this review is to summarize in vivo and in vitro usage of CAPE to prevent the chemotherapy-induced and radiotherapy-induced damages and side effects in experimental animals and to develop a new approach for the potential usage of CAPE in clinical trial as a protective agent during chemotherapy and radiotherapy regimens.

  7. Sclerosing Epithelioid Fibrosarcoma of the Bone: A Case Report of High Resistance to Chemotherapy and a Survey of the Literature

    Directory of Open Access Journals (Sweden)

    Thomas G. P. Grunewald


    Full Text Available Sclerosing epithelioid fibrosarcoma (SEF is a rare soft tissue sarcoma mostly occurring in extraosseous sites. SEF represents a clinically challenging entity especially because no standardized treatment regimens are available. Intraosseous localization is an additional challenge with respect to the therapeutical approach. We report on a 16-year-old patient with SEF of the right proximal tibia. The patient underwent standardized neoadjuvant chemotherapy analogous to the EURAMOS-1 protocol for the treatment of osteosarcoma followed by tumor resection and endoprosthetic reconstruction. Histopathological analysis of the resected tumor showed >90% vital tumor cells suggesting no response to chemotherapy. Therefore, therapy was reassigned to the CWS 2002 High-Risk protocol for the treatment of soft tissue sarcoma. To date (22 months after diagnosis, there is no evidence of relapse or metastasis. Our data suggest that SEF may be resistant to a chemotherapy regimen containing Cisplatin, Doxorubicin, and Methotrexate, which should be considered in planning treatment for patients with SEF.

  8. Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy. (United States)

    Moore, Halle C F; Unger, Joseph M; Phillips, Kelly-Anne; Boyle, Frances; Hitre, Erika; Porter, David; Francis, Prudence A; Goldstein, Lori J; Gomez, Henry L; Vallejos, Carlos S; Partridge, Ann H; Dakhil, Shaker R; Garcia, Agustin A; Gralow, Julie; Lombard, Janine M; Forbes, John F; Martino, Silvana; Barlow, William E; Fabian, Carol J; Minasian, Lori; Meyskens, Frank L; Gelber, Richard D; Hortobagyi, Gabriel N; Albain, Kathy S


    Ovarian failure is a common toxic effect of chemotherapy. Studies of the use of gonadotropin-releasing hormone (GnRH) agonists to protect ovarian function have shown mixed results and lack data on pregnancy outcomes. We randomly assigned 257 premenopausal women with operable hormone-receptor-negative breast cancer to receive standard chemotherapy with the GnRH agonist goserelin (goserelin group) or standard chemotherapy without goserelin (chemotherapy-alone group). The primary study end point was the rate of ovarian failure at 2 years, with ovarian failure defined as the absence of menses in the preceding 6 months and levels of follicle-stimulating hormone (FSH) in the postmenopausal range. Rates were compared with the use of conditional logistic regression. Secondary end points included pregnancy outcomes and disease-free and overall survival. At baseline, 218 patients were eligible and could be evaluated. Among 135 with complete primary end-point data, the ovarian failure rate was 8% in the goserelin group and 22% in the chemotherapy-alone group (odds ratio, 0.30; 95% confidence interval [CI], 0.09 to 0.97; two-sided P=0.04). Owing to missing primary end-point data, sensitivity analyses were performed, and the results were consistent with the main findings. Missing data did not differ according to treatment group or according to the stratification factors of age and planned chemotherapy regimen. Among the 218 patients who could be evaluated, pregnancy occurred in more women in the goserelin group than in the chemotherapy-alone group (21% vs. 11%, P=0.03); women in the goserelin group also had improved disease-free survival (P=0.04) and overall survival (P=0.05). Although missing data weaken interpretation of the findings, administration of goserelin with chemotherapy appeared to protect against ovarian failure, reducing the risk of early menopause and improving prospects for fertility. (Funded by the National Cancer Institute and others; POEMS/S0230 Clinical

  9. Role of ABC transporters in fluoropyrimidine-based chemotherapy response. (United States)

    Nies, Anne T; Magdy, Tarek; Schwab, Matthias; Zanger, Ulrich M


    Since over 50 years, 5-fluorouracil (5-FU) is in use as backbone of chemotherapy treatment regimens for a wide range of cancers including colon, breast, and head and neck carcinomas. However, drug resistance and severe toxicities such as mucositis, diarrhea, neutropenia, and vomiting in up to 40% of treated patients often lead to dose limitation or treatment discontinuation. Because the oral bioavailability of 5-FU is unpredictable and highly variable, 5-FU is commonly administered intravenously. To overcome medical complications and inconvenience associated with intravenous administration, the oral prodrugs capecitabine and tegafur have been developed. Both fluoropyrimidines are metabolically converted intracellularly to 5-FU, which then needs metabolic activation to exert its damaging activity on RNA and DNA. The low response rates of 10-15% of 5-FU monotherapy can be improved by combination regimens of infusional 5-FU and leucovorin together with oxaliplatin (FOLFOX) or irinotecan (FOLFIRI), thereby increasing response rates to 30-40%. The impact of metabolizing enzymes in the development of fluoropyrimidine toxicity and resistance has been studied in great detail. In addition, membrane drug transporters, which are critical determinants of intracellular drug concentrations, may play a role in occurrence of toxicity and development of resistance against fluoropyrimidine-based therapy as well. This review therefore summarizes current knowledge on the role of drug transporters with particular focus on ATP-binding cassette transporters in fluoropyrimidine-based chemotherapy response.

  10. Palliative chemotherapy: oxymoron or misunderstanding? (United States)

    Roeland, E J; LeBlanc, T W


    Oncologists routinely prescribe chemotherapy for patients with advanced cancer. This practice is sometimes misunderstood by palliative care clinicians, yet data clearly show that chemotherapy can be a powerful palliative intervention when applied appropriately. Clarity regarding the term "palliative chemotherapy" is needed: it is chemotherapy given in the non-curative setting to optimize symptom control, improve quality of life, and sometimes to improve survival. Unfortunately, oncologists lack adequate tools to predict which patients will benefit. In a study recently published in BMC Palliative Care, Creutzfeldt et al. presented an innovative approach to advancing the science in this area: using patient reported outcomes to predict responses to palliative chemotherapy. With further research, investigators may be able to develop predictive models for use at the bedside to inform clinical decision-making about the risks and benefits of treatment. In the meantime, oncologists and palliative care clinicians must work together to reduce the use of "end-of-life chemotherapy"-chemotherapy given close to death, which does not improve longevity or symptom control-while optimizing the use of chemotherapy that has true palliative benefits for patients.

  11. Chemotherapy for children with medulloblastoma

    NARCIS (Netherlands)

    Michiels, E.M.; Schouten-van Meeteren, A.Y.; Doz, F.; Janssens, G.O.R.J.; Dalen, E.C. van


    BACKGROUND: Post-surgical radiotherapy (RT) in combination with chemotherapy is considered as standard of care for medulloblastoma in children. Chemotherapy has been introduced to improve survival and to reduce RT-induced adverse effects. Reduction of RT-induced adverse effects was achieved by delet

  12. A history of cancer chemotherapy. (United States)

    DeVita, Vincent T; Chu, Edward


    The use of chemotherapy to treat cancer began at the start of the 20th century with attempts to narrow the universe of chemicals that might affect the disease by developing methods to screen chemicals using transplantable tumors in rodents. It was, however, four World War II-related programs, and the effects of drugs that evolved from them, that provided the impetus to establish in 1955 the national drug development effort known as the Cancer Chemotherapy National Service Center. The ability of combination chemotherapy to cure acute childhood leukemia and advanced Hodgkin's disease in the 1960s and early 1970s overcame the prevailing pessimism about the ability of drugs to cure advanced cancers, facilitated the study of adjuvant chemotherapy, and helped foster the national cancer program. Today, chemotherapy has changed as important molecular abnormalities are being used to screen for potential new drugs as well as for targeted treatments.

  13. Interstitial pneumonitis following intrapleural chemotherapy

    Directory of Open Access Journals (Sweden)

    Humphries Gary N


    Full Text Available Abstract Background Mucinous neoplasms within the abdomen may disseminate by direct extension through the diaphragm to involve the pleural space. Treatment of this condition is by parietal and visceral pleurectomy followed by hyperthermic intrapleural chemotherapy. Case presentation In this case report a patient developed persistent right upper lobe interstitial pneumonitis and progressive parenchymal fibrosis following intrapleural chemotherapy treatment with mitomycin C and doxrubicin. The condition persisted until death 28 months later. Death was from progressive intraabdominal disease with intestinal obstruction and sepsis associated with progressive pulmonary parenchymal disease. The right pleural space disease did not recur. Conclusion This manuscript is the first case report describing interstitial pneumonitis and lung fibrosis following intrapleural chemotherapy. Since pulmonary toxicity from chemotherapy is a dose-dependent phenomenon, dose reduction of intrapleural as compared to intraperitoneal hyperthermic chemotherapy may be necessary.

  14. Chemotherapy with cyclophosphamide, vincristine, cytosine arabinoside, and prednisone (COAP) in childhood acute lymphoblastic leukemia (ALL). (United States)

    Sallan, S E; Camitta, B M; Chan, D M; Traggis, D; Jaffe, N


    Three groups of children with acute lymphoblastic leukemia (ALL) were treated with intermittent cyclophosphamide, vincristine, cytosine arabinoside, and prednisone (COAP). Group A (no prior relapse) and Group B (prior single-agent relapse) received COAP after 12 months on another chemotherapy regimen. Children in Group C (prior relapse on multiagent regimens) received COAP following A-COAP (asparaginase plus COAP) reinduction. Median disease-free survival after beginning COAP was not reached for Group A, but was only 7 months for Groups B and C. As of November 1976, there were 8 of 15 Group A patients, 1 of 12 Group B patients, and 1 of 28 Group C patients who had remained disease-free from 38 to 60 (median 54.5) months and were off chemotherapy. COAP has activity in childhood ALL. However, effectiveness is markedly diminished in patients with prior bone marrow relapse.

  15. The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.

    Directory of Open Access Journals (Sweden)

    Wenbin Zhou

    Full Text Available BACKGROUND: Chemotherapy-induced amenorrhea (CIA is common in young breast cancer patients. The incidence of CIA associated with regimens involving epirubicin and taxane was not well known. Furthermore, previous studies suggested leucopenia and amenorrhea may reflect inter-individual variations in pharmacokinetics. The purpose of this study was to investigate the association between leucopenia after first cycle of chemotherapy and CIA in young breast cancer patients receiving epirubicin and taxane based chemotherapy. Furthermore, the incidence of CIA was also assessed. METHODOLOGY AND PRINCIPAL FINDINGS: Between October 2008 and March 2010, 186 consecutive premenopausal patients, treated with epirubicin and taxane based chemotherapy, were recruited. Information about CIA was collected by telephone and out-patient clinic. Of these 186 patients, data from 165 patients were included and analyzed. Of all 165 patients, CIA occurred in 72 patients (43.64%. In multivariate analysis, age older than 40 y (OR: 16.10, 95% CI: 6.34-40.88, P0.05. The rate of CIA in leucopenia group (52.56% was significantly higher than that in normal leukocyte group (34.62% (P = 0.024. In patients treated with a FEC regimen (cyclophosphamide, epirubicin and 5-fluorouracil, the rate of CIA in leucopenia group (59.57% was significantly higher than that in normal leukocyte group (36.84% (P = 0.037. CONCLUSIONS: Age at diagnosis and previous childbearing were both found to significantly increase the risk of CIA, whereas additional taxane was not associated with increased rate of CIA. Importantly, leucopenia after first cycle of chemotherapy was associated with increased risk of CIA, which suggested that leucopenia may be an early predictor of chemotherapy-induced infertility.

  16. Therapeutic effect analysis of different neoadjuvant chemotherapy on the locally cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Li


    Objective:To explore the therapeutic effect of different neoadjuvant chemotherapy on the locally cervical cancer.Methods:A total of 85 patients with cervical cancer for the initial treatment who were admitted in our hospital from January, 2011 to January, 2013 were included in the study and divided into the observation group and the control group according to different chemotherapy regimens. The way of drug administration is by transcatheter arterial chemoembolization (TACE). The patients in the observation group were given Taxol in combined with carboplatin for neoadjuvant chemotherapy, while the patients in the control group were given irinotecan in combined with carboplatin. The remission degree of clinical symptoms, chemotherapeutic effect, toxic and side effect, and operation evaluation 14 and 20 days after chemotherapy were evaluated.Results:The comparison of clinical symptom remission between the two groups was not statistically significant. The occurrence rate of myelosuppression in III-IV degree in the observation was significantly higher than that in the control group, but the occurrence rate of diarrhea was significantly lower than that in the control group. The comparisons of operation time and intraoperative amount of bleeding after chemotherapy between the two groups were not statistically significant. The comparisons of the occurrence rates of parametrial infiltration and lymphatic metastasis and the muscular layer invasion depth were not statistically significant.Conclusions:Arterial embolism neoadjuvant chemotherapy can obviously shorten the tumor volume in patients with local cervical cancer, relieve the clinical symptoms, and enhance the living qualities, but in the clinical application, appropriate chemotherapy regimen should be chosen according to the specific condition.

  17. Influence of Chemotherapy on the Lipid Peroxidation and Antioxidant Status in Patients with Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Zohreh Sanaat


    Full Text Available Chemotherapeutic agents used in patients with cancer cause to generate the enormous amounts of free radicals associated with cell injury. In this study we assess the effects of chemotherapy regimen on oxidant/antioxidant status in patients with acute myeloid leukemia (AML. 38 newly diagnosed patients with acute myeloid leukemia were recruited in this study. All patients received cytarabine and daunorubicin as chemotherapy regimen. Plasma levels of malondialdehyde (MDA, total antioxidant status (TAS, and the levels of erythrocyte activity of superoxide dismutase (SOD and glutathione peroxidase (GPx were determined before chemotherapy and 14 days after chemotherapy with cytarabine and daunorubicin. Plasma MDA concentrations increased significantly (from 2.68±0.89 nmol/L to 3.14±1.29 nmol/L during the 14days post-chemotherapy period (P=0.04. Plasma TAS concentrations changed with chemotherapy from 1.09±0.15 mmol/L to 1.02±0.14 mmol/L with P=0.005. Erythrocyte SOD and GPX activity decreased overtime from 1157.24±543.61 U/g Hb to 984.01±419.09 U/g Hb (P=0.04 and 46.96±13.70 U/g Hb to 41.40±6.44 U/g Hb (P=0.02 respectively. We report here that there is an increase in malondialdehyde levels and a decrease in the levels of antioxidant enzymes and total antioxidant status. This suggests that chemotherapy causes these changes as a result of enormous production of reactive oxygen species in the patients with AML. Antioxidant supplementation must be approached with caution because of the probability of reduction the therapeutic efficacy of these cytotoxic drugs.

  18. Clinical Study on Prospective Efficacy of All-Trans Acid, Realgar-Indigo Naturalis Formula Combined with Chemotherapy as Maintenance Treatment of Acute Promyelocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Li Xiang-Xin


    Full Text Available Objectives. To test the efficiency and safety of sequential application of retinoic acid (ATRA, Realgar-Indigo naturalis formula (RIF and chemotherapy (CT were used as the maintenance treatment in patients with acute promyelocytic leukemia (APL. Methods. This was a retrospective study of 98 patients with newly diagnosed APL who accepted two different maintenance treatments. After remission induction and consolidation chemotherapy according to their Sanz scores, patients received two different kinds of maintenance scheme. The first regimen was using ATRA, RIF, and standard dose of CT sequentially (ATRA/RIF/CT regimen, while the second one was using ATRA and low dose of chemotherapy with methotrexate (MTX plus 6-mercaptopurine (6-MP alternately (ATRA/CTlow regimen. The OS, DFS, relapse rate, minimal residual disease, and adverse reactions in two groups were monitored and evaluated. Results. ATRA/RIF/CT regimen could effectively reduce the chance of relapse in different risk stratification of patients, but there was no significant difference in 5-year DFS rate and OS rate between the two groups. Besides, the patients in the experimental group suffered less severe adverse reactions than those in the control group. Conclusions. The repeated sequential therapeutic regimen to APL with ATRA, RIF, and chemotherapy is worth popularizing for its high effectiveness and low toxicity.

  19. The effect of chewing gum on oral mucositis in children receiving chemotherapy


    Ocakcı, Ayşe Ferda; Ayverdi, Didem; Ekim, Ayfer


    Abstract Background: Oral mucositis is an important clinical problem, resulting in significant patient morbidity, a change in health-related quality of life, and supportive care. The purpose of this study was to assess the efficiency of chewing gum on children, who are receiving chemotherapy regimens, for prevention and treatment of oral mucositis. Method and Material: The study sample consisted of 60 children (30 study group-30 control group) between the ages 6-...

  20. Fucoidan reduces the toxicities of chemotherapy for patients with unresectable advanced or recurrent colorectal cancer


    Ikeguchi, Masahide; Yamamoto, Manabu; Arai, Yosuke; Maeta, Yoshihiko; Ashida, Keigo; Katano, Kuniyuki; Miki, Yasunari; Kimura, Takayuki


    Combination chemotherapy with oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX) or irinotecan plus 5-fluorouracil/leucovorin (FOLFIRI) has become a standard regimen for advanced or recurrent colorectal cancer. Numerous studies have reported that long-term use of FOLFOX or FOLFIRI leads to better survival for these patients. Thus, control of the toxicity of these drugs may be crucial to prolonging survival. Fucoidan is one of the major sulfated polysaccharides of brown seaweeds and exhibits ...

  1. Advances in the adjuvant chemotherapy of glioblastoma multiforme: opportunities and challenges for the neurosurgeons in China

    Institute of Scientific and Technical Information of China (English)

    LI Shou-wei; JIANG Tao


    @@ Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in adults, which accounts for approximately 50% of all gliomas. Its prognosis is particularly disappointing with a median life expectancy less than a year even when the patients are treated with the most aggressive regimens.1 Over the past 10 years, a number of trials have tried to establish whether adjuvant chemotherapy, as well as molecularly targeted therapy, provides GBM patients with clinically meaningful benefits.

  2. [The first report from Sapporo Tsukisamu Hospital--chemotherapy and chemoradiotherapy for patients with advanced pancreatic cancer]. (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Koito, Kazumitsu; Shirasaka, Tetsuhiko


    The remedy, especially chemotherapy, for advanced pancreatic cancer is hardly ever successful in terms of efficacy rate and survival period, because it is virtually unable to contribute to the improvement of median survival time (MST). Thus,we devised a new intermittent dosage regimen utilizing the cell cycle difference of normal GI tract, bone marrow cell and pancreatic cancer cell, making use of 5-FU (-->S-1), CDDP and paclitaxel in March 2002. Ten patients with advanced pancreatic cancer (4 in Stage IVa and 6 in Stage IVb) were treated with this new regimen. As a result, an efficacy ratio of 50.0% and a 1-year survival ratio of 60.0% were achieved. However, 2-year survival ratio of 12.0% was low, and there was no 3-year survivor. The MST was 19 months as of December 31, 2006. All of the non-hematological toxicities were under grade 2. Eight patients had hematological toxicities over grade 3 and most of them were anemia and neutropenia. Only 2 cases had thrombocytopenia. Although adverse effects related to this regimen were clinically manageable, it was difficult to improve MST of patients with advanced pancreatic cancer with chemotherapy alone including this regimen. Hence, we devised another regimen with the joint use of radiotherapy along with the same chemotherapy regimen in January 2003. Twenty patients with advanced pancreatic cancer (Stage IV) were treated with this regimen. It is presently under way, and an efficacy ratio of 35.0%, 1-year survival ratio of 86.3% and 2-year survival ratio of 64.0% were obtained by May 2005, showing that this may contribute to the extension of survival time of Stage IV pancreatic cancer patients.

  3. Mesenteric panniculitis: Various presentations and treatment regimens

    Institute of Scientific and Technical Information of China (English)

    Iyad Issa; Hassan Baydoun


    Mesenteric panniculitis is a rare, benign and chronic fibrosing inflammatory disease that affects the adipose tissue of the mesentery of the small intestine and colon. The specific etiology of the disease is unknown. The diagnosis is suggested by computed tomography and is usually confirmed by surgical biopsies. Treatment is empirical and based on a few selected drugs. Surgical resection is sometimes attempted for definitive therapy, although the surgical approach is often limited. We report two cases of mesenteric panniculitis with two different presentations and subsequently varying treatment regimens. Adequate response was obtained in both patients. We present details of these cases as well as a literature review to compare various presentations, etiologies and potential treatment modalities.

  4. Prolonged survival in advanced thymoma: Effectiveness of sequential multiple lines of chemotherapy in an inoperable case (United States)



    A standard therapeutic approach for advanced malignant thymoma has yet to be defined given the rarity of this condition. We present a patient with advanced thymoma, evaluated as inoperable at diagnosis due to multiple serosal metastases. The strong constitution and determination of the patient allowed treatment with six distinct and subsequent chemotherapy regimens, all administered on an outpatient basis. A survival of 64 months from diagnosis was achieved. A favorable clinical response was obtained after the first three treatment lines, with the disappearance of all lesions on both computed tomography and positron emission tomography (PET) images. However, this result was not confirmed by surgical exploration of the thorax, undertaken with the aim of radical excision of possible residual disease. The presence of multiple pleural nodules, not evident on the imaging techniques, prevented even limited tumor debulking. The chemotherapy lines administered following detection of the lessions, stabilized the disease for a further 2 years, while a satisfactory quality of life was maintained. Only in the last months did the tumor progress and signs of cardiotoxicity appear, with the latter constituting the eventual cause of death. This case is important since the medical literature does not indicate non-cross-resistant regimens for advanced thymoma following second-line chemotherapy, and the sequence of regimens presented in this case study may serve as a feasible outline program. Moreover, we highlight the known possibility of false-negative PET studies, which can occur despite the claimed glucose avidity of thymoma tissue. PMID:22866110

  5. Assessment of serum tumor markers, tumor cell apoptosis and immune response in patients with advanced colon cancer after DC-CIK combined with intravenous chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Lei-Fan Li; Xiu-Yun Wang; Hui-Qiong Xu; Xia Liu


    Objective:To study the effect of DC-CIK combined with intravenous chemotherapy on serum tumor markers, tumor cell apoptosis and immune response in patients with advanced colon cancer.Methods:A total of 79 patients with advanced colon cancer conservatively treated in our hospital between May 2012 and October 2015 were retrospectively studied and divided into DC-CIK group and intravenous chemotherapy group according to different therapeutic regimens, DC-CIK group received DC-CIK combined with intravenous chemotherapy and intravenous chemotherapy group received conventional intravenous chemotherapy. After three cycles of chemotherapy, the content of tumor markers in serum, expression levels of apoptotic molecules in tumor lesions as well as immune function indexes were determined.Results:After 3 cycles of chemotherapy, CEA, CA199, CA242, HIF-1α, IL-4, IL-5 and IL-10 content in serum of DC-CIK group were significantly lower than those of intravenous chemotherapy group;p53, FAM96B, PTEN, PHLPP, ASPP2and RASSF10 mRNA content in tumor lesions of DC-CIK group were significantly higher than those of intravenous chemotherapy group; the fluorescence intensity of CD3, CD4 and CD56 on peripheral blood mononuclear cell surface of DC-CIK group were significantly higher than those of intravenous chemotherapy group while the fluorescence intensity of CD8 and CD25 were significantly lower than those of intravenous chemotherapy group; IL-2 and IFN-γ content in serum of DC-CIK group were significantly higher than those of intravenous chemotherapy group while IL-4, IL-5 and IL-10 content were significantly lower than those of intravenous chemotherapy group.Conclusions: DC-CIK combined with intravenous chemotherapy has better effect on killing colon cancer cells and inducing colon cancer cell apoptosis than conventional intravenous chemotherapy, and can also improve the body's anti-tumor immune response.

  6. Systematic Review and Meta-Analysis on the Role of Chemotherapy in Advanced and Metastatic Neuroendocrine Tumor (NET.

    Directory of Open Access Journals (Sweden)

    Matthew H Wong

    Full Text Available In the era of somatostatin analogues and targeted therapies, the role of chemotherapy in NET remains largely undefined. This systematic review aimed to assess the effect of chemotherapy on response rates (RR, progression-free survival (PFS, overall survival (OS and toxicity compared to other chemotherapies/systemic therapies or best supportive care in patients with advanced or metastatic NET.Randomised controlled trials (RCTs from 1946 to 2015 were identified from MEDLINE, EMBASE, other databases and conference proceedings. Review of abstracts, quality assessment and data abstraction were performed independently by two investigators. Meta-analyses were conducted using Mantel-Haenszel analysis with random-effects modelling.Six RCTs comparing standard streptozotocin plus 5-fluorouacil (STZ/5FU chemotherapy to other chemotherapy regimens, and 2 comparing this to interferon (IFN were included. Only 1 study was considered at low risk of bias. STZ/5-FU was no different to other chemotherapies in response rate [RR 0.96; 95% confidence interval (CI 0.72-1.27], PFS (RR 0.95; CI 0.81-1.13, or OS (RR 1.03; CI 0.77-1.39. IFN may produce higher response than STZ/5FU (RR 0.20; CI 0.04-1.13, but event rates were small and survival was no different. Interferon was associated with higher overall haematological (RR 0.47; CI 0.27-0.82 and lower overall renal toxicity (RR 3.61; CI 1.24-10.51.Strong evidence is lacking in the area of chemotherapy in neuroendocrine tumors. There is currently no evidence that one chemotherapeutic regimen is significantly better than the other, nor is interferon better than chemotherapy. There is an urgent need to design RCTs comparing modern chemotherapy to other agents in NET.

  7. Glutamine facilitates chemotherapy while reducing toxicity. (United States)

    Klimberg, V S; Nwokedi, E; Hutchins, L F; Pappas, A A; Lang, N P; Broadwater, J R; Read, R C; Westbrook, K C


    Dose intensification of chemotherapy is thought to increase survival. With recent advances in hemopoietic cell modulators such as granulocyte colony stimulating factor, the limiting toxicity of intensifying chemotherapeutic regimens has become the severity of the associated enterocolitis. In animal models, glutamine protects the host from methotrexate-induced enterocolitis. This study evaluates the effects of a glutamine-supplemented diet on the tumoricidal effectiveness of methotrexate. Sarcoma-bearing Fisher 344 rats (n = 30) were pair-fed an isocaloric elemental diet containing 1% glutamine or an isonitrogenous amount of glycine beginning on day 25 of the study. Rats from each group received two intraperitoneal injections of methotrexate (5 mg/kg) or saline on days 26 and 33 of the study. On day 40, rats were killed, tumor volume and weight were recorded, and tumor glutaminase activity and tumor morphometrics were measured. Blood was taken for arterial glutamine content, complete blood count, and blood culture. The gut was processed for glutaminase activity and synthesis phase of the deoxyribonucleic acid. In rats receiving methotrexate, the tumor volume loss was nearly doubled when glutamine was added to the diet. Significant differences in tumor glutaminase activity and morphometrics were not detected. The toxicity to the host was ameliorated. Significantly increased synthesis phase of deoxyribonucleic acid of the whole jejunum, decreased bacteremia, "sepsis," and mortality were demonstrated. Glutamine supplementation enhances the tumoricidal effectiveness of methotrexate while reducing its morbidity and mortality in this sarcoma rat model.

  8. Addition of bevacizumab to first-line chemotherapy in advanced colorectal cancer: a systematic review and meta-analysis, with emphasis on chemotherapy subgroups

    Directory of Open Access Journals (Sweden)

    Macedo Ligia


    Full Text Available Abstract Background Bevacizumab has an important role in first-line treatment of metastatic colorectal cancer. However, clinical trials studying its effect have involved distinct chemotherapy regimens with divergent results. The aim of this meta-analysis is to gather current data and evaluate not only the efficacy of bevacizumab, but also the impact of divergent backbone regimens. Methods A wide search of randomized clinical trials using bevacizumab in first-line metastatic colorectal cancer was performed in Embase, MEDLINE, LILACS and Cochrane databases. Meeting presentations and abstracts were also investigated. The resulting data were examined and included in the meta-analysis according to the type of regimen. Results Six trials, totaling 3060 patients, were analyzed. There was an advantage to using bevacizumab for overall survival (OS and progression-free survival (PFS (HR = 0.84; CI: 0.77-0.91; P Conclusions Bevacizumab has efficacy in first-line treatment of advanced colorectal cancer, but the current data are insufficient to support efficacy in all regimens, especially infusional fluorouracil regimens, like FOLFIRI and FOLFOX.

  9. Simultaneous radiochemotherapy in cervical cancer: recommendations for chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dunst, J.; Haensgen, G. [Halle Univ., Wittenberg (Germany). Dept. of Radiotherapy


    Background: Simultaneous radiochemotherapy has recently been demonstrated to be superior to radiation alone in the treatment of cervical cancer. The objective of this article is to summarize the data of major randomized trials and to derive recommendations for daily clinical practice. Materials and Methods: We have analyzed the data from seven randomized trials in the recent literature in which radiotherapy alone as standard treatment has been compared to simultaneous radiochemotherapy. Four trials used cisplatin-based chemotherapy regimens, 5-FU, mitomycin C and epirubicin were used each in one trial. Results: All trials demonstrated some improvement in survival which was significant in the studies with cisplatin-based chemotherapy regimens. The survival benefit resulted mainly from an improvement in local control whereas chemotherapy had only a small and insignificant effect on distant metastases. Thus, the main action of chemotherapy is ''radiosensitization''. Cisplatin as single drug yielded comparable results as compared to combined regimens although the cisplatin dose was lower in the studies with combination chemotherapy. For the definitive treatment of locally advanced cancers, monotherapy with cisplatin can be recommended. Mitomycin C offers an attractive alternative to cisplatin in patients with contraindications for cisplatin. For postoperative radiochemotherapy, a combination of cisplatin/5-FU should be used because data with cisplatin alone are lacking so far. Simultaneous radiochemotherapy should also be considered for the curative treatment of local recurrences. Conclusions: The addition of simultaneous chemotherapy to radiotherapy is indicated in the vast majority of patients with cervical cancers who are treated with curative intent. (orig.) [German] Hintergrund: Die simultane Radiochemotherapie gilt seit kurzem als Behandlungsmethode der Wahl beim lokal fortgeschrittenen Zervixkarzinom. In dieser Arbeit wird versucht

  10. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer:Intraperitoneal chemotherapy with taxanes

    Institute of Scientific and Technical Information of China (English)

    Hironori; Yamaguchi; Joji; Kitayama; Hironori; Ishigami; Shinsuke; Kazama; Hiroaki; Nozawa; Kazushige; Kawai; Keisuke; Hata; Tomomichi; Kiyomatsu; Toshiaki; Tanaka; Junichiro; Tanaka; Takeshi; Nishikawa; Kensuke; Otani; Koji; Yasuda; Soichiro; Ishihara; Eiji; Sunami; Toshiaki; Watanabe


    The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising results.Herein,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results.IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h.The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP chemotherapy.There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease progression.Usually,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient basis.According to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/m2.Phase Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011.The prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection bias.Although several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.

  11. Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nagar, Himanshu; Boothe, Dustin; Parikh, Amar; Yondorf, Menachem; Parashar, Bhupesh [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Gupta, Divya; Holcomb, Kevin; Caputo, Thomas [Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Chao, K. S. Clifford; Nori, Dattatreyudu [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Wernicke, A. Gabriella, E-mail: [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States)


    Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated with VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen.

  12. Chemoimmunotherapy With a Modified Hyper-CVAD and Rituximab Regimen Improves Outcome in De Novo Philadelphia Chromosome–Negative Precursor B-Lineage Acute Lymphoblastic Leukemia (United States)

    Thomas, Deborah A.; O'Brien, Susan; Faderl, Stefan; Garcia-Manero, Guillermo; Ferrajoli, Alessandra; Wierda, William; Ravandi, Farhad; Verstovsek, Srdan; Jorgensen, Jeffrey L.; Bueso-Ramos, Carlos; Andreeff, Michael; Pierce, Sherry; Garris, Rebecca; Keating, Michael J.; Cortes, Jorge; Kantarjian, Hagop M.


    Purpose The adverse prognosis of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemia (ALL) prompted incorporation of monoclonal antibody therapy with rituximab into the intensive chemotherapy regimen hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone). Other modifications (irrespective of CD20 expression) included early anthracycline intensification, alterations in number of risk-adapted intrathecal chemotherapy treatments for CNS prophylaxis, additional early and late intensifications, and extension of maintenance phase chemotherapy by 6 months. Patients and Methods Two hundred eighty-two adolescents and adults with de novo Philadelphia chromosome (Ph)–negative precursor B-lineage ALL were treated with standard or modified hyper-CVAD regimens. The latter incorporated standard-dose rituximab if CD20 expression ≥ 20%. Results The complete remission (CR) rate was 95% with 3-year rates of CR duration (CRD) and survival (OS) of 60% and 50%, respectively. In the younger (age hyper-CVAD and rituximab regimens compared with standard hyper-CVAD (70% v 38%; P hyper-CVAD regimens were similar (72% v 68%, P = not significant [NS] and 64% v 65%, P = NS, respectively). Older patients with CD20-positive ALL did not benefit from rituximab-based chemoimmunotherapy (rates of CRD 45% v 50%, P = NS and OS 28% v 32%, P = NS, respectively), related in part to deaths in CR. Conclusion The incorporation of rituximab into the hyper-CVAD regimen appears to improve outcome for younger patients with CD20-positive Ph-negative precursor B-lineage ALL. PMID:20660823

  13. Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Daisuke Shimizu; Masafumi Taniwaki; Takeshi Okanoue; Kenichi Nomura; Yosuke Matsumoto; Kyoji Ueda; Kanji Yamaguchi; Masahito Minami; Yoshito Itoh; Shigeo Horiike; Masuji Morita


    A 62-year-old Japanese man who was positive for hepatitis B surface antigen (HBsAg) and anti-HBe antibody, underwent chemotherapy for non-Hodgkin's lymphoma (NHL). Mutations were detected in the precore region (nt1896) of HBV.Because steroid-containing regimen may cause reactivation of hepatitis B virus (HBV) and hepatitis may progress to be fulminant after its withdrawal, we administered CHO (CPA,DOX and VCR) therapy and the patient obtained complete response. However, he developed acute exacerbation of hepatitis due to HBV reactivation. Recovery was achieved with lamivudine (100 mg/d) and plasma exchange. The present case suggests that acute exacerbation of hepatitis can occur with steroid-free regimen. Because the efficacy of the prophylactic use of lamivudine has been reported and the steroid enhances curability of malignant lymphoma,the steroid containing regimen with prophylaxis of lamivudine should be evaluated further.

  14. Impact of Temozolomide on Immune Response during Malignant Glioma Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sadhak Sengupta


    Full Text Available Malignant glioma, or glioblastoma, is the most common and lethal form of brain tumor with a median survival time of 15 months. The established therapeutic regimen includes a tripartite therapy of surgical resection followed by radiation and temozolomide (TMZ chemotherapy, concurrently with radiation and then as an adjuvant. TMZ, a DNA alkylating agent, is the most successful antiglioma drug and has added several months to the life expectancy of malignant glioma patients. However, TMZ is also responsible for inducing lymphopenia and myelosuppression in malignant glioma patients undergoing chemotherapy. Although TMZ-induced lymphopenia has been attributed to facilitate antitumor vaccination studies by inducing passive immune response, in general lymphopenic conditions have been associated with poor immune surveillance leading to opportunistic infections in glioma patients, as well as disrupting active antiglioma immune response by depleting both T and NK cells. Deletion of O6-methylguanine-DNA-methyltransferase (MGMT activity, a DNA repair enzyme, by temozolomide has been determined to be the cause of lymphopenia. Drug-resistant mutation of the MGMT protein has been shown to render chemoprotection against TMZ. The immune modulating role of TMZ during glioma chemotherapy and possible mechanisms to establish a strong TMZ-resistant immune response have been discussed.

  15. Feasibility of alternating induction and maintenance chemotherapy in pancreatic cancer. (United States)

    Hann, Alexander; Bohle, Wolfram; Egger, Jan; Zoller, Wolfram


    Chemotherapy regimens for pancreatic ductal adenocarcinoma (PDAC) have changed since the introduction of FOLFIRINOX. Due to toxicity, dosage and number of applied cycles are limited. In analogy to chemotherapy strategies in colon cancer we used a scheme of induction, maintenance and re-induction therapy in PDAC to alleviate such toxicities and increase the number of applied cycles. Here we report first experiences with this approach. Data of all patients who received FOLFIRINOX for metastatic or locally advanced PDAC in our center using induction chemotherapy followed by maintenance therapy from 2011 until November 2016 was collected and analyzed retrospectively. Progression free survival was assessed starting induction therapy until progressive disease (PD) during maintenance or treatment pause (PFS1) and until progression during re-induction therapy (PFS2). 13 patients received induction therapy which was followed by maintenance therapy. Re-induction due to PD during therapy was applied in 11 patients. The median PFS1 was 10.6 months (95% CI; 6.7-14.4), PFS2 was 14.1 months (95% CI; 8.2-19.9) and overall survival was 18.3 months (95% CI; 14.8-21.8). The use of FOLFIRINOX as induction, followed by maintenance and re-induction therapy in case of PD is feasible in the treatment of PDAC and might lead to a prolonged PFS with less toxicity.

  16. 博尔宁胶囊联合FOLFOX4方案治疗结肠癌的临床观察%Clinical observation of colon carcinoma treated with Boerning capsules plus FOLFOX4 regimen

    Institute of Scientific and Technical Information of China (English)

    Ping Liu; Jianhui Liu; Daoqi Zhu; Jin'an Ma; Chunhong Hu


    Objective: To evaluate the effects and adverse reactions of Boerning capsules plus FOLFOX4 regimen in clinical treatment for colon carcinoma. Methods: Total patients with colon carcinoma were randomly divided into two groups from January 2005 to May 2006: group A (45 patients) were received Boerning capsules plus FOLFOX4 regimen treatment, and group B (49 patients) were received FOLFOX4 regimen treatment only. Results: Boerning capsules could obviously improve the life quality of the colon carcinoma patients. The weight gain in group A was higher than that of group B. No significant existed in the body immune function changes (T cell subgroup). But it could ameliorate the adverse reactions which induced by the chemotherapy. Conclusion: Boerning capsules can improve the life quality of the colon carcinoma patients and ameliorate the symptoms and sign which induced by the chemotherapy.

  17. Tolerance and toxicity of neoadjuvant docetaxel, cisplatin and 5 fluorouracil regimen in technically unresectable oral cancer in resource limited rural based tertiary cancer center

    Directory of Open Access Journals (Sweden)

    V M Patil


    Full Text Available Background: Recent studies indicate neoadjuvant chemotherapy (NACT can result in R0 resection in a substantial proportion of patients with technically unresectable oral cavity cancers. However, data regarding the efficacy and safety of docetaxel, cisplatin and 5 fluorouracil (TPF NACT in our setting is lacking. The present audit was proposed to evaluate the toxicities encountered during administration of this regimen. It was hypothesized that TPF NACT would be considered feasible for routine administration if an average relative dose intensity (ARDI of ≥0.90 or more in at least 70% of the patients. Materials and Methods: Technically unresectable oral cancers with Eastern Cooperative Oncology Group PS 0-2, with biopsy proven squamous cell carcinoma underwent two cycles of NACT with TPF regimen. Toxicity and response rates were noted following the CTCAE 4.03 and RECIST criteria. Descriptive analysis of completion rates (completing 2 cycles of planned chemotherapy with ARDI of 0.85 or more, reason for delay, toxicity, and response are presented. Results: The NACT was completed by all patients. The number of subjects who completed all planned cycles of chemotherapy are with the ARDI of the delivered chemotherapy been equal to or >0.85 was 11 (91.67%. All toxicity inclusive Grade 3-5 toxicity was seen in 11 patients (91.67%. The response rate of chemotherapy was 83.33%. There were three complete response, seven partial response, and two stable disease seen post NACT in this study. Conclusion: Docetaxel, cisplatin and 5 fluorouracil regimen can be routinely administered at our center with the supportive care methods and precautionary methods used in our study.

  18. Korelasi antara Imunoekspresi p53 dan Respons Kemoterapi Neoadjuvan Regimen Fluororasil, Adriamisin, dan Siklofosfamid pada Karsinoma Duktus Payudara Invasif

    Directory of Open Access Journals (Sweden)



    Full Text Available Invasive ductal breast carcinoma (IDBC stage IIIB need multimodality treatment. Neoadjuvant chemotherapy (NC is given to reduce the size and stage of tumor so that surgery can be performed. Neoadjuvant chemotherapy regimens generally used was fluorouracil, adriamycin and cyclophosphamide (FAC. FAC chemotherapy works by damaging deoxyribonucleic acid and induce apoptosis of cancer cells. Abnormalities of proteins or genes associated with apoptosis (p53 is believed to affect the chemotherapy response. This study was purpose to determine correlation between immunoexpression of p53 and response of neoadjuvant FAC chemotherapy in invasive ductal breast carcinoma. The study was a cross sectional analytic study of 40 IDBC cases given FAC NC at Dr. Hasan Sadikin Hospital Bandung between March 2008–February 2009. Response of FAC NC judged on the size of tumor mass following administration of FAC. Haematoxylin-eosin and immunohistochemistry stain using a mouse monoclonal antibody to p53 protein (Novocastra was made from paraffin blocks of patients, then determined the immunoexpression levels of p53. Somers’d and Gamma statistical were used to test the correlation between variables. The p-value 75%, 14 cases p53 10–75%, 7 cases p53<10%, and 6 cases were not expresed p53; There was a significant correlation between immunoexpression of p53 and the response of FAC chemotherapy (p=0.000. In conclusions, the higher expression of p53, the lower response to NC FAC. Immunoexpression of p53 can predict the response of FAC NC on IDBC stage IIIB.

  19. Shenqifuzheng injection combined with chemotherapy in the treatment of advanced gastric cancer: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Kunhou Yao


    Full Text Available Objective: The aim of this systematic review and meta-analysis was to evaluate the clinical efficacy of Shenqifuzheng (SQFZ injection combined with chemotherapy in the treatment of advanced gastric cancer. Materials and Methods: We conducted an electronic search by using PubMed, EMBASE, ASCO, ESMO and Chinese National Knowledge Infratructure (CNKI, databases. The randomized controlled trials about Shenqifuzheng injection combined with chemotherapy versus chemotherapy alone in the treatment of advanced gastric cancer were reviewed and collected. Pooled odds ratio (OR for the response rate and KPS improvement were calculated using the software MetaAnalyst 3.1. Results: Fifteen trials met our inclusion criteria and finally included in this meta-analysis. The objective response rate (ORR in patients treated with Shenqifuzheng injection combined with chemotherapy was much higher than that of chemotherapy only (OR = 1.66, 95% CI: 1.20-2.29 with statistical significance (P < 0.05. The pooled data showed the combined treatment can significant increase the Karnofsky score (KPS compared with the chemotherapy only (OR = 3.74, 95% CI: 2.66-5.27 (P < 0.05. Conclusion: SQFZ injection combined with chemotherapy treatment regimen can improve the clinical efficacy and performance status in patients with advanced gastric cancer compared with chemotherapy alone.

  20. What outcome after the prescription of neoadjuvant chemotherapy in lung cancer? (United States)

    Boudaya, Mohamed-Sadok; Smadhi, Hanène; Marghli, Adel; Charmiti, Fatma; Ouerghi, Sonia; Mohamed, Jalel; Brahem, Emna; Smati, Belhassen; Mestiri, Taher; Kilani, Tarek


    The treatment of patients with locally advanced non-small-cell lung cancer is controversial. Surgery remains the gold standard, even in this group. Neoadjuvant chemotherapy could allow surgical resection in patients initially judged inoperable. From January 2009 to May 2010, neoadjuvant chemotherapy was indicated in 27 patients with NSCLC (25 men, 2 women). Their mean age was 65 years. The stages were: IIB in 5, IIIA in 17 (6 in stage IIIAN2), IIIB in 2, and IV in 3. 23 patients received neoadjuvant chemotherapy, 2 refused induction treatment, and 2 had impaired status. The neoadjuvant chemotherapy regimen was gemcitabine-cisplatin in 17 patients and vinorelbine-cisplatin in 6. Only 5 patients underwent complete surgical treatment after induction: 1 in stage IIB, 1 in stage IIIAN0, 1 in IIIB, and 2 in stage IV (1 operated brain metastasis, and 1 operated adrenal metastasis). Surgical treatment was not achieved after neoadjuvant chemotherapy in 18 patients because of progressive disease. Neoadjuvant chemotherapy offers several potential benefits, but it may delay surgery or eliminate eligibility as a surgical candidate. Rigorous patient selection for this type of multimodal treatment is essential.

  1. Fighting Cancer Together: Development and Implementation of Shared Medical Appointments to Standardize and Improve Chemotherapy Education (United States)

    Prescott, Lauren S.; Dickens, Andrea S.; Guerra, Sandra L.; Tanha, Jila M.; Phillips, Desiree G.; Patel, Katherine T.; Umberson, Katie M.; Lozano, Miguel A.; Lowe, Kathryn B.; Brown, Alaina J.; Taylor, Jolyn S.; Soliman, Pamela T.; Garcia, Elizabeth A.; Levenback, Charles F.; Bodurka, Diane C.


    Objective Shared medical appointments offer a novel approach to improve efficiency and quality of care consistent with the goals of the Institute of Medicine. Our objective was to develop and implement a shared medical appointment for gynecologic cancer patients initiating chemotherapy. Methods We first assessed the level of interest in shared medical appointments among our patients and providers through qualitative interviews. Both patients and providers identified pre-chemotherapy as an optimal area to pilot shared medical appointments. We subsequently created a multidisciplinary team comprised of physicians, advanced practice providers, nurses, pharmacists, administrators, health education specialists and members of the Quality Improvement Department to establish a Shared Medical Appointment and Readiness Teaching (SMART) program for all gynecologic oncology patients initiating chemotherapy with platinum- and/or taxane-based regimens. We developed a standardized chemotherapy education presentation and provided patients with a tool kit that consisted of chemotherapy drug education, a guide to managing side effects, advance directives, and center contact information. Results From May 9, 2014 to June 26, 2015, 144 patients participated in 51 SMART visits. The majority of patients had ovarian cancer and were treated with carboplatin/paclitaxel. Surveyed patients reported being highly satisfied with the group visit and would recommend shared medical appointments to other patients. Conclusions This model of care provides patient education within a framework of social support that empowers patients. Shared medical appointments for oncology patients initiating chemotherapy are both feasible and well accepted. PMID:26549108

  2. Chemotherapy options for the elderly patient with advanced non-small cell lung cancer.

    LENUS (Irish Health Repository)

    Hennessy, B T


    Combination chemotherapy has been shown to improve overall survival compared with best supportive care in patients with advanced non-small cell lung cancer (NSCLC). The survival advantage is modest and was initially demonstrated with cisplatin-containing regimens in a large meta-analysis of randomized trials reported in 1995. Newer chemotherapy combinations have been shown to be better tolerated than older cisplatin-based combinations, and some trials have also shown greater efficacy and survival benefits with these newer combinations. Combination chemotherapy is, therefore, the currently accepted standard of care for patients with good performance statuses aged less than 70 years with advanced NSCLC. However, there are limited data from clinical trials to support the use of combination chemotherapy in elderly patients over 70 years of age with advanced NSCLC. Subgroup analyses of large randomized phase III trials suggest that elderly patients with good performance statuses do as well as younger patients treated with combination chemotherapy. There are few randomized trials reported that evaluate chemotherapy in patients aged greater than 70 years only. Based on data from trials performed by an Italian group, single-agent vinorelbine has been shown to have significant activity in elderly patients with advanced NSCLC and to be well tolerated by those patients with Eastern Cooperative Oncology Group performance statuses of two or less, with associated improvements in measures of global health.

  3. Investigation of the Effect of Neoadjuvant Chemotherapy on Stage II Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Yanli Song; Dong Wang


    OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage II breast cancer.METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage II, during the period of 1995 to 2001, were analyzed retrospectively. Among the patients, 47 were treated with neoadjuvant chemotherapy, and 66 received no adjuvant therapy before surgery (control group). After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen, the surgical procedure was conducted.RESULTS Complete remission (CR) was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission (PR) was reached for 22 cases. The rate of breast-conserving surgery was enhanced from 22.73% to 46.81% (P<0.05) in the neoadjuvant treatment group. There was no difference in the 5-year overall survival (OS) and disease-free survival (DFS) rate between the two groups (P>0.05), but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group (P<0.05).CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage II breast cancer and may improve the prognosis of the cases with clinical remission.

  4. 不同剂量去甲氧柔红霉素联合阿糖胞苷诱导治疗年轻初发急性髓系白血病的疗效和安全性分析%Efficacy and safety analysis of different dose idarubicin plus cytarabine regimen as induction chemotherapy for young patients with de-novo acute myeloid leukemia

    Institute of Scientific and Technical Information of China (English)

    张仪; 姚徐明; 朱双丽; 索珊珊; 毛莉萍; 韦菊英; 俞文娟; 麦文渊; 佟红艳


    目的 探讨不同剂量去甲氧柔红霉素(IDA)联合阿糖胞苷诱导方案(IA)治疗年轻初发急性髓系白血病(AML)(除外急性早幼粒细胞白血病)的临床疗效、安全性和长期预后.方法 回顾性分析2009年1月至2014年7月收治的采用IA方案治疗的149例<55岁初发AML患者临床资料,根据IDA剂量分为高标准剂量组(10~12 mg·m-2·d-1)、低标准剂量组(8~9 mg·m-2·d-1)和低剂量组(<8mg· m-2·d-1),比较各组患者的化疗反应、血液学及非血液学不良事件,并分析预后.结果 高标准剂量组34例,低标准剂量组53例,低剂量组62例.三组第1个疗程完全缓解(CR)率分别为79.4%、75.5%和46.8%,第1个疗程有效率分别为97.1%、94.3%和64.5%,总CR率分别为85.3%、81.1%和54.8%,高标准剂量组、低标准剂量组均显著高于低剂量组(P值均<0.05),前两者间差异无统计学意义(P值均> 0.05).多因素分析证实标准IDA剂量的确在诱导缓解疗效上优于低剂量(P<0.05).在不良反应方面,化疗期间WBC最低值三组间差异有统计学意义(P=0.002),其余差异均无统计学意义.低标准剂量组在总生存(OS)上显著优于低剂量组(P=0.030),高标准剂量组与低剂量组相比,OS也有改善的趋势(P=0.054).三组间在无事件生存、无复发生存差异均无统计学意义(P值均>0.05).结论 对于年轻(<55岁)初发AML患者,标准剂量IA方案可显著提高CR率,且患者的耐受性良好.标准剂量IA方案在一定程度上能改善年轻(<55岁)AML患者OS.%Objective To compare the efficacy,safety and long-term prognosis between different dose idarubicin (IDA) combined with cytarabine (IA) as induction chemotherapy in newly diagnosed young patients of acute myeloid leukemia (AML).Methods A total of 149 newly diagnosed young AML patients (APL excluded) between January 2009 to July 2014 was enrolled.According to the dose of IDA,the patients were divided into three

  5. Long-Lasting Complete Responses in Patients with Metastatic Melanoma after Adoptive Cell Therapy with Tumor-Infiltrating Lymphocytes and an Attenuated IL2 Regimen

    DEFF Research Database (Denmark)

    Andersen, Rikke; Donia, Marco; Ellebaek, Eva;


    administered together with TILs are severe. To further scrutinize whether similar results can be achieved with lower doses of IL2, we have carried out a phase I/II trial of TIL transfer after classical lymphodepleting chemotherapy followed by an attenuated IL2 regimen. EXPERIMENTAL DESIGN: Twenty-five patients...... decrescendo regimen ( Identifier: NCT00937625). RESULTS: Classical IL2-related toxicities were observed but patients were manageable in a general oncology ward without the need for intervention from the intensive care unit. RECIST 1.0 evaluation displayed three complete responses and seven...... to treatment. CONCLUSIONS: TIL-ACT with a reduced IL2 decrescendo regimen results in long-lasting complete responses in patients with treatment-refractory melanoma. Larger randomized trials are needed to elucidate whether clinical efficacy is comparable with TIL-ACT followed by HD bolus IL2. Clin Cancer Res...


    Institute of Scientific and Technical Information of China (English)

    黄慧强; 姜文奇; 何友兼; 孙晓非; 刘冬耕; 徐瑞华; 张力; 周中梅; 林桐榆; 李宇红; 管忠震


    Objective: High dose chemotherapy supported by autologous hematopoietic stem cells transplantation (AHSCT) has developed dramaticly in recent years and become the most effective approach to improve radical treatment for the chemo-sensitive lymphoma. The purposes of this study was to evaluate the efficacy and tolerance of preparative regimen BEAC and hematopoietic reconsti- tution after high dose chemotherapy in Chinese patients with advanced and recurrent lymphoma. Methods: After confirmed complete or partial remission from conventional chemotherapy, 24 patients with advanced or recurrent lymphoma including 1 recurrent HD and 23 NHL, 16 male and 8 female with median age of 29 (13(50) years, were enrolled into this study and treated by BEAC regimen (CTX 3600(4000 mg/m2, VP-16 1200 mg/m2. BCNU 300 mg/m2 and Ara-C 1500(2000 mg/m2). 3 patients were supported by ABMT and 21 by APBSCT. Mobilization regimen for APBSCT was CTX 3500 mg/m2 + G-CSF 3.5(5 (g/kg + Dexamethasone 10 mg. Autologous hematopoietic stem cells was re-infused 24(48 h after completion of high dose chemotherapy. Results: MNC 1.3 (1.0(1.7) (108/kg and MNC 1.8 (1.0(4.4) (108, CFU-GM 5.1 (1.9(9.6) (105/kg plus CD34 + cells 2.9 (1.9(8.7) (106/kg were re-infused in the ABMT group and APBSCT group respectively. All patients obtained prompt and sustained hematopoietic reconstitution. ANC (0.5 (109/L and Pt (2.0 (109/L were at day 9 (6(17) and day 10 (0(31) respectively. 16 patients were alive with median 21 (2(69) months follow-up till end of May, 2001. 1, 2 and 3 years survival rate were 60.5%, 50.1% and 50.1%, respectively. Non-hematologic toxicity was mild and tolerable. Conclusions: High dose chemotherapy supported by AHSCT in the treatment of previously-untreated poor- prognostic and recurrent lymphoma was a safe and effective modality. Further investigation was warranted.

  7. Life expectancy with perioperative chemotherapy and chemoradiotherapy for locally advanced gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sadighi S


    Full Text Available "nBackground: Although postoperative chemoradiotherapy should be considered for all patients at high risk for recurrence of adenocarcinoma of the stomach, curative surgery occurs in less than 50% of nonmetastatic gastric cancers. A regimen of docetaxel, cisplatin and infusional fluorouracil improves survival of patients with incurable locally-advanced gastric adenocarcinoma. So we assessed the perioperative regimen of docetaxel, cisplatin and infusions 5FU (TCF and postoperative chemoradiotherapy to improve outcomes in patients with potentially resectable gastric adenocarcinoma. "nMethods: Between March 2005 and March 2008, we 100 enrolled patients with stage II to IV (M0 adenocarcinoma of the stomach who had not been treated previously. Treatment consisted of three preoperative and one postoperative cycles of TCF followed by chemoradiotherapy. The primary end point was overall survival. The secondary end points were progression-free survival and toxicity of treatment. "nResults: A total of 100 patients participated, 83 of whom received neoadjuvant and 17 received adjuvant chemotherapy. Seventy-five patients underwent at least D0 gastrectomy. After chemotherapy, tumor stages were significantly lower than before beginning the protocol. Out of 100 patients, 44 had stage IV before chemotherapy versus 15 after the treatment. Three patients showed complete pathologic response. The median survival time was 25 months. "nConclusion: Docetaxel, cisplatin and 5FU combination chemotherapy is an active preoperative treatment in locally advanced gastric cancer. Perioperative chemoradio-therapy should be considered as an option to lengthen patient survival.

  8. Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Blesing, C.; Patel, K.; Warner, N. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Marshall, R.E.K.; Maynard, N.D. [Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); Gleeson, F.V. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom)


    Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial. Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2. Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV{sub max} (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect. There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low. (orig.)

  9. Patients with Advanced Ovarian Cancer Administered Oral Etoposide following Taxane as Maintenance Chemotherapy

    Directory of Open Access Journals (Sweden)

    Hiroaki Nagano


    Full Text Available Introduction: The concept of maintenance therapy is one of the highly relevant approaches in the management of advanced ovarian cancer. The fundamental goal of maintenance therapy is to improve survival outcomes. We attempted to reinforce maintenance chemotherapy by adding oral etoposide following taxane administration. Cases: We retrospectively evaluated 14 patients with advanced ovarian cancer who had achieved clinically defined complete response to a primary platinum/taxane chemotherapy regimen and who were administered oral etoposide (50 mg/day × 21 days per cycle monthly for 3-5 cycles following paclitaxel or docetaxel administration as maintenance chemotherapy. With regard to oral etoposide toxicity, grade 2 oral mucositis and grade 3 anemia were observed in 1 patient each. Three to five cycles of etoposide were administered to all patients, though daily dosage was reduced to 25 mg in 2 patients due to toxicity. The median progression-free survival was 43.5 months, the median overall survival was 86 months, and 5-year overall survival was 77.1%. Conclusion: The results from this ovarian cancer treatment evaluation suggest that oral etoposide may be administered safely following paclitaxel or docetaxel as maintenance chemotherapy. We expect this regimen to contribute to the improvement in the survival outcomes of patients with advanced ovarian cancer.

  10. Acute emesis: moderately emetogenic chemotherapy

    DEFF Research Database (Denmark)

    Herrstedt, Jørn; Rapoport, Bernardo; Warr, David


    This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the third Perugia Consensus Conference, which took place in June 2009. The review will focus on new studies appearing since the Second consensus conference...... receiving multiple cycles of moderately emetogenic chemotherapy will be reviewed. Consensus statements are given, including optimal dose and schedule of serotonin(3) receptor antagonists, dexamethasone, and neurokinin(1) receptor antagonists. The most significant recommendations (and changes since the 2004...... version of the guidelines) are as follows: the best prophylaxis in patients receiving moderately emetogenic chemotherapy (not including a combination of an anthracycline plus cyclophosphamide) is the combination of palonosetron and dexamethasone on the day of chemotherapy, followed by dexamethasone...

  11. Managing Chemotherapy Side Effects: Constipation (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Constipation Take these steps: Eat high-fiber foods such as: ● ● Whole-grain breads and cereals ● ● Fruits and vegetables ● ● Nuts and seeds ...

  12. Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy. (United States)

    Ansari, Mansour; Porouhan, Pezhman; Mohammadianpanah, Mohammad; Omidvari, Shapour; Mosalaei, Ahmad; Ahmadloo, Niloofar; Nasrollahi, Hamid; Hamedi, Seyed Hasan


    Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the frst 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (±1.31) and 1.46 (±1.28) with no statistically significant difference. After the 2nd chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After 3rd chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (±1.14), versus 1.42 (±1.30)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (±0.96) and in control arm it was 1.40 (±0.92). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (±1.03), 0.68 (±1.00) and 0.77 (±1.18). In control arm, mean vomiting was 0.983 (±1.23), 1.03 (±1.22) and 1.15 (±1.27). In all sessions, ginger decreased vomiting severity from 1.4 (±1.04) to 0.71 (±0.86). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe (0.64±0.87) compared to those who received placebo (1.13±1.12), which was statistically significant (p-value <0.05). Further and larger studies are needed to draw conclusions.

  13. Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

    Institute of Scientific and Technical Information of China (English)

    Chen; Aiping; Ding; Zhaoxia; Xu; Bing; Zhao; Shuping; Dai; Shuzhen


    Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arterial infusion chemotherapy by using Seldinger technique.Combined regimens were applied including cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy.Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac arterial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

  14. Etravirine: a good option for concomitant use with chemotherapy for Hodgkin's lymphoma. (United States)

    Kurz, Mario; Stoeckle, Marcel; Krasniqi, Fatime; Battegay, Manuel; Marzolini, Catia


    The treatment of malignancies in HIV patients is challenged by the issue of drug-drug interactions between antiretroviral therapy and antineoplastic agents. While protease inhibitors have been shown to increase the incidence and severity of cancer therapy-related side effects, the impact of other antiretroviral agents on the tolerability and response to chemotherapy is less well documented. We report the successful use of an etravirine-based regimen in a patient treated with BEACOPP chemotherapy for advanced Hodgkin's lymphoma. Etravirine constitutes a valuable option for concomitant use with chemotherapy due to its moderate inducing effect on drug metabolising enzymes. © The Author(s) 2014 Reprints and permissions:

  15. Metronomic chemotherapy in anaplastic thyroid carcinoma: A potentially feasible alternative to therapeutic nihilism

    Directory of Open Access Journals (Sweden)

    Swaroop Revannasiddaiah


    Full Text Available Anaplastic thyroid carcinoma (ATC is one of the most aggressive malignancies and prognostic outlook remains very dismal. Treatment most often is palliative in intent attempting to relieve the patients from local compressive symptoms in the neck. Radical surgery, radiotherapy (RT, and chemotherapy have not been tested in large prospective trials, and current evidence from retrospective series and small trials indicate only marginal survival benefits. Given the poor prognostic and therapeutic outlook, patients must be encouraged to be actively involved in the decision making process. We report the case of an elderly patient who had no response to palliative RT, and was treated with oral metronomic chemotherapy. The response to oral metronomic chemotherapy was dramatic, and the patient has enjoyed complete freedom from symptoms as well as radiologically exhibits a complete regression. Thus, we document the first ever use of a simple, cost-effective, and convenient oral metronomic chemotherapeutic regimen delivering a remarkable response in an elderly patient with ATC.

  16. Postoperative survival following perioperative MAGIC versus neoadjuvant OE02-type chemotherapy in oesophageal adenocarcinoma. (United States)

    Reece-Smith, A M; Saunders, J H; Soomro, I N; Bowman, C R; Duffy, J P; Kaye, P V; Welch, N T; Madhusudan, S; Parsons, S L


    The optimal management of resectable oesophageal adenocarcinoma is controversial, with many centres using neoadjuvant chemotherapy following the Medical Research Council (MRC) oesophageal working group (OE02) trial and the MRC Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial. The more intensive MAGIC regimen is used primarily in gastric cancer but some also use it for oesophageal cancer. A database of cancer resections (2001-2013) provided information on survival of patients following either OE02 or MAGIC-type treatment. The data were compared using Kaplan-Meier analysis. Straight-to-surgery patients were also reviewed and divided into an 'early' cohort (2001-2006, OE02 era) and a 'late' cohort (2006-2013, MAGIC era) to estimate changes in survival over time. Subgroup analysis was performed for responders (tumour regression grade [TRG] 1-3) versus non-responders (TRG 4 and 5) and for anatomical site (gastro-oesophageal junction [GOJ] vs oesophagus). An OE02 regimen was used for 97 patients and 275 received a MAGIC regimen. Those in the MAGIC group were of a similar age to those undergoing OE02 chemotherapy but the proportion of oesophageal cancers was higher among MAGIC patients than among those receiving OE02 treatment. MAGIC patients had a significantly lower stage following chemotherapy than OE02 patients and a higher median overall survival although TRG was similar. On subgroup analysis, this survival benefit was maintained for GOJ and oesophageal cancer patients as well as non-responders. Analysis of responders showed no difference between regimens. 'Late' group straight-to-surgery patients were significantly older than those in the 'early' group. Survival, however, was not significantly different for these two cohorts. Although the original MAGIC trial comprised few oesophageal cancer cases, our patients had better survival with MAGIC than with OE02 chemotherapy in all anatomical subgroups, even though there was no significant change in operative

  17. Adjuvant breast cancer chemotherapy during late-trimester pregnancy: not quite a standard of care

    Directory of Open Access Journals (Sweden)

    Epstein Richard J


    Full Text Available Abstract Background Diagnosis of breast cancer during pregnancy was formerly considered an indication for abortion. The pendulum has since swung to the other extreme, with most reviews now rejecting termination while endorsing immediate anthracycline-based therapy for any pregnant patient beyond the first trimester. To assess the evidence for this radical change in thinking, a review of relevant studies in the fields of breast cancer chemotherapy, pregnancy, and drug safety was conducted. Discussion Accumulating evidence for the short-term safety of anthracycline-based chemotherapy during late-trimester pregnancy represents a clear advance over the traditional norm of therapeutic abortion. Nonetheless, the emerging orthodoxy favoring routine chemotherapy during gestation should continue to be questioned on several grounds: (1 the assumed difference in maternal survival accruing from chemotherapy administered earlier – i.e., during pregnancy, rather than after delivery – has not been quantified; (2 the added survival benefit of adjuvant cytotoxic therapy prescribed within the hormone-rich milieu of pregnancy remains presumptive, particularly for ER-positive disease; (3 the maternal survival benefit associated with modified adjuvant regimens (e.g., weekly schedules, omission of taxanes, etc. has not been proven equivalent to standard (e.g., post-delivery regimens; and (4 the long-term transplacental and transgenerational hazards of late-trimester chemotherapy are unknown. Summary Although an incrementally increased risk of cancer-specific mortality is impossible to exclude, mothers who place a high priority on the lifelong well-being of their progeny may be informed that deferring optimal chemotherapy until after delivery is still an option to consider, especially in ER-positive, node-negative and/or last-trimester disease.

  18. Alternative temozolomide dosing regimens and novel combinations for the treatment of advanced metastatic melanoma

    Directory of Open Access Journals (Sweden)

    Wen-Jen Hwu


    Full Text Available Over the past 30 years, there has been no significant improvement in treatment outcomes for patients with advanced stage IV metastatic melanoma, and prognosis remains poor. Melanoma is known to be responsive to immunomodulatory agents, to be a highly vascular tumor, and to be fairly resistant to standard cytotoxic chemotherapy. Ongoing research is attempting to find novel combinations that may have therapeutic synergy. Alternative dosedense schedules of temozolomide appear promising and are being actively investigated, based on their potential to overcome chemoresistance to alkylating agents and the proven activity of temozolomide in the brain. Outcomes of studies investigating single-agent temozolomide suggest that it has activity similar to single-agent dacarbazine. Other studies combining temozolomide with either interferon- alfa or thalidomide suggest that the addition of these immunomodulatory agents to temozolomide improves response rates and may improve overall survival. The best results have been achieved with the extended, daily, dosedense temozolomide regimen. Further research is needed to determine the optimal temozolomide regimen and best combination approach

  19. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC) including sequential cisplatin and VM-26. (United States)

    Shafford, E A; Rogers, D W; Pritchard, J


    Forty-two children, all over one year of age, were given vincristine, cyclophosphamide, and sequentially timed cisplatin and VM-26 (OPEC) or OPEC and doxorubicin (OPEC-D) as initial treatment for newly diagnosed stage III or IV neuroblastoma. Good partial response was achieved in 31 patients (74%) overall and in 28 (78%) of 36 patients whose treatment adhered to the chemotherapy protocol, compared with a 65% response rate achieved in a previous series of children treated with pulsed cyclophosphamide and vincristine with or without doxorubicin. Only six patients, including two of the six children whose treatment did not adhere to protocol, failed to respond, but there were five early deaths from treatment-related complications. Tumor response to OPEC, which was the less toxic of the two regimens, was at least as good as tumor response to OPEC-D. Cisplatin-induced morbidity was clinically significant in only one patient and was avoided in others by careful monitoring of glomerular filtration rate and hearing. Other centers should test the efficacy of OPEC or equivalent regimens in the treatment of advanced neuroblastoma.

  20. NOVP: a novel chemotherapeutic regimen with minimal toxicity for treatment of Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Hagemeister, F.B.; Cabanillas, F.; Velasquez, W.S.; Meistrich, M.L.; Liang, J.C.; McLaughlin, P.; Redman, J.R.; Romaguera, J.E.; Rodriguez, M.A.; Swan, F. Jr. (Univ. of Texas, M.D. Anderson Cancer Center, Houston (USA))


    Patients with early-staged Hodgkin's disease have had a higher relapse rate following radiotherapy alone if they have B symptoms, large mediastinal masses, hilar involvement, or stage III disease. From June 1988 to December 1989, 27 previously untreated patients with early-staged Hodgkin's disease with adverse features for disease-free survival received combined-modality therapy. Seventeen patients had stage I or II disease, 10 had stage III, 5 had B symptoms, 13 had large mediastinal masses, and 6 had peripheral masses measuring 10 cm or more in diameter. All patients initially received three cycles of a novel chemotherapeutic regimen combining Novantrone (mitoxantrone, American Cyanamid Company), vincristine, vinblastine, and prednisone (NOVP). Twenty-four patients with clinically staged I or II disease with adverse features or stage III disease did not undergo laparotomy; three patients had favorable stage I or II disease and at laparotomy had stage III disease. Radiotherapy-treatment fields depended on the extent of nodal involvement. Twenty-six patients completed all therapy as planned to complete remission (CR) and one of these has had progression; she is in second CR following additional radiotherapy. With a median follow-up of 12 months, all patients are alive. Tolerance to treatment was excellent with only grade 1 or 2 nausea, alopecia and myalgias, and brief myelosuppression. NOVP is an effective adjuvant chemotherapy regimen for inducing responses, with minimal toxicity, prior to definitive radiotherapy for patients with early-staged Hodgkin's disease.

  1. Treatment of locally advanced carcinomas of head and neck with intensity-modulated radiation therapy (IMRT in combination with cetuximab and chemotherapy: the REACH protocol

    Directory of Open Access Journals (Sweden)

    Simon Christian


    Full Text Available Abstract Background Primary treatment of carcinoma of the oro-/hypopharynx or larynx may consist of combined platinum-containing chemoradiotherapy. In order to improve clinical outcome (i.e. local control/overall survival, combined therapy is intensified by the addition of the EGFR inhibitor cetuximab (Erbitux®. Radiation therapy (RT is carried out as intensity-modulated RT (IMRT to avoid higher grade acute and late toxicity by sparing of surrounding normal tissues. Methods/Design The REACH study is a prospective phase II study combining chemoradiotherapy with carboplatin/5-Fluorouracil (5-FU and the monoclonal epidermal growth factor-receptor (EGFR antibody cetuximab (Erbitux® as intensity-modulated radiation therapy in patients with locally advanced squamous-cell carcinomas of oropharynx, hypopharynx or larynx. Patients receive weekly chemotherapy infusions in the 1st and 5th week of RT. Additionally, cetuximab is administered weekly throughout the treatment course. IMRT is delivered as in a classical concomitant boost concept (bid from fraction 16 to a total dose of 69,9 Gy. Discussion Primary endpoint of the trial is local-regional control (LRC. Disease-free survival, progression-free survival, overall survival, toxicity, proteomic and genomic analyses are secondary endpoints. The aim is to explore the efficacy as well as the safety and feasibility of this combined radioimmunchemotherapy in order to improve the outcome of patients with advanced head and neck cancer. Trial registration ISRCTN87356938

  2. ABV方案化疗对艾滋病相关晚期卡波氏肉瘤外周血CD4淋巴细胞的影响%The effect of ABV regimen on CD4 lymphocyte count in patients with advanced HIV related Kaposi's sarcoma

    Institute of Scientific and Technical Information of China (English)

    Lin Lin; Datta Dharmadhikari; Alexander yon Paleske


    Objective: The combination of highly active antiretroviral therapy (HAART) and chemotherapy with ABV regimen (doxorubicin, bleomycin and vincristine) is a promising approach for the treatment of advanced HIV-related Kaposi's sarcoma (KS). Here we analyzed the relationship between the CD4 lymphocyte cell count and the clinical response to chemotherapy.Methods: The 176 HIV infected patients with advanced KS who failed to respond to prior HAART were selected. All these patients were then preceded to chemotherapy with ABV regimen which was administered at 3 weekly intervals for 6 cycles.For each patient CD4 cell count was done before starting chemotherapy and after finishing 6 cycles of chemotherapy. The difference of CD4 cell counts pre chemotherapy and post chemotherapy was compared with the clinical progress of the patients after 6 cycles of chemotherapy. Results: The overall clinical remission was shown in 93.7% patients. Progressive disease (PD) and no change in clinical condition (NC) was shown in 6.3% patients. The increase in CD4 cell count post chemotherapy was found in 89.8% patients and the decrease in CD4 cell count was seen in 10.2% patients. The difference of the mean CD4 cell counts for patients in group CR + PR (complete relief + partial relief) before and after chemotherapy was highly significant.The difference of the mean CD4 cell counts for patients in group NC + PD before and after chemotherapy was not significant.The difference in CD4 cell counts in CR + PR and NC + PD groups before and after chemotherapy was highly significant.Conclusion: The HIV related KS patients on HAART benefit from the chemotherapy as it increases the CD4 cell count and it has positive impact on clinical remission of KS.

  3. The Sex Res Non Naturales and the Regimen of Health

    DEFF Research Database (Denmark)

    Agerholm, Frank Juul


    The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle......The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle...

  4. Dynamics of early histopathological changes in GVHD after busulphan/cyclophosphamide conditioning regimen. (United States)

    Al-Hashmi, Sulaiman; Hassan, Zuzana; Sadeghi, Behnam; Rozell, Björn; Hassan, Moustapha


    Hematopoietic stem cell transplantation (HSCT) is a curative treatment for otherwise incurable diseases. Conditioning regimen is an important part of HSCT and consists of chemotherapy with or without irradiation. Conditioning exerts myelosuppressive, immunosuppressive and antitumor effects, but also contributes to HSCT-related complications including graft-versus-host disease (GVHD). Since almost 50% of the transplanted patients are conditioned with cytostatics without irradiation, we developed and characterized a GVHD mouse model following conditioning with busulphan and cyclophosphamide. Recipient Balb/c female mice were treated with busulphan (20 mg/kg/day for 4 days) and cyclophosphamide (100 mg/kg/day for two days). After one day of rest, recipient mice were transplanted with 2×10(7) bone marrow and 3×10(7) spleen cells from male C57BL/6 (allogeneic group) or female Balb/c (syngeneic/control group) mice. The allogeneic, but not syngeneic transplanted mice developed GVHD. Histopathology of the major internal organs (liver, pancreas, spleen, lungs, heart and kidney) was examined before conditioning start, after conditioning's end and 5, 7 and 21 days after transplantation using hematoxylin-eosin staining. Decreased spleen cellularity and diminished glycogen content in the liver were observed after conditioning regimen. Histopathological changes such as vasculitis, inflammation and apoptotic cell forms in liver, spleen, pancreas, lungs and heart were observed in allogeneic transplanted mice, however, only hypocellular spleen and extramedullar hematopoiesis were detected in syngeneic transplanted animals. No morphological changes were observed in kidney in either HSCT setting. This is the first study describing early histopathological changes after conditioning regimen with busulphan/cyclophosphamide and dynamics of GVHD development in several major internal organs.

  5. Outcomes of autologous transplantation for multiple myeloma according to different induction regimens

    Directory of Open Access Journals (Sweden)

    Edvan de Queiroz Crusoe


    Full Text Available Background: Induction therapy followed by high-dose chemotherapy and autologous transplantation is the standard treatment for suitable patients with multiple myeloma. Objective: The aim of this study was to assess whether induction therapy with thalidomidecontaining regimens was associated with improved results compared to vincristine, doxorubicin, and dexamethasone, and whether cyclophosphamide, thalidomide, and dexamethasone were associated with better results than thalidomide and dexamethasone. Methods: The records of 152 patients who underwent autologous transplantation at this institution from August of 2004 to January of 2012 were reviewed, selecting those with at least partial response to a maximum of eight cycles of induction therapy and sufficient follow-up information for analysis. Results: This study included 89 patients; 44 were female, with a mean age of 55 years (there was a significant trend for increasing age over the years of the study.The median number of induction therapy cycles was four, again with a trend of increase over the years.At least a very good partial response to induction therapy was achieved more often in the cyclophosphamide, thalidomide, and dexamethasone group (61.1% and in the thalidomide and dexamethasone group (59.2% than in the vincristine, doxorubicin, and dexamethasone group (16.2%. The overall median progression-free survival was 34 months, with no statistically significant difference between the three groups. The overall median survival was not reached, and there was no significant difference between the three groups; the estimated five-year overall survival was 55%. Conclusion: Although the quality of responses appeared to be better with thalidomidecontaining regimens, these improvements did not translate into improved long-term outcomes. Given its track record, cyclophosphamide, thalidomide, and dexamethasone is currently considered the preferred regimen for first-line induction therapy in the

  6. Neoadjuvant chemotherapy and pathologic response: a retrospective cohort

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Diocésio Alves Pinto de [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Zucca-Matthes, Gustavo; Vieira, René Aloísio da Costa [Hospital de Câncer de Barretos, Barretos, SP (Brazil); Andrade, Cristiane Thomaz de Aquino Exel de [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Costa, Allini Mafra da [Hospital de Câncer de Barretos, Barretos, SP (Brazil); Monteiro, Aurélio Julião de Castro [Instituto Oncológico de Ribeirão Preto, Ribeirão Preto, SP (Brazil); Lago, Lissandra Dal [Institut Jules Bordet, Brussels (Belgium); Nunes, João Soares [Hospital de Câncer de Barretos, Barretos, SP (Brazil)


    To evaluate the complete pathologic response attained by patients diagnosed with locally advanced breast cancer submitted to neoadjuvant chemotherapy based on the doxorubicin/ cyclophosphamide regimen followed by paclitaxel. A retrospective cohort of patients with locally advanced breast cancer, admitted to the Hospital de Câncer de Barretos between 2006 and 2008 submitted to the doxorubicin/cyclophosphamide protocol followed by paclitaxel (4 cycles of doxorubicin 60mg/m{sup 2} and cyclophosphamide 600mg/m{sup 2} every 21 days; 4 cycles of paclitaxel 175mg/m{sup 2} every 21 days). The following variables were assessed: age, menopause, performance status, initial clinical staging, anthropometric data, chemotherapy (dose – duration), toxicity profile, post-treatment staging, surgery, pathologic complete response rate, disease-free survival, and pathological characteristics (type and histological degree, hormonal profile and lymph node involvement). Statistical analysis was performed using a 5% level of significance. Of the 434 patients evaluated, 136 were excluded due to error in staging or because they had received another type of chemotherapy. Median age was 50 years, all with performance status 0-1. Median initial clinical size of tumor was 65mm and the median final clinical size of the tumor was 22mm. Fifty-one (17.1%) patients experienced a pathologic complete response. Those with a negative hormonal profile or who were triple-negative (negative Her-2 and hormonal profile) experienced a favorable impact on the pathologic complete response. Neoadjuvant chemotherapy with doxorubicin/ cyclophosphamide followed by paclitaxel provided a pathologic complete response in the population studied in accordance with that observed in the literature. Triple-negative patients had a greater chance of attaining this response.

  7. Ginger effects on control of chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Seyyed Meisam Ebrahimi


    Full Text Available Background : Chemotherapy-induced nausea (CIN in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem. Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally four times a day (1 gr/d and the same samples from the placebo group received starch capsules (250 mg, orally for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software. Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively. Also, the intensity (P=0.0001 and number (P=0.0001 of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications. Conclusion: Consuming ginger root powder capsules (1 gr/d from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can

  8. Adherence to asthma controller medication regimens. (United States)

    Stempel, D A; Stoloff, S W; Carranza Rosenzweig, J R; Stanford, R H; Ryskina, K L; Legorreta, A P


    Improved adherence to inhaled corticosteroids (ICS) is recognized as an important factor in reduced morbidity, mortality and consumption of health care resources. The present study was designed to replicate previous reports of patient adherence with fluticasone/salmeterol in a single inhaler (FSC), fluticasone and salmeterol in separate inhalers (FP+SAL), fluticasone and montelukast (FP+MON), fluticasone alone (FP) and montelukast alone (MON). A 24-month observational retrospective study was conducted using administrative claims data. Subjects were 12 years old with 24 months of continuous enrollment; had 1 asthma claim (ICD-9: 493), 1 short-acting beta(2)-agonist claim, and 1 FSC, FP, SAL, or MON claim. Outcomes included asthma medication refill rates and persistence measured by treatment days. This study was designed with a unique population of patients with asthma from different health plans to validate previous findings. A total of 3,503 subjects were identified based on their index medication: FSC (996), FP+SAL (259), FP+MON (101), FP (1254) and MON (893). Mean number of prescription refills for FSC (3.98) was significantly higher than FP (2.29) and the FP component of FP+SAL (2.36), and FP+MON (2.15), P<0.05. No significant differences were observed between FSC and MON fill rates (4.33). Mean number of treatment days was greater for FSC compared to FP, FP+SAL, and FP+MON (P<0.0001). This study confirms a previous report that adherence profiles of fluticasone and salmeterol in a single inhaler are significantly better when compared to the controller regimens of fluticasone and salmeterol in separate inhalers, fluticasone and montelukast, or fluticasone alone and similar to montelukast alone.

  9. Castration-resistant prostate cancer (CRPC):the rise and fall of systemic chemotherapy. Shadows of recent phase 3 studies

    Institute of Scientific and Technical Information of China (English)

    Omar Abdel-Rahman


    Castration-resistant prostate cancer (CRPC) is defined as prostate cancer that recurs while a patient is receiving androgen deprivation therapy (ADT). Many treatment options have been suggested for this chal enging disease;starting from 2-year hormonal manipulations, mitoxantrne-and docetaxel-based regimens reaching to the overwhelming new systemic op-tions for CRPC (newer hormonal treatments, cytotoxic chemotherapies, bone-targeted agents and immunotherapeutics);and the question is:do the traditional cytotoxic regimens stil have a role amidst al these new options?

  10. Intensified dose-dense neoadjuvant chemotherapy using paclitaxel-gemcitabine and docetaxel-doxorubicin combinations for locally advanced breast cancer

    Directory of Open Access Journals (Sweden)

    I. V. Frai


    Full Text Available The developed chemotherapy (CT regimen with paclitaxel and gemcitabine with the interval being reduced between the cycles up to 2 weeks can shorten the time of preoperative treatment 1.5-fold and may be further investigated in the neoadjuvant CT for inoperable breast cancer. Intensified CT in the regimen of paclitaxel 175 mg/m2 one day, gemcitabine 2000 mg/m2 one day, docetaxel 70 mg/m2 one day + doxorubi- cin 60 mg/m2 one day + colony-stimulating factors every 2 weeks has a high clinical effectiveness and a satisfactory tolerability.

  11. Neutrophil dynamics during concurrent chemotherapy and G-CSF administration: Mathematical modelling guides dose optimisation to minimise neutropenia. (United States)

    Craig, Morgan; Humphries, Antony R; Nekka, Fahima; Bélair, Jacques; Li, Jun; Mackey, Michael C


    The choice of chemotherapy regimens is often constrained by the patient's tolerance to the side effects of chemotherapeutic agents. This dose-limiting issue is a major concern in dose regimen design, which is typically focused on maximising drug benefits. Chemotherapy-induced neutropenia is one of the most prevalent toxic effects patients experience and frequently threatens the efficient use of chemotherapy. In response, granulocyte colony-stimulating factor (G-CSF) is co-administered during chemotherapy to stimulate neutrophil production, increase neutrophil counts, and hopefully avoid neutropenia. Its clinical use is, however, largely dictated by trial and error processes. Based on up-to-date knowledge and rational considerations, we develop a physiologically realistic model to mathematically characterise the neutrophil production in the bone marrow which we then integrate with pharmacokinetic and pharmacodynamic (PKPD) models of a chemotherapeutic agent and an exogenous form of G-CSF (recombinant human G-CSF, or rhG-CSF). In this work, model parameters represent the average values for a general patient and are extracted from the literature or estimated from available data. The dose effect predicted by the model is confirmed through previously published data. Using our model, we were able to determine clinically relevant dosing regimens that advantageously reduce the number of rhG-CSF administrations compared to original studies while significantly improving the neutropenia status. More particularly, we determine that it could be beneficial to delay the first administration of rhG-CSF to day seven post-chemotherapy and reduce the number of administrations from ten to three or four for a patient undergoing 14-day periodic chemotherapy.

  12. Among once-daily regimens, single tablet regimens (STRs are associated with better adherence

    Directory of Open Access Journals (Sweden)

    R Murri


    Full Text Available Previous published evidences showed that taking HAART once-daily (OD is associated to better adherence when compared to BID or TID regimens. However, no further studies investigated whether, among OD regimens, adherence levels can be differently influenced. Aim of the study was to evaluate levels of self-reported adherence in HIV+ people according to type of HAART dosing (STR, OD with more than one pill or BID. To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. Self-perception of adherence was also investigated with a single item for comparison with real adherence behavior. Most of the subjects were males (66% with a mean age of 46 years, with higher education level (72% and a long history of HIV infection (mean 13.6 years. 17% of patients were on a first-line regimen. 21% reported to miss at least one dose during the past week (STR: 6%; OD >1 pill 23% and BID 21%; p<0.05. People taking STR and BID tend to report less discontinuations (all the drug of the day for at least 3 times in a month compared to OD>1 pill (6 and 4% vs 11%. People taking therapies other than HAART reported similar adherence levels of people taking only HAART, even when stratified for dosing groups. Even people judging their adherence as ‘optimal’ or ‘very good’, 10 and 17% respectively, reported having missed a dose during the last week. At stepwise regression model, optimal adherence was correlated to being male (OR: 2.38; 95% CI: 1.19–4.74, younger (OR: 3.04; 95% CI: 1.01–9.13 and with a shorter HIV infection (OR: 3.58; 95% CI: 1.04–12.38. People taking simpler once-daily STR tend to report better adherence than people taking OD>1 pill or BID. Perception of optimal adherence is largely

  13. Microvessel density and endothelial cell proliferation levels in colorectal liver metastases from patients given neo-adjuvant cytotoxic chemotherapy and bevacizumab

    DEFF Research Database (Denmark)

    Eefsen, Rikke Løvendahl; Engelholm, Lars Henning; Willemoe, Gro L.;


    The treatment of patients with colorectal liver metastasis has improved significantly and first line therapy is often combined chemotherapy and bevacizumab, although it is unknown who responds to this regimen. Colorectal liver metastases grow in different histological growth patterns showing diff...

  14. Cell of origin predicts outcome to treatment with etoposide-containing chemotherapy in young patients with high-risk diffuse large B-cell lymphoma

    DEFF Research Database (Denmark)

    Gang, Anne O; Pedersen, Mette Ø; Knudsen, Helle;


    Addition of etoposide to the R-CHOP chemotherapy regimen with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab (R-CHOEP) has resulted in improved survival in young patients with high-risk diffuse large B-cell lymphoma (DLBCL). It is not known whether biological factors can...

  15. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013

    Directory of Open Access Journals (Sweden)

    Xu H


    Full Text Available Hairong Xu,1 Lanfang Xu,2 John H Page,1 Kim Cannavale,2 Olivia Sattayapiwat,2 Roberto Rodriguez,3 Chun Chao2 1Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA; 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; 3Department of Hematology Oncology, Los Angeles Medical Center, Kaiser Permanente Southern California, Psadena, CA, USA Purpose: The purpose of this study was to evaluate and characterize the risk of anemia during the course of chemotherapy among patients with five common types of solid tumors. Patients and methods: Patients diagnosed with incident cancers of breast, lung, colon/rectum, stomach, and ovary who received chemotherapy were identified from Kaiser Permanente Southern California Health Plan (2010–2012. All clinical data were collected from the health plan’s electronic medical records. Incidence proportions of patients developing anemia and 95% confidence intervals were calculated overall and by anemia severity and type, as well as by stage at cancer diagnosis, and by chemotherapy regimen and cycle. Results: A total of 4,426 patients who received chemotherapy were included. Across cancers, 3,962 (89.5% patients developed anemia during the course of chemotherapy (normocytic 85%, macrocytic 10%, microcytic 5%; normochromic 47%, hyperchromic 44%, hypochromic 9%. The anemia grades were distributed as follows: 58% were grade 1, 34% grade 2, 8% grade 3, and <1% grade 4. The incidence of grade 2+ anemia ranged from 26.3% in colorectal cancer patients to 59.2% in ovarian cancer patients. Incidence of grade 2+ anemia increased from 29% in stage I to 49% in stage IV. Incidence of grade 2+ anemia varied from 18.2% in breast cancer patients treated with cyclophosphamide + docetaxel regimen to 59.7% in patients with ovarian cancer receiving carboplatin + paclitaxel regimen. Conclusion: The incidence of moderate-to-severe anemia (hemoglobin <10 g/dL remained considerably

  16. Meta-analysis of first-line therapies with maintenance regimens for advanced non-small-cell lung cancer (NSCLC) in molecularly and clinically selected populations. (United States)

    Tan, Pui San; Bilger, Marcel; de Lima Lopes, Gilberto; Acharyya, Sanchalika; Haaland, Benjamin


    Evidence has suggested survival benefits of maintenance for advanced NSCLC patients not progressing after first-line chemotherapy. Additionally, particular first-line targeted therapies have shown survival improvements in selected populations. Optimal first-line and maintenance therapies remain unclear. Here, currently available evidence was synthesized to elucidate optimal first-line and maintenance therapy within patient groups. Literature was searched for randomized trials evaluating first-line and maintenance regimens in advanced NSCLC patients. Bayesian network meta-analysis was performed within molecularly and clinically selected groups. The primary outcome was combined clinically meaningful OS and PFS benefits. A total of 87 records on 56 trials evaluating first-line treatments with maintenance were included. Results showed combined clinically meaningful OS and PFS benefits with particular first-line with maintenance treatments, (1) first-line intercalated chemotherapy+erlotinib, maintenance erlotinib in patients with EGFR mutations, (2) first-line afatinib, maintenance afatinib in patients with EGFR deletion 19, (3) first-line chemotherapy + bevacizumab, maintenance bevacizumab in EGFR wild-type patients, (4) chemotherapy+conatumumab, maintenance conatumumab in patients with squamous histology, (5) chemotherapy+cetuximab, maintenance cetuximab or chemotherapy + necitumumab, maintenance necitumumab in EGFR FISH-positive patients with squamous histology, and (6) first-line chemotherapy+bevacizumab, maintenance bevacizumab or first-line sequential chemotherapy+gefitinib, maintenance gefitinib in patients clinically enriched for EGFR mutations with nonsquamous histology. No treatment showed combined clinically meaningful OS and PFS benefits in patients with EGFR L858R or nonsquamous histology. Particular first-line with maintenance treatments show meaningful OS and PFS benefits in patients selected by EGFR mutation or histology. Further research is needed

  17. Comparison of efficacy of different route of administration of chemotherapy on unresectable, advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Zhang Caihua


    Full Text Available Abstract Background The aim of this study was to compare the efficacy of two neoadjuvant chemotherapies (FLEEOX and XELOX with different routes of administration for unresectable gastric cancer. Methods A total of 85 patients with unresectable gastric cancer hospitalized from January 2007 to December 2009 received neoadjuvant chemotherapy. The FLEEOX group (48 patients received the FLEEOX regimen(fluorouracil, leucovorin, http://epirubicin, epotoside, and oxaliplatin, which combined arterial with venous administration for one or two cycles, while the XELOX group (37 patients received XELOX (capecitabine plus oxaliplatin via venous administration for two to four cycles. The clinical response and overall survival of the two groups were compared. Results In the FLEEOX group, the clinical response rate (RR of chemotherapy was 85.4% (41 of 48 patients and the median survival time was 25 months. The 1-year and 2-year disease-free survival (DFS rates were 85.4% and 45.8%, respectively. In the XELOX group, the clinical RR was 59.5% and the median survival time was 9 months, while the 1-year and 2-year survival rates were 35.2% and 8.3%, respectively. The clinical RR, the R0 resection rate, the median survival time, and the 1-year and 2-year DFS rates were significantly better (P 0.05 in the FLEEOX group than in the XELOX group. In addition, there were no significant differences in the rates of toxic and adverse reactions or post-operative complications between the two groups. Conclusions For patients with a preoperative diagnosis of unresectable gastric cancer, the efficacy of the FLEEOX regimen, which combines arterial with venous administration, was better than that of the XELOX regimen, using venous administration only. This combination of arterial and venous administration could be useful for improving the efficacy of neoadjuvant chemotherapy for gastric cancer.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND : Eclampsia is one of the most important cause of maternal mortality and morbidity worldwide Dr . J . A . Pritchard in 1955 , introduced magnesium sulphate for control of convulsions in eclampsia and now magnesium sulfate is the anticonvulsant drug of choice for both prevention and treatment of eclampsia , but due to its narrow therapeutic window its dose - related toxicity is a major concern . Considering the lower body weight of Indian women than wes tern counter part , different low dose magnesium sulphate regime has been formulated in different parts of India and Bangladesh and these modifications appeared to reduce drug toxicity . The Objective was to compare the efficacy of low dose magnesium sulphat e regimen ( Dhaka regimen with standard Pritchard’s regimen for management of eclampsia . METHODS: This was a hospital based prospective study conducted in the Dept . of O & G of VSSMCH , Burla from Oct . 2012 to S ept . 2014 . Total 300 patients with eclampsia were included in study and randomly distributed into two groups containing 150 patients each in both Dhaka & Pritchard groups . The statistical software SPSS version 20 has been used for the analysis . An alpha error of 5% has been taken as significant . RESU LTS: In the present study , there is no recurrence of convulsion among both the groups . The Dhaka regimen was associated with significantly lower deep tendon reflex loss ( 2 . 67% vs 8 . 0%; P =0 . 040 , significantly lower total amount of Mgso4 requirement , and lower maternal mortality ( 3 . 33% vs 6 . 67%; P = 0 . 185 as compared with the standerd Pritchard regimen . CONCLUSIONS : The maternal morbidity and mortality in the present study were comparable to those of standard Pritchard’s regimen . The Dhaka regimen was equ ally effective and more safe for the management of eclampsia in a region where most women are of low body weight KEYWORDS: Antepartum E clampsia ; Magnesium S ulphate; Dhaka R egimen; Pritchard R

  19. Pulse-modulated second harmonic imaging microscope quantitatively demonstrates marked increase of collagen in tumor after chemotherapy (United States)

    Raja, Anju M.; Xu, Shuoyu; Sun, Wanxin; Zhou, Jianbiao; Tai, Dean C. S.; Chen, Chien-Shing; Rajapakse, Jagath C.; So, Peter T. C.; Yu, Hanry


    Pulse-modulated second harmonic imaging microscopes (PM-SHIMs) exhibit improved signal-to-noise ratio (SNR) over conventional SHIMs on sensitive imaging and quantification of weak collagen signals inside tissues. We quantify the spatial distribution of sparse collagen inside a xenograft model of human acute myeloid leukemia (AML) tumor specimens treated with a new drug against receptor tyrosine kinase (ABT-869), and observe a significant increase in collagen area percentage, collagen fiber length, fiber width, and fiber number after chemotherapy. This finding reveals new insights into tumor responses to chemotherapy and suggests caution in developing new drugs and therapeutic regimens against cancers.

  20. Sequential induction chemotherapy followed by radical chemo-radiation in the treatment of locoregionally advanced head-and-neck cancer


    Bhide, S A; M. Ahmed; Barbachano, Y; K Newbold; Harrington, K J; Nutting, C M


    We describe a retrospective series of patients with advanced head-and-neck cancer who were treated with induction chemotherapy followed by radical chemo-radiation. Patients treated with two cycles of induction chemotherapy followed by definitive chemo-radiation for squamous cell carcinoma of the head-and-neck region, from 2001 – 2006 at the Royal Marsden Hospital, formed the basis of this study. Cisplatin (75 mg m−2) on day 1 and 5-FU (1000 mg m−2) day 1 – 4 was the standard regimen used for ...

  1. Acute inferior ST segment elevation myocardial infarction due to chemotherapy in a young man with testicular cancer

    Directory of Open Access Journals (Sweden)

    Veysel Tosun


    Full Text Available Testicular cancer is the most common malignancy in men between 15 and 29 years of age. cisplatin, etoposide and bleomycin combination chemotherapy remains the mainstay of testicular cancer treatment. Acute myocardial infarction is a rare complication of these chemotherapeutics. In this case report, we present a case of 36-year-old male with acute inferior ST-segment elevation myocardial infarction after bleomycin injection. Because the patient had no significant risk factors for coronary artery disease, the infarction was likely caused by the chemotherapy regimen.

  2. The association between preoperative chemotherapy and the prevalence of hepatic steatosis in hepatectomy for metastatic colorectal cancer. (United States)

    Kalil, Antonio Nocchi; Coral, Gabriela Perdomo; Santos, Félix Antônio Insaurriaga dos; Gonzalez, Maria Cristina; Neutzling, Cristiane Becker


    Some studies have suggested that preoperative chemotherapy for hepatic colorectal metastases may cause hepatic injury and increase perioperative morbidity and mortality. To evaluate the prevalence of hepatic steatosis in patients undergoing preoperative chemotherapy for metastatic colorectal cancer. Observational retrospective cohort study in which 166 patients underwent 185 hepatectomies for metastatic colorectal cancer with or without associated preoperative chemotherapy from 2004 to 2011. The data were obtained from a review of the medical records and an analysis of the anatomopathological report on the non-tumor portion of the surgical specimen. The study sample was divided into two groups: those who were exposed and those who were unexposed to chemotherapy. From the hepatectomies, 136 cases (73.5%) underwent preoperative chemotherapy, with most (62.5%) using a regimen of 5-fluorouracil + leucovorin. A 40% greater risk of cell damage was detected in 62% of the exposed group. The predominant histological pattern of the cell damage was steatosis, which was detected in 51% of the exposed cases. Exposure to chemotherapy increased the risk of steatosis by 2.2 fold. However, when the risk factors were controlled, only the presence of risk of hepatopathy was associated with steatosis, with a relative risk of 4 (2.7-5.9). Patients exposed to chemotherapy have 2.2 times the risk of developing hepatic steatosis, and its occurrence is associated with the presence of predisposing factors such as diabetes mellitus and hepatopathy.

  3. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Song; Jian Liu; Li-Ya Zhou


    Objective:Helicobacterpylori (H.pylori) eradication remains a challenge with increasing antibiotic resistance.Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety.However,many issues on hybrid therapy are still unclear such as the eradication efficacy,safety,compliance,influencing factors,correlation with antibiotic resistance,and comparison with other regimens.Therefore,a comprehensive review on the evidence of hybrid therapy for H.pylori infection was conducted.Data Sources:The data used in this review were mainly from PubMed articles published in English up to September 30,2015,searching by the terms of"Helicobacterpylori" or "H.pylori",and "hybrid".Study Selection:Clinical research articles were selected mainly according to their level of relevance to this topic.Results:Totally,1871 patients of 12 studies received hybrid therapy.The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses.Compliance was 93.3-100.0%,overall adverse effects rate was 14.5-67.5%,and discontinued medication rate due to adverse effects was 0-6.7%.H.pylori culture and sensitivity test were performed only in 13.3% patients.Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible,isolated metronidazole or clarithromycin resistance,and dual clarithromycin and metronidazole resistance were 98.5%,97.6%,92.9%,and 80.0%,respectively.Overall,the efficacy,compliance,and safety of hybrid therapy were similar with sequential or concomitant therapy.However,hybrid therapy might be superior to sequential therapy in Asians.Conclusions:Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions.Dual clarithromycin and metronidazole resistance were the key factor to efficacy.Hybrid therapy was similar to sequential or concomitant therapy in the efficacy,safety,and compliance.

  4. Treatment of primary brain lymphoma without immune deficiency, The importance of chemotherapy before radiotherapy

    Directory of Open Access Journals (Sweden)

    Keihani M


    Full Text Available The purpose of this study was to find a more efficacious treatment for patients with primary central nervous system Lymphoma using chemotherapy. The objective was to determine the optimal time for radiotherapy treatment in relation to chemotherapy. Retrospective evaluation in patients with brain lymphoma was conducted from 1992 to 1998. Twenty-three patients were evaluated. Patients were divided into two groups based on the timing of radiotherapy in relation to the chemotherapy. The first group of patients (n=13 initially received radiotherapy followed by chemotherapy. Five of these patients receied classic CHOP (cyclophosphamide, Doxorubicine, Vincistine and Prednisone, six patients received Cis-platin (60 Megs/M2 and Etoposide (120 Megs/M2 and two patients received Cis-platin (60 Megs/M2, Etoposide (120 Megs/M2 and Cytarabine (600 Megs/M2 every 2 to 3 weeks. The second group of patients (Group II, n=10 received the followeing treatment regimen: a course of BCNU 120 Megs/M2 with Ifosfamide 1200 Megs/M2, Mesna and Etoposide 120 Megs/M2 on the first day of treatment (course A. Two weeks later, treatment was continued with a course of Cis-platin 35 Megs/M2 and Cytarabine 600 Megs/M2 (course B. The treatment was continued 14 days later with a course of Mitoxantron 12 Megs/M2, Ifosfamide 1200 Megs/M2 puls Mesna (course C. After the fourth week of chemotherapy, these patients received radiotherapy to the brain (5000 RADS in 4 weeks. During radiotherapy and at the beginning of course chemotherapy, intrathecal therapy with Methorexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemothotrexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemotherapy treatment was repeated to a total of 3 times. After complete clearance of the tumor determined by MRI and absence of tumor cells in the spinal fluid, the chemotherapeutic regimen was repeated one last time. The

  5. Phase II Trial of Improved Regimen with Gemcitabine in Patients 
with Advanced Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Lulu MIAO


    Full Text Available Background and objective Gemcitabine-platinum-combined with chemotherapy is the most common treatment for advanced non-small cell lung cancer (NSCLC. Gemcitabine is administered once a week in a general three-week schedule. In the present study, gemcitabine is administered on d1 and d5 to improve compliance, and the efficacy and safety of the improved regimen is evaluated in untreated patients with advanced NSCLC. Methods A total of 83 patients were enrolled between October 2007 and October 2009. In each cycle, gemcitabine was administered at a dose of 1,000 mg/m2-1,250 mg/m2 via a 30 min intravenous infusion on d1 and d5 followed by cisplatin at a dose of 75 mg/m2 or carboplatin (AUC=5 on d1 every three weeks. At least two cycles of chemotherapy were completed in each case, and clinical response and toxicity of the regimen were observed. Results The objective response rate was 37.3%. The median progression free survival and overall survival time were 6.1 months and 15.0 months, respectively. The one-year and two-year survival rates were 57.8% and 16.2%, respectively. Myelosuppression and gastrointestinal responses were the main toxicities. The incidence of grade 3/4 of leucopenia, hypohemia, and thrombocytopenia were 26.5%, 10.8% and 7.2%, respectively. A total of 27.5% of the patients in the cisplatin group had grade 3/4 gastrointestinal responses. Treatment related deaths were not observed in this study. Conclusion The regimen is active and well-tolerated in untreated patients with advanced NSCLC. Further randomized controlled studies are necessary.

  6. Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report

    Directory of Open Access Journals (Sweden)

    Kosuke Endo


    Full Text Available Hepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus.

  7. [Efficacy of Elental on prevention for chemotherapy-induced oral mucositis in colorectal cancer patients]. (United States)

    Ogata, Yutaka; Takeuchi, Masaaki; Ishibashi, Nobuya; Kibe, Shirou; Takahashi, Kenjirou; Uchida, Shinji; Murakami, Naotaka; Yahara, Toshirou; Shirouzu, Kazuo


    The present study was designed to evaluate the preventive effects of elemental diet Elental (ED) on chemotherapy-induced stomatitis in patients with colorectal cancer. A total of 23 patients with colorectal cancer experiencing grade 1-3 stomatitis during treatment with chemotherapy (2- or 3-week per cycle) entered the current study. Their average age was 67 years, ranging from 44 to 84 years. A total of 22 patients received the same chemotherapy regimen, but also received more than 80 g of Elental (ED) (including 1, 932 mg of L-glutamine), per day. FOLFOX, FOLFIRI or XELOX-based chemotherapy was used. A dose reduction of 5-FU, capacitabine or S-1 was performed in 5 patients who experienced grade 2 or 3 stomatitis. The maximum grade of stomatitis decreased in 18 of the 22 patients after the first treatment course, and decreased in 20 of 22 patients after the second course with ED.The preventive efficacy of ED on stomatitis was noted in a dose-dependent manner.Similarly, the maximum grade of neutropenia decreased in 10 of 11 patients after their first or second treatment course with ED. We conclude that ED can significantly decrease the severity of chemotherapy-induced stomatitis in colorectal cancer patients in association with the control of neutropenia.

  8. A target based approach identifies genomic predictors of breast cancer patient response to chemotherapy

    Directory of Open Access Journals (Sweden)

    Hallett Robin M


    Full Text Available Abstract Background The efficacy of chemotherapy regimens in breast cancer patients is variable and unpredictable. Whether individual patients either achieve long-term remission or suffer recurrence after therapy may be dictated by intrinsic properties of their breast tumors including genetic lesions and consequent aberrant transcriptional programs. Global gene expression profiling provides a powerful tool to identify such tumor-intrinsic transcriptional programs, whose analyses provide insight into the underlying biology of individual patient tumors. For example, multi-gene expression signatures have been identified that can predict the likelihood of disease reccurrence, and thus guide patient prognosis. Whereas such prognostic signatures are being introduced in the clinical setting, similar signatures that predict sensitivity or resistance to chemotherapy are not currently clinically available. Methods We used gene expression profiling to identify genes that were co-expressed with genes whose transcripts encode the protein targets of commonly used chemotherapeutic agents. Results Here, we present target based expression indices that predict breast tumor response to anthracycline and taxane based chemotherapy. Indeed, these signatures were independently predictive of chemotherapy response after adjusting for standard clinic-pathological variables such as age, grade, and estrogen receptor status in a cohort of 488 breast cancer patients treated with adriamycin and taxotere/taxol. Conclusions Importantly, our findings suggest the practicality of developing target based indices that predict response to therapeutics, as well as highlight the possibility of using gene signatures to guide the use of chemotherapy during treatment of breast cancer patients.

  9. Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy

    Directory of Open Access Journals (Sweden)

    Mathieu D. Saint-Pierre


    Full Text Available Introduction. Malignant pleural mesothelioma (MPM is associated with a poor prognosis. Palliative platinum-based chemotherapy may help to improve symptoms and prolong life. Since 2004, the platinum is commonly partnered with a folate antimetabolite. We performed a review investigating if survival had significantly changed before and after the arrival of folate antimetabolites in clinical practice. Methods. All MPM patients from January 1991 to June 2012 were identified. Data collected included age, gender, asbestos exposure, presenting signs/symptoms, performance status, histology, stage, bloodwork, treatment modalities including chemotherapy, and date of death or last follow-up. The primary endpoint was overall survival. Cox models were applied to determine variables associated with survival. Results. There were 245 patients identified. Median overall survival for all patients was 9.4 months. After multivariate analysis, performance status, stage, histology, leucocytosis, and thrombophilia remained independently associated with survival. Among all patients who received chemotherapy, there was no difference in overall survival between the periods before and after folate antimetabolite approval: 14.2 versus 13.2 months (P=0.35. Specifically receiving combined platinum-based/folate antimetabolite chemotherapy did not improve overall survival compared to all other chemotherapy regimens: 14.1 versus 13.6 months (P=0.97. Conclusions. In this review, we did not observe an incremental improvement in overall survival after folate antimetabolites became available.

  10. Relationship between BRCA1 Expression and Efifcacy of Platinum-based Chemotherapy in Colorectal Cancer

    Institute of Scientific and Technical Information of China (English)

    Xu Guanghui; Li Yu; Liu Yi


    Objective:To explore the expression of breast cancer susceptibility gene 1 (BRCA1) in human colorectal cancer and its correlation with efifcacy of platinum-based chemotherapy. Methods:A total of 78 samples from patients with colorectal cancer and receiving platinum-based chemotherapy were selected, and meanwhile 14 cases of normal colonic mucosa samples were selected as a normal control, 12 cases of non-cancerous tissue in colorectal cancer samples were selected as a pericarcinorma control. The expression of BRCA1 in these tissues was detected using immunohistochemical S-P method, and all patients treated with drugs were followed-up for survival time. Results: The positive rate of BRCA1 expression in colorectal cancer tissue was 52.6%, signiifcantly lower than that in the control groups. BRCA1 expression was closely associated with histological differentiation degrees (χ2=14.16,P=0.001), but not with the age, gender, local inifltration, lymph node metastasis and TNM staging. Comparing with those with positive BRCA1 expression, the patients with negative BRCA1 expression after oxaliplatin-based chemotherapy had signiifcantly longer disease-free survival (DFS) (P=0.032). Conclusion:Application of oxaliplatin-based chemotherapy in the patients with negative BRCA1 expression can obtain the survival beneift, and the level of BRCA1 expression can be useful in the selection of chemotherapy regimens and evaluation of prognosis for patients with colorectal cancer after surgery.

  11. Analysis of Efficacy of DICE (Dexamethasone, Ifosfamide,Cisplatin and Etoposide) Regimen on Recurrent and Refractory Intermediate and High Grade Non-Hodgkin's Lymphoma

    Institute of Scientific and Technical Information of China (English)

    Lei Yang; Zhucheng Song; Xiaohong Xu; Jinzhi Wei; Qinghe Tan; Zhirong Cong; Chunlei Peng


    OBJECTIVE Thus far there is no standard salvage regimen for patients with recurrent and refractory intermediate and high grade non-Hodgkin's lymphoma (NHL). This study intends to investigate the therapeutic efficacy of the DICE (dexamethasone, isofosfamide, cisplatin and etoposide) regimen on the recurrent and refractory NHL, and to observe the related adverse effects. METHODS Clinical records of 22 patients with recurrent and refractory NHL, who failed to achieve a remission from the CHOP [cyclophosphamide, hydroxydaunomycin/doxorubicin (adriamycin), oncovin, prednisone] regimen within 2 to 6 cycles of treatment, were reviewed. DICE, as a salvage regimen with a median course of treatment of 4 cycles (ranging from 2 to 7 cycles), was now used, and evaluation of the therapeutic efficacy and adverse effect of DICE was conducted in all the patients. Of the 22 NHL cases, 8 were of T-cell origin and the other 14 B-cell origin. Salvage treatment was performed in the patients, with appraisal, prevention and treatment of the toxic reactions. RESULTS Following DICE treatment in the 22 patients, the total effective rate of the regimen was 63.6%, and the complete remission (CR) rate was 40.9%. The effective rates of DICE on the T and B-cell sourced NHL were 75.0% and 57.1%, and the CR rate were 37.5%, 42.9%, respectively (P > 0.05). An increase of the lactate dehydrogenase (LDH) level accompanied by a giant lump was the short-term effect on patients with recurrence (mean P < 0.05) who were drug resistant. Myelosuppression, digestive system reaction and alopecia were the commonly-seen complications in the patients who Received DICE regimen. All patients recovered after treatment, and no chemotherapy-related death occurred. CONCLUSION DICE regimen is effective in treating refractory and recurrent NHL.

  12. Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel. (United States)

    Gu, Xi; Jia, Shi; Wei, Wei; Zhang, Wen-Hai


    Breast cancers (BC) are treated with surgery, radiotherapy, and chemotherapy. Neoadjuvant chemotherapy (NACT) is an emerging treatment option in many cancers and is given before primary therapy to shrink tumor size. The efficacy of NACT in varied settings of BC, such as inoperable tumors, borderline resectable tumors, and breast-conserving surgery, has been debated extensively in literature, and the results remain unclear and depended on a wide variety of factors such as cancer type, disease extent, and the specific combination of chemotherapy drugs. This study was performed to examine the efficacy, toxicity, and tolerability of pirarubicin (THP) and epirubicin (EPI) in combination with docetaxel and cyclophosphamide in a NACT setting for BC. A total of 48 patients with stage II or III breast cancers were randomly divided into two groups: THP group and EPI group. The patients in THP group received 2-4 cycles of neoadjuvant chemotherapy with DTC regimen (docetaxel, THP, cyclophosphamide), while patients in the EPI group received 2-4 cycles of DEC regimen (docetaxel, EPI, cyclophosphamide) before surgery. The incidence of adverse reactions and the efficacy of the treatment regimen were compared between the two groups. Prognostic evaluation indexes were estimated by Kaplan-Meier survival analysis, including the 5-year disease-free survival (DFS) and overall survival (OS). The overall response rate in THP group was 83.3 %, and the EPI group showed a response rate of 79.2 %, with no statistically significant difference in response rate between the two groups. The incidence of cardiac toxicity, myelosuppression, nausea, and vomiting in the THP group was significantly lower than the EPI group (all P < 0.05). The incidence of hepatic toxicity, alopecia, and diarrhea in the THP group was also lower than the EPI group, but these differences were not statistically significant. The 5-year DFS and OS in THP versus EPI groups were 80 versus 76 % (DFS) and 86 versus 81 % (OS

  13. Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Novin Nikbakhsh


    Full Text Available Background: Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL improvement of gastric patients receiving chemotherapy. Materials and Methods: This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients received olanzapine tablets (2.5–10 mg/day a day before the beginning of chemotherapy; in the 1st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V status. Results: All the recruited patients continued the allocated interventions (no lost to follow-up. N/V decreased in the case group, but the difference was not statistically significant (P = 0.438. The patients' appetite and body mass index increased (P = 0.006. Anxiety and depression subscales of HADS had significant differences between the two groups (P 0.05. No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05. Conclusion: Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

  14. The impact of pharmacist certification on the quality of chemotherapy in Japan. (United States)

    Suzuki, Shinya; Sakurai, Hiroomi; Kawasumi, Kenji; Tahara, Makoto; Saito, Shinichiro; Endo, Kazushi


    Background In the Japanese healthcare system, board certification not only maintains the quality of daily practice but is also required for hospitals to receive healthcare reimbursement. To date, no data on the effects of the board certification system in Japanese hospitals have been reported. Objective We performed a survey to clarify the impact of pharmacist certification on the quality of chemotherapy. Setting A nationwide mailing survey was conducted in Japan. Method We surveyed oncology pharmacists from 388 cancer designated hospitals (DHs) and 984 randomly selected general hospitals (GHs). Main outcome measure Multivariate analysis of factors for compliance with standard cancer chemotherapy to clarify the impact of pharmacist certification on the quality of chemotherapy. Results The response rate was 70.6 % (274/388) at the DHs and 43.4 % (428/984) at the GHs. Of the 13 different regimens, 66.1 % (181/274) of DHs and 64.7 % (277/428) of GHs reported having experienced either improper doses or intervals of drug administration. The median number of improper regimens was 1 at both the DHs (range 0-15) and GHs (range 0-22). We identified two groups of hospitals, those with two or more improper regimens and those with one improper regimen or less. Univariate analysis showed significant differences in the number of DHs (p < 0.01), performance of more than 10 chemotherapies per day (p < 0.05), presence of more than 400 beds (p < 0.01) and the professional qualifications of oncology pharmacists or medical oncologists. From multivariate analysis, significant differences were observed in certifications from the Japanese Society of Pharmacy Healthcare and Sciences certified Senior Oncology Pharmacist (odds ratio 0.29, p < 0.01) and the Japanese Society of Medical Oncology certified oncologist (odds ratio 0.48, p < 0.01). Conclusion Board certification was more prevalent in the designated (cancer specialist) hospitals than general hospitals and adherence to

  15. Breast Cancer Chemotherapy and Your Heart (United States)

    ... American Heart Association Cardiology Patient Page Breast Cancer Chemotherapy and Your Heart Christine Unitt , Kamaneh Montazeri , Sara ... cancer treatments. Breast cancer treatments include the following: Chemotherapy involves drugs that are intended to kill the ...

  16. Controlled-protein dietary regimens for Parkinson's disease. (United States)

    Cereda, Emanuele; Barichella, Michela; Pezzoli, Gianni


    Continuous levodopa replacement still is the most efficacious treatment for patients with Parkinson's disease. Unfortunately, the neutral aromatic amino acids contained in dietary proteins may compete with this drug for intestinal absorption and transport across the blood-brain barrier, thus limiting its efficacy and being responsible for the occurrence of motor fluctuations. Current guidelines recommend low-protein dietary regimens with protein redistribution, as shifting protein intake to the evening has proved to ameliorate the response to levodopa. However, adherence to this dietary regimen does not seem to be satisfactory and response is variable. Recent studies have shown that low-protein products designed for chronic renal failure patients are safe, tasty, well-tolerated and useful in improving both adherence to low-protein dietary regimens and levodopa-related motor fluctuations. However, there still is the need to define the selection criteria for the patients who may benefit the most from adherence to this regimen.

  17. What to Start: Selecting a First HIV Regimen (United States)

    HIV Treatment What to Start: Choosing an HIV Regimen (Last updated 2/24/2016; last reviewed 2/24/ ... of HIV medicines used to treat HIV infection. HIV treatment (also called antiretroviral therapy or ART) begins with ...

  18. Clinical Application of Magnetic Resonance Imaging in Management of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Jeon-Hor Chen


    Full Text Available Neoadjuvant chemotherapy (NAC, also termed primary, induction, or preoperative chemotherapy, is traditionally used to downstage inoperable breast cancer. In recent years it has been increasingly used for patients who have operable cancers in order to facilitate breast-conserving surgery, achieve better cosmetic outcome, and improve prognosis by reaching pathologic complete response (pCR. Many studies have demonstrated that magnetic resonance imaging (MRI can assess residual tumor size after NAC, and that provides critical information for planning of the optimal surgery. NAC also allows for timely adjustment of administered drugs based on response, so ineffective regimens could be terminated early to spare patients from unnecessary toxicity while allowing other effective regimens to work sooner. This review article summarizes the clinical application of MRI during NAC. The use of different MR imaging methods, including dynamic contrast-enhanced MRI, proton MR spectroscopy, and diffusion-weighted MRI, to monitor and evaluate the NAC response, as well as how changes of parameters measured at an early time after initiation of a drug regimen can predict final treatment outcome, are reviewed. MRI has been proven a valuable tool and will continue to provide important information facilitating individualized image-guided treatment and personalized management for breast cancer patients undergoing NAC.

  19. Changes in Pathological Complete Response Rates after Neoadjuvant Chemotherapy for Breast Carcinoma over Five Years

    Directory of Open Access Journals (Sweden)

    Daniel C. McFarland


    Full Text Available Historically, neoadjuvant chemotherapy (NACT was extrapolated from adjuvant regimens. Dual HER2 blockade and the introduction of carboplatin for triple negative breast cancers (TNBC emerged by December 2013 and have improved pathological complete response (pCR rates. The objective of this study was to assess the pCR rates before and after the introduction of these new neoadjuvant regimens. Materials and Methods. Stage I–III breast cancer patients who received NACT were analyzed for rates of pCR by clinical characteristics (i.e., age, BMI, axillary lymphadenopathy, and histologic subtype, by time period (1 = 3/2010–11/2013, 2 = 12/2013–3/2015, and by type of chemotherapy (e.g., anthracycline/taxane only, carboplatin-containing, and HER2 blockade. Results. 113 patients received NACT. Overall pCR rate was 26.5 percent (n=30. The pCR rate increased from 14% to 43.1% (p=0.001 from time period 1 to time period 2 and were associated with HER2 positivity (p=0.003, receiving treatment during time period 2 (p=0.001 and using an anthracycline/taxane plus additional agent type of regimen (p=0.004. Conclusions. Our study revealed a significant difference in rates of pCR over five years. Window of opportunity trials and other trials that utilize pCR analysis should be encouraged.

  20. Changes in Pathological Complete Response Rates after Neoadjuvant Chemotherapy for Breast Carcinoma over Five Years. (United States)

    McFarland, Daniel C; Naikan, Jessica; Rozenblit, Mariya; Mandeli, John; Bleiweiss, Ira; Tiersten, Amy


    Historically, neoadjuvant chemotherapy (NACT) was extrapolated from adjuvant regimens. Dual HER2 blockade and the introduction of carboplatin for triple negative breast cancers (TNBC) emerged by December 2013 and have improved pathological complete response (pCR) rates. The objective of this study was to assess the pCR rates before and after the introduction of these new neoadjuvant regimens. Materials and Methods. Stage I-III breast cancer patients who received NACT were analyzed for rates of pCR by clinical characteristics (i.e., age, BMI, axillary lymphadenopathy, and histologic subtype), by time period (1 = 3/2010-11/2013, 2 = 12/2013-3/2015), and by type of chemotherapy (e.g., anthracycline/taxane only, carboplatin-containing, and HER2 blockade). Results. 113 patients received NACT. Overall pCR rate was 26.5 percent (n = 30). The pCR rate increased from 14% to 43.1% (p = 0.001) from time period 1 to time period 2 and were associated with HER2 positivity (p = 0.003), receiving treatment during time period 2 (p = 0.001) and using an anthracycline/taxane plus additional agent type of regimen (p = 0.004). Conclusions. Our study revealed a significant difference in rates of pCR over five years. Window of opportunity trials and other trials that utilize pCR analysis should be encouraged.

  1. Single-tablet regimens (STRs enhance patients’ acceptability of HAART

    Directory of Open Access Journals (Sweden)

    F Maggiolo


    Full Text Available Patients’ acceptability of HAART is a subjective variable that may deeply influence therapeutic outcome. The feeling of the patient may alter adherence and lead to virologic failure. Acceptability may depend on various variables often difficulty evaluated by the care-giver. In a clinical setting the evaluation of acceptability is difficult, too, as patients may feel a judgement and be less sincere. Aim of this study was to asses adherence and acceptability of HAART. To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. In these notes we focus on this last patient-oriented outcome. Most of the subjects were males (66% with a mean age of 46 years, with higher education level (72% and a long history of HIV infection (mean 13.6 years. Consequently only 17% of patients were on a first-line regimen. Patients reporting a high or very high acceptability of HAART were 60% compared to a 31% reporting a fair grade of satisfaction and a 9% indicating low or null acceptability. However the type of the regimen significantly influenced patients’ acceptability. Single-tablet regimens (STRs, OD regimens with more than one tablet/day or BID regimens were scored as highly acceptable in 84%; 61%; and 53% of cases, respectively (P < 0.0001 (Figure. Statistical significance was retained when the dosing schedule was entered in a multivariate logistic model. When the analysis was restricted to experienced patients 62% of them were currently on a regimen based on a reduced number of pills compared to the previous one. Patients scored the previous regimen as more difficult to comply with in 72% of cases; as difficult in 22% and less difficult in 6%. The eventuality of AEs (40%; respect of timing of

  2. Chemotherapy of human african trypanosomiasis. (United States)

    Bacchi, Cyrus J


    Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  3. Chemotherapy of Human African Trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Cyrus J. Bacchi


    Full Text Available Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

  4. Managing Chemotherapy Side Effects: Diarrhea (United States)

    ... such as Pedialyte ® ••Tea (without caffeine) ••Water ••Applesauce ••Bananas ••Crackers ••Cream of wheat or rice cereal ••Eggs •• ... has a series of 18 Chemotherapy Side Effects Sheets at:

  5. Chemotherapy-associated recurrent pneumothoraces in lymphangioleiomyomatosis.

    LENUS (Irish Health Repository)

    Kelly, Emer


    Lymphangioleiomyomatosis is a rare cause of pneumothorax in women. We present the case of a 48-year-old woman with lymphangioleiomyomatosis, who had never had a pneumothorax prior to commencing chemotherapy for breast cancer. During chemotherapy she developed 3 pneumothoraces and 2 episodes of pneumomediastinum. We suggest that the pneumothoraces were caused by the chemotherapy. To our knowledge, this is the first reported case of chemotherapy triggering pneumothoraces in a woman with lymphangioleiomyomatosis.

  6. Chemotherapy and You: Support for People with Cancer (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Chemotherapy and You: Support for People With Cancer Chemotherapy ... ePub This booklet covers: Questions and answers about chemotherapy. Answers common questions, such as what chemotherapy is ...

  7. Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer

    Directory of Open Access Journals (Sweden)

    Geva R


    Full Text Available Ravit Geva,1,2 Loredana Vecchione,2 Sabine Tejpar,2 Hubert Piessevaux,3 Eric Van Cutsem,2 Hans Prenen21Gastrointestinal Malignancies Service, Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 2Department of Gastroenterology, Digestive Oncology Unit, University Hospitals Leuven, Leuven, Belgium; 3Department of Gastroenterology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumPurpose: The combination of chemotherapy and bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, is consistently being used as first- and second-line treatment in patients with metastatic colorectal cancer (mCRC. There is little data of the activity of bevacizumab in chemorefractory mCRC patients. The aim of this retrospective single center study was to evaluate the activity of bevacizumab combined with chemotherapy in this study population.Methods: Forty-six consecutive mCRC patients treated in the University Hospital Gasthuisberg (Leuven, Belgium receiving bevacizumab in advanced lines following failure of conventional chemotherapy were included in this study. Treatment regimen consisted of bevacizumab 5 mg/kg in combination with leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX or leucovorin, 5-fluorouracil, and irinotecan (FOLFIRI.Results: Bevacizumab plus chemotherapy was used in third-line treatment in eight (17% patients and in fourth-line treatment or more in 38 patients (83%. All patients previously failed irinotecan-based chemotherapy, 44 (96% failed oxaliplatin-based regimens, and 40 (87% failed treatment with cetuximab. Bevacizumab was given in combination with irinotecan-based chemotherapy in 36 patients, oxaliplatin-based chemotherapy in nine patients, and with single agent 5-fluorouracil in one patient. Objective response was demonstrated in ten patients (22% and disease control in 38 (83% with a median progression-free survival of 8.9 months and a median overall survival of 13.8 months. Only four

  8. Combined chemotherapy and radiation therapy in limited disease small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Moon Kyung; Ahn, Yong Chan; Park, Keun Chil; Lim Do Hoon; Huh, Seung Jae; Kim, Dae Yong; Shin, Kyung Hwan; Lee, Kyu Chan; Kwon, O Jung [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)


    This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer. Forty six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen (etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deliver 44 Gy using 10MV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylactic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved in 30 (65%) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50%), anemia in 17 (37%), thrombo-cytopenia in nine (20%), alopecia in nine (20%), nausea/vomiting in five (11%), and peripheral neuropathy in one (2%). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24%) out of the total 246 cycles. No radiation esophagitis over grade III was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The

  9. Chemotherapy-induced Fatigue among Jordanian Cancer Patients: What are the Contributing Factors?

    Directory of Open Access Journals (Sweden)

    Kholoud Abu Obead


    Full Text Available Background: The purposes of this study were to examine the impact of chemotherapy treatment on Jordanian cancer patients’ fatigue and to correlate their fatigue with selected sociodemographic variables at the beginning of treatment and after four weeks of treatment. Methods: This was a single group quasi-experimental correlational design study that enrolled 43 patients diagnosed with cancer who required chemotherapy treatment. Fatigue was measured according to the Piper Fatigue Scale (PFS before starting chemotherapy treatment and after four weeks of receiving the first dose of chemotherapy. Data were collected over a period of four weeks and analyzed with descriptive statistics, the paired-sample t-test, and Pearson product-moment correlation. Results: The study included 17 (39.5% males and 26 (60.5% females with a mean age of 45.98 years. Most (n=17 were diagnosed with breast cancer. Obesity was present in about 64.4% of patients. The majority (46% received an anthracycline-based regimen. There were statistically significant differences between respondents’ total mean scores of fatigue pre-treatment and four weeks following chemotherapy treatment (t= -2.31, df=42, P<0.05. In addition, significant differences were found in the scores for behavioral, affective, sensory, and cognitive dimensions subscales (t= -2.24, -2.19, - 2.4, -2.4, df=42, P<0.05 between pre-treatment and four weeks after receiving the first dose of chemotherapy treatment. We observed a significant negative relationship between fatigue scores and hemoglobin levels (r= -0.04, P<0.01. Conclusion: Cancer-related fatigue is common among cancer patients who received chemotherapy and result in substantial adverse physical, behavioral, cognitive and affective consequences for patient. Given the impact of fatigue, treatment options should be routinely considered in the care of patients with cancer.

  10. Effects of second and subsequent lines of chemotherapy for metastatic breast cancer. (United States)

    Park, In Hae; Lee, Keun Seok; Ro, Jungsil


    We assessed the effect of chemotherapy regimens beyond first-line agents on the clinical outcomes in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). We included 240 patients who were prospectively enrolled into various clinical trials and were receiving cytotoxic chemotherapy for HER2-negative MBC at the National Cancer Center, Korea, from October 2002 to September 2012. Clinicopathologic data were collected for the analysis. A total of 240, 209, and 166 patients received first-, second-, and third-line chemotherapy, respectively. The median age was 49 years (range, 28-77 years), and most had hormone receptor-positive cancer (n = 177; 73.8%). The median progression-free survival (PFS) was 7.6 months for first-line (PFS1) versus 5.1 months for second-line (PFS2) versus 3.6 months for third-line (PFS3) chemotherapy. The PFS from previous chemotherapy significantly affected subsequent PFS: PFS1 for PFS2, PFS1 ≥ 7.6 months, hazard ratio (HR) 0.647; 95% confidence interval (CI), 0.0.484-0.864 (P = .003); PFS2 for PFS3, PFS2 ≥ 5.1 months, HR 0.676; 95% CI, 0.0.484-0.944; P = .022). The median overall survival was 31.2 months (95% CI, 26.4-36.0 months). Hormone receptor positivity (HR 0.548; 95% CI, 0.261-0.499; P chemotherapy is justified in patients with MBC who benefited from previous chemotherapy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Successful adjuvant bi-weekly gemcitabine chemotherapy for pancreatic cancer without impairing patients’ quality of life

    Directory of Open Access Journals (Sweden)

    Toyama Yoichi


    Full Text Available Abstract Background Although adjuvant gemcitabine (GEM chemotherapy for pancreatic cancer is standard, the quality of life (QOL in those patients is still impaired by the standard regimen of GEM. Therefore, we studied whether mild dose-intensity adjuvant chemotherapy with bi-weekly GEM administration could provide a survival benefit with acceptable QOL to the patients with pancreatic cancer. Methods After a phase I trial, an adjuvant bi-weekly 1,000 mg/m2 of GEM chemotherapy was performed in 58 patients with pancreatic cancer for at least 12 courses (Group A. In contrast, 36 patients who declined the adjuvant bi-weekly GEM chemotherapy underwent traditional adjuvant 5FU-based chemotherapy (Group B. Careful periodical follow-ups for side effects of GEM and disease recurrence, and assessment of patients’ QOL using the EORTC QOL questionnaire (QLQ-C30 and pancreatic cancer-specific supplemental module (QLQ-PAN26 were performed. Retrospectively, the degree of side effects, patients’ QOL, compliance rate, disease-free survival (DFS, and overall survival (OS in Group A were compared with those in Group B. Results No severe side effects (higher than Grade 2 according to the common toxicity criteria of ECOG were observed, except for patients in Group B, who were switched to the standard GEM chemotherapy. Patients’ QOL was better in Group A than B (fatigue: 48.9 ± 32.1 versus 68.1 ± 36.3, nausea and vomiting: 26.8 ± 20.4 versus 53.7 ± 32.6, diarrhea: 21.0 ± 22.6 versus 53.9 ± 38.5, difficulty gaining weight: 49.5 ± 34.4 versus 67.7 ± 40.5, P P P Conclusions Adjuvant chemotherapy with bi-weekly GEM offered not only the advantage of survival benefits but the excellent compliance with acceptable QOL for postoperative pancreatic cancer patients.

  12. Integration of chemotherapy into current treatment strategies for brain metastases from solid tumors

    Directory of Open Access Journals (Sweden)

    Thamm Reinhard


    Full Text Available Abstract Patients with brain metastases represent a heterogeneous group where selection of the most appropriate treatment depends on many patient- and disease-related factors. Eventually, a considerable proportion of patients are treated with palliative approaches such as whole-brain radiotherapy. Whole-brain radiotherapy in combination with chemotherapy has recently gained increasing attention and is hoped to augment the palliative effect of whole-brain radiotherapy alone and to extend survival in certain subsets of patients with controlled extracranial disease and good performance status. The randomized trials of whole-brain radiotherapy vs. whole-brain radiotherapy plus chemotherapy suggest that this concept deserves further study, although they failed to improve survival. However, survival might not be the most relevant endpoint in a condition, where most patients die from extracranial progression. Sometimes, the question arises whether patients with newly detected brain metastases and the indication for systemic treatment of extracranial disease can undergo standard systemic chemotherapy with the option of deferred rather than immediate radiotherapy to the brain. The literature contains numerous small reports on this issue, mainly in malignant melanoma, breast cancer, lung cancer and ovarian cancer, but very few sufficiently powered randomized trials. With chemotherapy alone, response rates were mostly in the order of 20–40%. The choice of chemotherapy regimen is often complicated by previous systemic treatment and takes into account the activity of the drugs in extracranial metastatic disease. Because the blood-brain barrier is partially disrupted in most macroscopic metastases, systemically administered agents can gain access to such tumor sites. Our systematic literature review suggests that both chemotherapy and radiochemotherapy for newly diagnosed brain metastases need further critical evaluation before standard clinical

  13. Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes

    Directory of Open Access Journals (Sweden)

    Faiman B


    Full Text Available Beth Faiman, Jason Valent Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA Abstract: Improved understanding as to the biology of multiple myeloma (MM and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus requiring clinicians to become more astute in assessment, monitoring, and intervention of side effects as well as monitoring response to therapy. Appropriate diagnosis and monitoring strategies are essential to ensure that patients receive the appropriate chemotherapy and supportive therapy at relapse, and that side effects are appropriately managed to allow for continued therapy and adherence to the regimen. Multiple drugs with complex regimens are currently available with varying side effect profiles. Knowledge of the drugs used to treat MM and the common adverse events will allow for preventative strategies to mitigate adverse events and prompt intervention. The purpose of this paper is to review updates in the diagnosis and management of MM, and to provide strategies for assessment and monitoring of patients receiving chemotherapy for MM. Keywords: multiple myeloma, treatment, symptoms, assessment, monitoring, symptom management, targeted therapies

  14. Combination of Intensive Chemotherapy and Anticancer Vaccines in the Treatment of Human Malignancies: The Hematological Experience

    Directory of Open Access Journals (Sweden)

    Knut Liseth


    Full Text Available In vitro studies have demonstrated that cancer-specific T cell cytotoxicity can be induced both ex vivo and in vivo, but this therapeutic strategy should probably be used as an integrated part of a cancer treatment regimen. Initial chemotherapy should be administered to reduce the cancer cell burden and disease-induced immune defects. This could be followed by autologous stem cell transplantation that is a safe procedure including both high-dose disease-directed chemotherapy and the possibility for ex vivo enrichment of the immunocompetent graft cells. The most intensive conventional chemotherapy and stem cell transplantation are used especially in the treatment of aggressive hematologic malignancies; both strategies induce T cell defects that may last for several months but cancer-specific T cell reactivity is maintained after both procedures. Enhancement of anticancer T cell cytotoxicity is possible but posttransplant vaccination therapy should probably be combined with optimalisation of immunoregulatory networks. Such combinatory regimens should be suitable for patients with aggressive hematological malignancies and probably also for other cancer patients.

  15. Arterial occlusion precipitated by cisplatinbased chemotherapy



    Cisplatin-based therapy is curative in testicular cancer. Adverse effects of cisplatin-based chemotherapy include dose-dependent myelosuppression, nephrotoxicity, neurotoxicity, and ototoxicity. By contrast, chemotherapy-associated vascular complications are unpredictable. Few incidents of digital gangrene with cisplatin have been reported. Here, we present a patient who developed arterial occlusion leading to gangrene of the toe after cisplatinbased chemotherapy.

  16. Impact of Prophylactic Cranial Irradiation Timing on Brain Relapse Rates in Patients With Stage IIIB Non-Small-Cell Lung Carcinoma Treated With Two Different Chemoradiotherapy Regimens

    Energy Technology Data Exchange (ETDEWEB)

    Topkan, Erkan, E-mail: [Baskent University Adana Medical Faculty, Department of Radiation Oncology, Kisla Saglik Yerleskesi, Adana (Turkey); Parlak, Cem; Kotek, Ayse; Yuksel, Oznur [Baskent University Adana Medical Faculty, Department of Radiation Oncology, Kisla Saglik Yerleskesi, Adana (Turkey); Cengiz, Mustafa [Hacettepe University Medical Faculty, Oncology Hospital, Department of Radiation Oncology, Sihhiye, Ankara (Turkey); Ozsahin, Mahmut [University of Lausanne, University Hospital, Department of Radiation Oncology, Lausanne (Switzerland); Pehlivan, Berrin [Akdeniz University Medical Faculty, Department of Radiation Oncology, Antalya (Turkey)


    Purpose: To retrospectively assess the influence of prophylactic cranial irradiation (PCI) timing on brain relapse rates in patients treated with two different chemoradiotherapy (CRT) regimens for Stage IIIB non-small-cell lung cancer (NSCLC). Methods and Materials: A cohort of 134 patients, with Stage IIIB NSCLC in recursive partitioning analysis Group 1, was treated with PCI (30 Gy at 2 Gy/fr) following one of two CRT regimens. Regimen 1 (n = 58) consisted of three cycles of induction chemotherapy (ICT) followed by concurrent CRT (C-CRT). Regimen 2 (n = 76) consisted of immediate C-CRT during thoracic radiotherapy. Results: At a median follow-up of 27.6 months (range, 7.2-40.4), 65 patients were alive. Median, progression-free, and brain metastasis-free survival (BMFS) times for the whole study cohort were 23.4, 15.4, and 23.0 months, respectively. Median survival time and the 3-year survival rate for regimens 1 and 2 were 19.3 vs. 26.1 months (p = 0.001) and 14.4% vs. 34.4% (p < .001), respectively. Median time from the initiation of primary treatment to PCI was 123.2 (range, 97-161) and 63.4 (range, 55-74) days for regimens 1 and 2, respectively (p < 0.001). Overall, 11 (8.2%) patients developed brain metastasis (BM) during the follow-up period: 8 (13.8%) in regimen 1 and 3 (3.9%) in regimen 2 (p = 0.03). Only 3 (2.2%) patients developed BM at the site of first failure, and for 2 of them, it was also the sole site of recurrence. Median BMFS for regimens 1 and 2 were 17.4 (13.5-21.3) vs. 26.0 (22.9-29.1 months), respectively (p < 0.001). Conclusion: These results suggest that in Stage IIIB NSCLC patients treated with PCI, lower BM incidence and longer survival rates result from immediate C-CRT rather than ITC-first regimens. This indicates the benefit of earlier PCI use without delay because of induction protocols.

  17. Absolute neutrophil values in malignant patients on cytotoxic chemotherapy. (United States)

    Madu, A J; Ibegbulam, O G; Ocheni, S; Madu, K A; Aguwa, E N


    A total of eighty patients with various malignancies seen between September 2008 and April 2009 at the University of Nigeria Teaching Hospital (UNTH) Ituku Ozalla, Enugu, Nigeria, had their absolute neutrophil counts, done at Days 0 and 12 of the first cycle of their various chemotherapeutic regimens. They were adult patients who had been diagnosed of various malignancies, consisting of Breast cancer 36 (45%), Non-Hodgkin's lymphoma 8 (10%), Hodgkin's lymphoma 13 (16.25%), Colorectal carcinoma 6 (7.5%), Multiple myeloma 7 (8.75%), Cervical carcinoma 1 (1.25%) and other malignancies 9 (11.25%), Manual counting of absolute neutrophil count was done using Turks solution and improved Neubauer counting chamber and Galen 2000 Olympus microscope. The socio demographic data of the patients were assessed from a questionnaire. There were 27 males (33.75%) and 53 females (66.25%). Their ages ranged from 18 - 80 years with a median of 45 years. The mean absolute neutrophil count of the respondents pre-and post chemotherapy was 3.7 +/- 2.1 x 10(9)/L and 2.5 +/- 1.6 x 10(9)/L respectively. There were significant differences in both the absolute neutrophil count (p=0.00) compared to the pre-chemotherapy values. Chemotherapeutic combinations containing cyclophosphamide and Adriamycin were observed to cause significant reduction in absolute neutrophil.

  18. An Evidence Practice Gap in Antiemetic Prescription with Chemotherapy

    Directory of Open Access Journals (Sweden)

    Chepsy C-Philip


    Full Text Available Background: Chemotherapy induced nausea and vomiting is an added distress to patients burdened by the illness. In an effort to tackle the emetogenic potential of the agents, guidelines have been proposed to maintain uniformity in prescription and improvement in patient tolerance; but their utility and practice is not consistent. The aim of this clinical audit was to assess the antiemetic.practice and investigate the adherence to antiemetic clinical practice guidelineMethods: We performed an audit of the antiemetic practices in our tertiary referral centre. A.questionnaire based interview was completed at the outpatient visit to tabulate the dataResults: 99 (81.8% patients received chemotherapy of at least low emetogenic risk. 83 (84% patients received prophylaxis which was appropriate in 65% based on the our centre’s antiemetic regimen. This was however inappropriate in 76% of patients based on the international practice.parametersConclusions: Guidelines are not uniformly representative of all populations and modifications toguidelines based on local data are required to ensure success of such policies. There exist evidence-.practice gaps in antiemetic policies

  19. The chemotherapy of tuberculosis: past, present and future. (United States)

    Mitchison, D; Davies, G


    The history of the development of modern chemotherapy for tuberculosis (TB), largely due to the British Medical Research Council, is first described. There is a current need to shorten the duration of treatment and to prevent and cure drug-resistant disease. These aims will only be achieved if the way in which multidrug treatment prevents resistance from emerging and the reasons for the very slow response to chemotherapy are understood. Consideration of mutation rates to resistance and the size of bacterial populations in lesions makes it very unlikely that resistance would emerge spontaneously, leaving irregularity in drug taking and inadequate dosage as the main reasons for its occurrence. Slow response to treatment seems due to the presence of persister populations whose natural history is only partly known. In the future, we need to explore the persister state in patients and in experimental murine TB, and to take it into account in the design of future mouse experiments. The activity of rifamycins and pyrazinamide is being increased by a rise in rifamycin dosage and the inhalation of pyrazinoic acid. New drugs are gradually being brought into use, initially TMC207 and the nitroimadazoles, PA824 and OPC67683. They will need to be tested in new combination regimens for drug-susceptible and multi- and extensively drug-resistant disease.

  20. Merkel Cell Carcinoma: Chemotherapy and Emerging New Therapeutic Options

    Directory of Open Access Journals (Sweden)

    Laura Desch


    Full Text Available Merkel cell carcinoma (MCC is a rare neuroendocrine skin tumor that typically occurs in elderly, immunosuppressed patients. Infection with Merkel cell virus (MCV and immunosuppression play an important role in the development of MCC. Different staging systems make it difficult to compare the existing clinical data. Furthermore, there predominantly exist single case reports and case series, but no randomized controlled trials. However, it is necessary to develop further therapy options because MCC tends to grow rapidly and metastasizes early. In the metastatic disease, therapeutic attempts were made with various chemotherapeutic combination regimens. Because of the high toxicity of these combinations, especially those established in SCLC, and regarding the unsatisfying results, the challenge is to balance the pros and cons of chemotherapy individually and carefully. Up to now, emerging new therapy options as molecular-targeted agents, for example, pazopanib, imatinib, or somatostatin analogues as well as immunologicals, for example, imiquimod and interferons, also showed less success concerning the disease-free response rates. According to the literature, neither chemotherapy nor molecular-targeted agents or immunotherapeutic strategies have shown promising effects in the therapy of the metastatic disease of MCC so far. There is a great demand for randomized controlled studies and a need for an MCC registry and multicenter clinical trials due to the tumors curiosity.

  1. Pulmonary Fibrosis Secondary to FOLFOX Chemotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Wai Cheong Soon


    Full Text Available A 54-year-old female presented with a 2-week history of increasing shortness of breath and fever. She had a history of a poorly differentiated sigmoid adenocarcinoma for which she underwent an anterior resection 6 months prior to admission, followed by 12 cycles of adjuvant FOLFOX chemotherapy. The patient was treated for a severe community-acquired pneumonia; however, she remained hypoxic. A chest CT revealed extensive right-sided fibrotic changes, tractional dilatation of the airways and ground glass density, which had developed since a staging CT scan performed 2 months previously. Although her symptoms improved with steroid therapy, repeat imaging revealed that right hydropneumothorax had developed, and this required the insertion of a chest drain. Following its successful removal, the patient continues to improve clinically and radiographically. The rapid onset and nature of these changes is consistent with a drug-induced fibrotic lung disease secondary to FOLFOX chemotherapy. The phenomenon is underreported and yet, it is relatively common: it occurs in approximately 10% of patients who are treated with antineoplastic agents, although information specifically relating to FOLFOX-induced pulmonary toxicity is limited. It is associated with significant morbidity and mortality, but is often hard to differentiate from other lung conditions, making the diagnosis a challenge. Pulmonary toxicity is an important complication associated with antineoplastic agents. It should be considered in any patient on a chemotherapeutic regimen who presents with dyspnoea and hypoxia in order to try to reduce the associated morbidity and mortality.

  2. Risk of infection among patients with non-metastatic solid tumors or non-Hodgkin's lymphoma receiving myelosuppressive chemotherapy and antimicrobial prophylaxis in US clinical practice. (United States)

    Weycker, Derek; Chandler, David; Barron, Rich; Xu, Hairong; Wu, Hongsheng; Edelsberg, John; Lyman, Gary H


    Purpose Guidelines generally do not recommend oral antimicrobials for prophylaxis against chemotherapy-related infections in patients with solid tumors. Evidence on antimicrobial prophylaxis use, and associated chemotherapy-related infection risk, in US clinical practice is limited. Methods A retrospective cohort design and data from two US private healthcare claims repositories (2008-2011) were employed. Study population included adults who received myelosuppressive chemotherapy for non-metastatic cancer of the breast, colon/rectum, or lung, or for non-Hodgkin's lymphoma. For each subject, the first chemotherapy course was characterized, and within the first course, each chemotherapy cycle and chemotherapy-related infection episode was identified. Use of prophylaxis with oral antimicrobials and colony-stimulating factors in each cycle also was identified. Results A total of 7116 (22% of all) non-metastatic breast cancer, 1833 (15%) non-metastatic colorectal cancer, 1999 (15%) non-metastatic lung cancer, and 1949 (21%) non-Hodgkin's lymphoma patients received antimicrobial prophylaxis in ≥1 cycle. Mean number of antimicrobial prophylaxis cycles during the course among these patients was typically <2, with little difference across cancers and chemotherapy regimens. Fluoroquinolones were the most commonly received class of antimicrobials, accounting for 20%-50% all antimicrobials administered. Among subjects who received first-cycle antimicrobial prophylaxis, chemotherapy-related infection risk in that cycle ranged from 3% to 6% across cancer types. Among patients who received first-cycle antimicrobial prophylaxis and developed chemotherapy-related infections, 38%-67% required inpatient care. Chemotherapy-related infection risk in subsequent cycles with antimicrobial prophylaxis was comparable. Conclusion The results of this study suggest that use of antimicrobial prophylaxis during myelosuppressive chemotherapy is far from uncommon in clinical practice. The

  3. Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer

    DEFF Research Database (Denmark)

    Sternberg, Cora N; Donat, S Machele; Bellmunt, Joaquim


    To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review th...

  4. Effect of Suboptimal Chemotherapy on Preoperative Chemoradiation in Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hye; Kang, Hyun Cheol; Chie, Eui Kyu; Kang, Gyeong Hoon; Park, Jae Gahb; Oh, Do Youn; Im, Seock Ah; Kim, Tae You; Bang, Yung Jue; Ha, Sung Whan [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    To examine the effect of suboptimal chemotherapy in patients undergoing preoperative chemoradiotherapy for the treatment of rectal cancer. The medical records of 43 patients who received preoperative concurrent chemoradiotherapy, followed by radical surgery for the treatment of pathologically proven adenocarcinoma of the rectum from April 2003 to April 2006 were retrospectively reviewed. The delivered radiation dose ranged from 41.4 to 50.4 Gy. The standard group consisted of patients receiving two cycles of a 5-FU bolus injection for three days on the first and fifth week of radiotherapy or twice daily with capecitabine. The standard group included six patients for each regimen. The non-standard group consisted of patients receiving one cycle of 5-FU bolus injection for three days on the first week of radiotherapy. The non-standard group included 31 patients. Radical surgery was performed at a median of 58 days after the end of radiotherapy. A low anterior resection was performed in 36 patients, whereas an abdominoperineal resection was performed in 7 patients. No significant difference was observed between the groups with respect to pathologic responses ranging from grades 3 to 5 (83.3% vs. 67.7%, p=0.456), downstaging (75.0% vs. 67.7%, p=0.727), and a radial resection margin greater than 2 mm (66.7% vs. 83.9%, p=0.237). The sphincter-saving surgery rate in low-lying rectal cancers was lower in the non-standard group (100% vs. 75%, p=0.068). There was no grade 3 or higher toxicity observed in all patients. Considering that the sphincter-saving surgery rate in low-lying rectal cancer was marginally lower for patients treated with non-standard, suboptimal chemotherapy, and that toxicity higher than grade 2 was not observed in the both groups, suboptimal chemotherapy should be avoided in this setting.

  5. APC2 and CYP1B1 methylation changes in the bone marrow of acute myeloid leukemia patients during chemotherapy. (United States)

    Xia, Yongming; Hong, Qingxiao; Chen, Xiaoying; Ye, Huadan; Fang, Lili; Zhou, Annan; Gao, Yuting; Jiang, Danjie; Duan, Shiwei


    Aberrant promoter DNA methylation is a major mechanism of leukemogenesis in hematologic malignancies, including acute myeloid leukemia (AML). However, the association between promoter methylation with chemotherapeutic outcomes remains unknown. In the present study, bone marrow samples were collected prior to and following chemotherapy in 30 AML patients. Methylation-specific polymerase chain reaction technology was used to examine the promoter methylation status of adenomatous polyposis col 2 (APC2) and cytochrome P450 family 1 subfamily B polypeptide 1 (CYP1B1). The results revealed no change in the methylation status of the APC2 promoter in patients following various chemotherapy regimens. However, the methylation status of the CYP1B1 promoter changed in response to 6 different chemotherapy regimens. AML patients of the M3 subtype displayed an induction of the CYP1B1 promoter methylation levels more frequently (57.1%) than patients affected by the other subtypes (M1: 33.3%; M2: 12.5%; M4: 16.7%; M5: 0% and M6: 0%). In addition, a higher frequency of male patients (4/13) exhibited modulation of the CYP1B1 promoter methylation status compared with female patients (3/17). Furthermore, of five AML patients with a poor prognosis, two exhibited changes leading to CYP1B1 hypomethylation and two leading to CYP1B1 hypermethylation. By contrast, three other patients exhibited hypermethylation changes along with remission. This may be explained by the different chemotherapy regimens used to treat these patients or by other unknown factors. The present study revealed that CYP1B1 promoter methylation was induced during chemotherapy, whereas the APC2 promoter remained hemimethylated. Furthermore, the changes in CYP1B1 methylation were dependent on the AML subtypes and the gender of the patients.

  6. The clinical efficacy of a clarithromycin-based regimen for Mycobacterium avium complex disease: A nationwide post-marketing study. (United States)

    Kadota, Jun-Ichi; Kurashima, Atsuyuki; Suzuki, Katsuhiro


    The revised 2007 American Thoracic Society/Infectious Diseases Society of America statement recommend clarithromycin-based combination therapy for treatment of Mycobacterium avium complex lung disease and stipulates approximately 1 year of continuous treatment after bacilli negative conversion. However, supporting data are insufficient. Our objective was to obtain data on the clinical outcome of clarithromycin-based daily regimens by conducting a nationwide retrospective post-marketing study of M. avium complex lung disease. In accordance with the Japanese guidelines, patients were enrolled in this survey according to their chest radiographic findings and microbiologic test results. They were treated with a multidrug regimen including clarithromycin, rifampicin, and ethambutol (clarithromycin-based regimen) until bacilli negative conversion, and the treatment was continued for approximately 1 year after the initial conversion. Data were collected before administration, at the time of bacilli negative conversion, at the end of treatment, and at 6 months after the end of treatment. Of the 466 subjects enrolled in the study, 271 patients who received clarithromycin at 800 mg/day underwent evaluation for M. avium complex disease. The final bacilli negative conversion rate in those patients was 94.7%. The bacteriological relapse rate was 5.0% (5/100 patients). Bacteriological relapse was noted in patients treated for less than 15 months after conversion. No life-threatening or serious adverse drug reactions were observed. This study demonstrated that a clarithromycin-based daily regimen can yield a high bacteriological conversion rate in M. avium complex disease. After conversion, treatment for less than 15 months might be insufficient to prevent bacteriological relapse. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Sequential regimen of clofarabine, cytosine arabinoside and reduced-intensity conditioned transplantation for primary refractory acute myeloid leukemia (United States)

    Mohty, Mohamad; Malard, Florent; Blaise, Didier; Milpied, Noel; Socié, Gérard; Huynh, Anne; Reman, Oumédaly; Yakoub-Agha, Ibrahim; Furst, Sabine; Guillaume, Thierry; Tabrizi, Resa; Vigouroux, Stéphane; Peterlin, Pierre; El-Cheikh, Jean; Moreau, Philippe; Labopin, Myriam; Chevallier, Patrice


    The prognosis of patients with acute myeloid leukemia in whom primary treatment fails remains very poor. In order to improve such patients’ outcome, we conducted a phase 2, prospective, multicenter trial to test the feasibility of a new sequential regimen, combining a short course of intensive chemotherapy and a reduced intensity-conditioning regimen, before allogeneic stem-cell transplantation. Twenty-four patients (median age, 47 years) with acute myeloid leukemia in primary treatment failure were included. Cytogenetic risk was poor in 15 patients (62%) and intermediate in nine (38%). The sequential regimen consisted of clofarabine (30 mg/m2/day) and cytosine arabinoside (1 g/m2/day) for 5 days, followed, after a 3-day rest, by reduced-intensity conditioning and allogeneic stem-cell transplantation combining cyclophosphamide (60 mg/kg), intravenous busulfan (3.2 mg/kg/day) for 2 days and anti-thymocyte globulin (2.5 mg/kg/day) for 2 days. Patients in complete remission at day +120 received prophylactic donor lymphocyte infusion. Eighteen patients (75%) achieved complete remission. With a median follow-up of 24.6 months, the Kaplan-Meier estimate of overall survival was 54% (95% CI: 33–71) at 1 year and 38% (95% CI: 18–46) at 2 years. The Kaplan-Meier estimate of leukemia-free survival was 46% (95% CI: 26–64) at 1 year and 29% (95% CI: 13–48) at 2 years. The cumulative incidence of non-relapse mortality was 8% (95% CI: 1–24) at 1 year and 12% (95% CI: 3–19) at 2 years. Results from this phase 2 prospective multicenter trial endorsed the safety and efficacy of a clofarabine-based sequential reduced-toxicity conditioning regimen, which warrants further investigation. This study was registered at, identifier number: NCT01188174. PMID:27561720

  8. Treatment of Nausea and Vomiting During Chemotherapy. (United States)

    Mustian, Karen M; Devine, Katie; Ryan, Julie L; Janelsins, Michelle C; Sprod, Lisa K; Peppone, Luke J; Candelario, Grace D; Mohile, Supriya G; Morrow, Gary R


    Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.

  9. A retrospective analysis of efficacy and safety of adding bevacizumab to chemotherapy as first- and second-line therapy in advanced non-small-cell lung cancer (NSCLC). (United States)

    Quan, Rencui; Huang, Jiaxing; Chen, Nan; Fang, Wenfeng; Hu, Zhihuang; Zhan, Jianhua; Zhou, Ting; Zhang, Li; Zhang, Hongyu


    Several phase III clinical trials had authenticated that the addition of bevacizumab to paclitaxel plus carboplatin or gemcitabine plus cisplatin showed encouraging efficacy as first-line therapy for advanced NSCLC patients. However, the benefits of adding bevacizumab to other chemotherapy regimens in first- or second-line therapy have not been reported. To compare the clinical efficacy and safety of bevacizumab concomitant with chemotherapy regimens in patients with advanced NSCLC as first- or second-line therapy, we retrospectively reviewed the effects of adding bevacizumab to chemotherapy regimens in naive-chemotherapy and pre-chemotherapy patients with advanced non-squamous NSCLC. A total of 79 patients with advanced non-squamous NSCLC received at least two cycles of bevacizumab with chemotherapy between October 2010 and December 2013 were selected. Our primary end points were overall response rate (ORR) and disease control rate (DCR). The secondary objective was overall survival (OS) and safety. Seventy-nine patients were included in this study. Overall response rates at first evaluation (after 2 cycles) were 23.1 % (9/39) and 5.0 % (2/40) in first- and second-line therapy (P = 0.020), respectively. And disease control rates were 84.6 % (33/39) and 50 % (20/40), respectively (P = 0.001). The median OS were 27.2 months (95 % CI 13.3-41.1 months) and 29.6 months (95 % CI 6.7-52.5 months), respectively (P = 0.740). Grade 3-4 adverse events included leukopenia (2/39), and neutropenia (3/39) in first-line therapy versus neutropenia (1/40) and thrombocytopenia (2/40) in second-line treatment. In our experience, combination of bevacizumab and chemotherapy had encouraging anti-tumor efficacy as both first- and second-line therapy.

  10. A combined model of human erythropoiesis and granulopoiesis under growth factor and chemotherapy treatment. (United States)

    Schirm, Sibylle; Engel, Christoph; Loeffler, Markus; Scholz, Markus


    . Moreover, we modelled 15 different chemotherapeutic drugs by estimating their bone marrow toxicity. Taking into account different growth-factor schedules, this adds up to 33 different chemotherapy regimens explained by the model. We conclude that we established a comprehensive biomathematical model to explain the dynamics of granulopoiesis and erythropoiesis under combined chemotherapy, G-CSF, and EPO applications. We demonstrate how it can be used to make predictions regarding haematotoxicity of yet untested chemotherapy and growth-factor schedules.

  11. Hypofractionation regimens for stereotactic radiotherapy for large brain tumors. (United States)

    Yuan, Jiankui; Wang, Jian Z; Lo, Simon; Grecula, John C; Ammirati, Mario; Montebello, Joseph F; Zhang, Hualin; Gupta, Nilendu; Yuh, William T C; Mayr, Nina A


    To investigate equivalent regimens for hypofractionated stereotactic radiotherapy (HSRT) for brain tumor treatment and to provide dose-escalation guidance to maximize the tumor control within the normal brain tolerance. The linear-quadratic model, including the effect of nonuniform dose distributions, was used to evaluate the HSRT regimens. The alpha/beta ratio was estimated using the Gammaknife stereotactic radiosurgery (GKSRS) and whole-brain radiotherapy experience for large brain tumors. The HSRT regimens were derived using two methods: (1) an equivalent tumor control approach, which matches the whole-brain radiotherapy experience for many fractions and merges it with the GKSRS data for few fractions; and (2) a normal-tissue tolerance approach, which takes advantages of the dose conformity and fractionation of HSRT to approach the maximal dose tolerance of the normal brain. A plausible alpha/beta ratio of 12 Gy for brain tumor and a volume parameter n of 0.23 for normal brain were derived from the GKSRS and whole-brain radiotherapy data. The HSRT prescription regimens for the isoeffect of tumor irradiation were calculated. The normal-brain equivalent uniform dose decreased as the number of fractions increased, because of the advantage of fractionation. The regimens for potential dose escalation of HSRT within the limits of normal-brain tolerance were derived. The designed hypofractionated regimens could be used as a preliminary guide for HSRT dose prescription for large brain tumors to mimic the GKSRS experience and for dose escalation trials. Clinical studies are necessary to further tune the model parameters and validate these regimens.

  12. Microvessel density and endothelial cell proliferation levels in colorectal liver metastases from patients given neo-adjuvant cytotoxic chemotherapy and bevacizumab. (United States)

    Eefsen, Rikke Løvendahl; Engelholm, Lars; Willemoe, Gro L; Van den Eynden, Gert G; Laerum, Ole Didrik; Christensen, Ib Jarle; Rolff, Hans Christian; Høyer-Hansen, Gunilla; Osterlind, Kell; Vainer, Ben; Illemann, Martin


    The treatment of patients with colorectal liver metastasis has improved significantly and first line therapy is often combined chemotherapy and bevacizumab, although it is unknown who responds to this regimen. Colorectal liver metastases grow in different histological growth patterns showing differences in angiogenesis. To identify possible response markers, histological markers of angiogenesis were assessed. Patients who underwent resection of colorectal liver metastasis at Rigshospitalet, Copenhagen, Denmark from 2007 to 2011 were included (n = 254) including untreated and patients treated with chemotherapy or chemotherapy plus bevacizumab. The resected liver metastases were characterised with respect to growth pattern, endothelial and tumour cell proliferation as well as microvessel density and tumour regression. Tumour regression grade of liver metastases differed significantly between untreated/chemotherapy treated patients in comparison to chemotherapy plus bevacizumab treated patients (both p chemotherapy-treated patients (p = 0.006/p = 0.002). Tumour cell proliferation assessed by Ki67 expression correlated to a shorter recurrence free survival in the total patient cohort. In conclusion, liver metastases from patients treated with neo-adjuvant chemotherapy and bevacizumab had significantly lower microvessel densities and tumour regression grades when compared to liver metastases from untreated or chemotherapy treated patients. This may indicate that bevacizumab treatment results in altered vascular biology and tumour viability, with possible tumour reducing effect.

  13. Chemotherapy-induced monoamine oxidase expression in prostate carcinoma functions as a cytoprotective resistance enzyme and associates with clinical outcomes.

    Directory of Open Access Journals (Sweden)

    Ryan R Gordon

    Full Text Available To identify molecular alterations in prostate cancers associating with relapse following neoadjuvant chemotherapy and radical prostatectomy patients with high-risk localized prostate cancer were enrolled into a phase I-II clinical trial of neoadjuvant chemotherapy with docetaxel and mitoxantrone followed by prostatectomy. Pre-treatment prostate tissue was acquired by needle biopsy and post-treatment tissue was acquired by prostatectomy. Prostate cancer gene expression measurements were determined in 31 patients who completed 4 cycles of neoadjuvant chemotherapy. We identified 141 genes with significant transcript level alterations following chemotherapy that associated with subsequent biochemical relapse. This group included the transcript encoding monoamine oxidase A (MAOA. In vitro, cytotoxic chemotherapy induced the expression of MAOA and elevated MAOA levels enhanced cell survival following docetaxel exposure. MAOA activity increased the levels of reactive oxygen species and increased the expression and nuclear translocation of HIF1α. The suppression of MAOA activity using the irreversible inhibitor clorgyline augmented the apoptotic responses induced by docetaxel. In summary, we determined that the expression of MAOA is induced by exposure to cytotoxic chemotherapy, increases HIF1α, and contributes to docetaxel resistance. As MAOA inhibitors have been approved for human use, regimens combining MAOA inhibitors with docetaxel may improve clinical outcomes.

  14. Osteosarcoma: the addition of muramyl tripeptide to chemotherapy improves overall survival--a report from the Children's Oncology Group. (United States)

    Meyers, Paul A; Schwartz, Cindy L; Krailo, Mark D; Healey, John H; Bernstein, Mark L; Betcher, Donna; Ferguson, William S; Gebhardt, Mark C; Goorin, Allen M; Harris, Michael; Kleinerman, Eugenie; Link, Michael P; Nadel, Helen; Nieder, Michael; Siegal, Gene P; Weiner, Michael A; Wells, Robert J; Womer, Richard B; Grier, Holcombe E


    To compare three-drug chemotherapy with cisplatin, doxorubicin, and methotrexate with four-drug chemotherapy with cisplatin, doxorubicin, methotrexate, and ifosfamide for the treatment of osteosarcoma. To determine whether the addition of muramyl tripeptide (MTP) to chemotherapy enhances event-free survival (EFS) and overall survival in newly diagnosed patients with osteosarcoma. Six hundred sixty-two patients with osteosarcoma without clinically detectable metastatic disease and whose disease was considered resectable received one of four prospectively randomized treatments. All patients received identical cumulative doses of cisplatin, doxorubicin, and methotrexate and underwent definitive surgical resection of primary tumor. Patients were randomly assigned to receive or not to receive ifosfamide and/or MTP in a 2 x 2 factorial design. The primary end points for analysis were EFS and overall survival. In the current analysis, there was no evidence of interaction, and we were able to examine each intervention separately. The chemotherapy regimens resulted in similar EFS and overall survival. There was a trend toward better EFS with the addition of MTP (P = .08). The addition of MTP to chemotherapy improved 6-year overall survival from 70% to 78% (P = .03). The hazard ratio for overall survival with the addition of MTP was 0.71 (95% CI, 0.52 to 0.96). The addition of ifosfamide to cisplatin, doxorubicin, and methotrexate did not enhance EFS or overall survival for patients with osteosarcoma. The addition of MTP to chemotherapy resulted in a statistically significant improvement in overall survival and a trend toward better EFS.

  15. ABVE-PC and modified BEACOPP regimen in Indian children with Hodgkin lymphoma: Feasibility and efficacy

    Directory of Open Access Journals (Sweden)

    Somasundaram Jayabose


    Full Text Available Aims: To study the toxicity of ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide and modified-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide,vincristine, procarbazine, prednisone in intermediate-risk and high-risk Hodgkin lymphoma patients. Methods: High-risk patients received 4 cycles of modified-BEACOPP (m-BEACOPP plus 4 cycles of ABVD. Intermediate-risk patients received 4 cycles of ABVE-PC plus 2 cycles of ABVD. Results: From 2010 to 2014, 17 patients received 66 cycles of m-BEACOPP and 9 patients received 40 cycles of ABVE-PC. In the m-BEACOPP and ABVE-PC courses, respectively, significant thrombocytopenia (<50,000/mm3 occurred in 10.6% vs 0% of courses; anemia (Hb. <8 gm/dl in 27.3% vs 15%; neutropenia (ANC<500/mm3 in 46.9% vs 32.5%; and febrile neutropenia in 33.3% vs. 22.5%. Only episode of documented infection (hepatic abscess occurred in ABVE-PC. There were no episodes of sepsis, typhlitis or pneumonia in either group. All 26 patients are in remission with a median follow-up of 35 months (range, 17-61; and there have been no relapses. Two of 26 (7.7% patients failed to achieve rapid early response after 2 cycles and complete remission after 4 cycles of chemotherapy; both achieved remission with more intensive regimens followed by radiation. The remaining 24 patients did not receive radiation therapy. Conclusions: Both m-BEACOPP and ABVE-PC regimens have acceptable toxicity; and thus can be used in most centres with optimum supportive care facilities. They offer promising response rate and relapse free survival without the need for radiation therapy in most patients; and thus may be considered for children with high-risk and intermediate-risk Hodgkin lymphoma.

  16. Stem cell mobilization chemotherapy with gemcitabine is effective and safe in myeloma patients with bortezomib-induced neurotoxicity. (United States)

    Mueller, Beatrice U; Keller, Sandra; Seipel, Katja; Mansouri Taleghani, Behrouz; Rauch, Daniel; Betticher, Daniel; Egger, Thomas; Pabst, Thomas


    Vinorelbine chemotherapy with granulocyte-colony stimulating factor (G-CSF) stimulation is a widely applied non-myelosuppressive mobilization regimen in Switzerland for myeloma patients, but its neurotoxic potential limits its use in patients with bortezomib-induced polyneuropathy. In this single-center study, we alternatively evaluated safety and effectiveness of gemcitabine chemotherapy with G-CSF for mobilization of autologous stem cells. Between March 2012 and February 2013, all bortezomib-pretreated myeloma patients planned to undergo first-line high-dose melphalan chemotherapy received a single dose of 1250 mg/m2 gemcitabine, with G-CSF started on day 4. The 24 patients in this study had received a median of four cycles of bortezomib-dexamethason-based induction. Bortezomib-related polyneuropathy was identified in 21 patients (88%) by clinical evaluation and a standardized questionnaire. Administration of gemcitabine mobilization did not induce new or aggravate pre-existing neuropathy. Stem cell mobilization was successful in all 24 patients, with a single day of apheresis being sufficient in 19 patients (78%). The median yield was 9.51×10(6) CD34+ cells/kg. Stem collection could be accomplished at day 8 in 67%. Our data suggest that single-dose gemcitabine together with G-CSF is an effective mobilization regimen in myeloma patients and a safe alternative non-myelosuppressive mobilization chemotherapy for myeloma patients with bortezomib-induced polyneuropathy.

  17. Pulmonary blastoma: remission with chemotherapy

    DEFF Research Database (Denmark)

    Nissen, Mogens Holst; Jacobsen, M; Vindeløv, L


    A 59-year-old man with pulmonary blastoma, who had undergone right-sided pneumonectomy, had a relapse of the tumour 7 months later. Light-microscopic and ultrastructural studies were consistent with recurrence from the primary tumour. Cell kinetic studies revealed a high fraction of tumour cells ...... in the S-phase. Complete remission of the recurrence was obtained within 16 days after initiation of combination chemotherapy consisting of CCNU, vincristine, VP-16 and cyclophosphamide....

  18. Oxytocin regimen for labor augmentation, labor progression, and perinatal outcomes. (United States)

    Zhang, Jun; Branch, D Ware; Ramirez, Mildred M; Laughon, S Katherine; Reddy, Uma; Hoffman, Mathew; Bailit, Jennifer; Kominiarek, Michelle; Chen, Zhen; Hibbard, Judith U


    To examine the effects and safety of high-dose (compared with low-dose) oxytocin regimen for labor augmentation on perinatal outcomes. Data from the Consortium on Safe Labor were used. A total of 15,054 women from six hospitals were eligible for the analysis. Women were grouped based on their oxytocin starting dose and incremental dosing of 1, 2, and 4 milliunits/min. Duration of labor and a number of maternal and neonatal outcomes were compared among these three groups stratified by parity. Multivariable logistic regression and generalized linear mixed model were used to adjust for potential confounders. Oxytocin regimen did not affect the rate of cesarean delivery or other perinatal outcomes. Compared with 1 milliunit/min, the regimens starting with 2 milliunits/min and 4 milliunits/min reduced the duration of first stage by 0.8 hours (95% confidence interval 0.5-1.1) and 1.3 hours (1.0-1.7), respectively, in nulliparous women. No effect was observed on the second stage of labor. Similar patterns were observed in multiparous women. High-dose regimen was associated with a reduced risk of meconium stain, chorioamnionitis, and newborn fever in multiparous women. High-dose oxytocin regimen (starting dose at 4 milliunits/min and increment of 4 millliunits/min) is associated with a shorter duration of first-stage of labor for all parities without increasing the cesarean delivery rate or adversely affecting perinatal outcomes. II.

  19. Development of antibiotic regimens using graph based evolutionary algorithms. (United States)

    Corns, Steven M; Ashlock, Daniel A; Bryden, Kenneth M


    This paper examines the use of evolutionary algorithms in the development of antibiotic regimens given to production animals. A model is constructed that combines the lifespan of the animal and the bacteria living in the animal's gastro-intestinal tract from the early finishing stage until the animal reaches market weight. This model is used as the fitness evaluation for a set of graph based evolutionary algorithms to assess the impact of diversity control on the evolving antibiotic regimens. The graph based evolutionary algorithms have two objectives: to find an antibiotic treatment regimen that maintains the weight gain and health benefits of antibiotic use and to reduce the risk of spreading antibiotic resistant bacteria. This study examines different regimens of tylosin phosphate use on bacteria populations divided into Gram positive and Gram negative types, with a focus on Campylobacter spp. Treatment regimens were found that provided decreased antibiotic resistance relative to conventional methods while providing nearly the same benefits as conventional antibiotic regimes. By using a graph to control the information flow in the evolutionary algorithm, a variety of solutions along the Pareto front can be found automatically for this and other multi-objective problems.

  20. [Combination Therapy of Pregabalin with Tramadol for Treatment of Peripheral Neuropathy in Patients with Gynecological Cancer Receiving Taxane Containing Chemotherapy]. (United States)

    Nishikawa, Tadaaki; Hasegawa, Kosei; Shintani, Daisuke; Yano, Yuri; Sato, Sho; Yabuno, Akira; Kurosaki, Akira; Yoshida, Hiroyuki; Fujiwara, Keiichi


    Taxane-based regimens are often used in gynecologic cancer chemotherapy. Chemotherapy-induced peripheral neuropathy( CIPN)is one of the typical side effects caused by taxanes. Grade 2 or higher CIPN is observed in 5% to 30% of ovarian cancer patients who are treated with paclitaxel, which is recognized as one of the unmanageable side effects leading to treatment interruption. We retrospectively investigated the significance of combination therapy of pregabalin with tramadol for CIPN in patients with gynecological cancer. In the current study, 19 patients(19/22; 86%)were administered pregabalin with tramadol orally for at least 1week, and we observed improvement of the CIPN in 15 patients(15/19; 79%).We suggest that the combination therapy of pregabalin with tramadol has a positive impact on the CIPN in patients under a taxane-based chemotherapy.

  1. Symptoms in Children After Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sevcan Atay Turan


    Full Text Available Introduction: Identification of symptoms resulted from chemotherapy in children. Materials and Methods: In this study 46 children and adolescents who had chemotherapy in a pediatric oncology clinic of an oncology hospital were included. Sociodemographic questionnaire and Memorial Symptom Assessment Scale (10-18 years were used as data collection tool. Results: In this survey the mean age of children with cancer was 13.47±2.14 years and the majority of them (41.3% were monitored with non-Hodgkin’s lymphoma diagnosis. The most common symptoms in children who had chemotherapy in hospital were fatigue (76.1%, feeling nervous (69.6%, alopecia (65.2%, nausea (60.9% and feeling sad (60.9%, while the least common symptoms were swelling in the arms/legs (8.7% and problems in urination (6.5%. The most troublesome symptoms were dizziness (66.6%, difficulty in swallowing (64.3%, pain (47.8% and hair loss (43.4%. Conclusions: It was seen that the children still experience high prevalence of post-treatment symptoms, they had more intense psychological symptoms and physical symptoms caused more discomfort.

  2. Comparison of the efficacy and safety of S-1-based and capecitabine-based regimens in gastrointestinal cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xunlei Zhang

    Full Text Available PURPOSE: Oral fluoropyrimidine (S-1, capecitabine has been considered as an important part of various regimens. We aimed to evaluate the efficacy and safety of S-1-based therapy versus capecitabine -based therapy in gastrointestinal cancers. METHODS: Eligible studies were identified from Pubmed, EMBASE. Additionally, abstracts presented at American Society of Clinical Oncology (ASCO conferences held between 2000 and 2013 were searched to identify relevant clinical trials. The outcome included overall survival (OS, progression-free survival (PFS, overall response rate (ORR, disease control rate (DCR and advent events. RESULTS: A total of 6 studies (4 RCTs and 2 retrospective analysis studies containing 790 participants were included in this meta-analysis, including 401 patients in the S-1-based group and 389 patients in the capecitabine-based group. Results of our meta-analysis indicated that S-1-based and capecitabine-based regimens showed very similar efficacy in terms of PFS (HR 0.92, 95% CI 0.78-1.09, P = 0.360, OS (HR 1.01, 95% CI 0.84-1.21, P = 0.949, ORR (HR 1.04, 95% CI 0.87-1.25, P = 0.683 and DCR (HR 1.02, 95% CI 0.94-1.10, P = 0.639. There was also no significant difference in toxicity between regimens other than mild more hand-foot syndrome in capecitabine-based regimens. CONCLUSION: Both the S-1-based and capecitabine-based regimens are equally active and well tolerated, and have the potential of backbone chemotherapy regimen in further studies of gastrointestinal cancers.

  3. Second-line chemotherapy with irinotecan plus carmustine in glioblastoma recurrent or progressive after first-line temozolomide chemotherapy: a phase II study of the Gruppo Italiano Cooperativo di Neuro-Oncologia (GICNO). (United States)

    Brandes, Alba A; Tosoni, Alicia; Basso, Umberto; Reni, Michele; Valduga, Francesco; Monfardini, Silvio; Amistà, Pietro; Nicolardi, Linda; Sotti, Guido; Ermani, Mario


    Glioblastoma multiforme (GBM), the most frequent brain tumor in adults, is not considered chemosensitive. Nevertheless, there is widespread use of first-line chemotherapy, often with temozolomide, as a therapeutic option in patients with progressive disease after surgery and radiotherapy. However, at the time of second recurrence and/or progression, active and noncross-resistant chemotherapy regimens are required. The aim of the present multicenter phase II trial, therefore, was to ascertain the efficacy of second-line carmustine (BCNU) and irinotecan chemotherapy. Patients with histologically confirmed GBM, recurring or progressing after surgery, standard radiotherapy and a first-line temozolomide-based chemotherapy, were considered eligible. The primary end-point was progression-free survival at 6 months (PFS-6), and secondary end-points included response rate, toxicity, and survival. All patients were on enzyme-inducing antiepileptic prophylaxis. Chemotherapy consisted of BCNU (100 mg/m2 on day 1) plus irinotecan (175 mg/m2/weekly for 4 weeks), every 6 weeks, for a maximum of eight cycles. In the absence of grade 2 toxicity, the irinotecan dose was increased to 200 mg/m2. A total of 42 patients (median age, 53.4 years; median Karnofsky performance status, 80; range, 60 to 90) were included in the study. PFS-6 was 30.3% (95% CI, 18.5% to 49.7%). Median time to progression was 17 weeks (95% CI, 11.9 to 23.9). Nine partial responses (21.4%; 95% CI, 9% to 34%) were obtained. Toxicity was manageable. The BCNU plus irinotecan regimen seems active and non-cross-resistant in patients with GBM with recurrence after temozolomide-based chemotherapy.

  4. Late relapse of testicular cancer: Recurrence after 24 years and treatment with chemotherapy alone

    Directory of Open Access Journals (Sweden)

    Emre Akar


    Full Text Available Late relapse of testicular cancer, defined as >2 years interval between initial treatment and recurrence, is a rare disease with the incidence rate of 2.6%. Due to its chemoresistant features, treatment options of late relapses are controversial while surgical approach and cisplatin-based chemotherapies can be considered. We report here a patient with nonseminomatous germ cell tumor who experienced relapse 24 years after his first diagnosis. After detecting left supraclavicular lymphadenopathy and absence of any other malignant lesion in positron emission tomography-computerized tomography, patient was treated with three cycles of VeIP regimen (vinblastine/ifosfamide/cisplatin. Second complete response to this treatment was achieved with chemotherapy alone.

  5. Intravenous or oral administration of vinorelbine in adjuvant chemotherapy with cisplatin and vinorelbine for resected NSCLC

    DEFF Research Database (Denmark)

    Sorensen, Steffen Filskov; Carus, Andreas; Meldgaard, Peter


    OBJECTIVES: Cisplatin and vinorelbine given intravenously is a well-established adjuvant chemotherapy regimen after surgery for early-stage NSCLC. Vinorelbine can also be administered orally. However, the efficacy of orally administrated vinorelbine in adjuvant treatment of NSCLC is unknown. We...... assessed the overall survival (OS) and disease-free survival (DFS) of patients treated with adjuvant i.v. vinorelbine or p.o. vinorelbine, in combination with i.v. cisplatin. MATERIALS AND METHODS: We reviewed two time-separated cohorts of patients referred to the Department of Oncology at Aarhus...... University Hospital (Denmark) from 2005 to 2012 for adjuvant chemotherapy after surgery for NSCLC. RESULTS AND CONCLUSION: Of the 265 patients included in this study, 126 patients received i.v. and 139 received p.o. vinorelbine/cisplatin. The two groups were comparable with respect to important baseline...

  6. Treatment of refractory/relapsed adult acute lymphoblastic leukemia with bortezomib- based chemotherapy

    Directory of Open Access Journals (Sweden)

    Zhao J


    Full Text Available Junmei Zhao,* Chao Wang,* Yongping Song, Yuzhang Liu, Baijun FangHenan Key Lab of Experimental Haematology, Henan Institute of Haematology, Henan Tumor Hospital, Zhengzhou University, Zhengzhou, People’s Republic of China  *These authors contributed equally to this work Abstract: Nine pretreated patients aged >19 years with relapsed/refractory acute lymphoblastic leukemia (ALL were treated with a combination of bortezomib plus chemotherapy before allogeneic hematopoietic stem cell transplantation (allo-HSCT. Eight (88.9% patients, including two Philadelphia chromosome-positive ALL patients, achieved a complete remission. Furthermore, the evaluable patients have benefited from allo-HSCT after response to this reinduction treatment. We conclude that bortezomib-based chemotherapy was highly effective for adults with refractory/relapsed ALL before allo-HSCT. Therefore, this regimen deserves a larger series within prospective trials to confirm these results. Keywords: acute lymphoblastic leukemia, refractory, relapsed, bortezomib

  7. Systemic chemotherapy in muscle invasive and metastatic bladder cancer: present and future. (United States)

    Del Bene, Gabriella; Sternberg, Cora N


    Bladder cancer is the most frequent among the urothelial tumors, and it is responsible for about 2% of all cancer mortality worldwide. The mainstay of chemotherapy treatment, both for muscle-invasive and metastatic disease, is cisplatin-based regimens. In recent years, ground-breaking results have been achieved with immunotherapy, which have led to important breakthroughs in the bladder cancer treatment scenario, with the approval of several new agents. New insights derive from a greater characterization of the tumor genome, which could lead to developing new therapies, more personalized, in the near future.

  8. Safety evaluation of aprepitant for the prevention of chemotherapy-induced nausea and vomiting

    DEFF Research Database (Denmark)

    Ruhlmann, Christina H; Herrstedt, Jørn


    -drug interactions need to be considered before prescription. AREAS COVERED: This article thoroughly reviews aprepitant and, in particular, clinically relevant safety aspects of the drug. The literature review was performed using Medline with the following search terms: adverse events, aprepitant, chemotherapy, CYP3......A4, MK-0869, neurokinin(1) receptor antagonist, safety and tolerability. EXPERT OPINION: The recommended antiemetic regimen of aprepitant, a 5-HT(3) RA and a corticosteroid is safe. The combination of aprepitant, a 5-HT(3) RA and dexamethasone is now the gold standard of antiemetic treatment...

  9. Use of transdermal and intravenous granisetron and the ability of the Hesketh score to assess nausea and vomiting induced by multiday chemotherapy (United States)

    Boccia, Ralph V; Clark, Gemma; Howell, Julian D


    Purpose Hesketh scores define emetogenicity of single-agent and multiagent single-day chemotherapy. This analysis determined the emetogenicity of multiagent, multiday chemotherapy and the Granisetron Transdermal System (GTDS; Sancuso®). Methods This was a retrospective analysis of a multicenter, randomized, double-blind, phase III noninferiority trial of GTDS versus oral granisetron in patients receiving 3 days of multiagent moderately or highly emetogenic chemotherapy, regardless of granisetron formulation. Emesis was defined as vomiting/retching or the use of rescue medication. Logistic regression and classification trees were used to determine the optimal combination of Hesketh scores over the multiagent, multiday regimens for the prediction of emesis. Results Of 393 patients, 272 (69.2%) were chemotherapy naïve. The most common types of cancer were lung (30.5%) and gynecologic (21.9%). The most common chemotherapeutic regimen (in 14.2% of patients) was cisplatin plus etoposide on days 1–3. The best binary emesis predictor was day 1 Hesketh score. Patients with a day 1 Hesketh score of 5 had the highest rate of emesis (62.5%) versus patients with a score < 5 (31.7%). For patients with day 1 Hesketh score < 5, only 14.3% of those receiving only one drug on day 1 experienced emesis. Conclusion Hesketh emetogenicity scores of individual agents are applicable to multiday, multiagent chemotherapeutic regimens in patients receiving antiemetics. PMID:22904638

  10. Docetaxel plus cetuximab biweekly is an active regimen for the first-line treatment of patients with recurrent/metastatic head and neck cancer (United States)

    Posch, Doris; Fuchs, Hannah; Kornek, Gabriela; Grah, Anja; Pammer, Johannes; Aretin, Marie-Bernadette; Fuereder, Thorsten


    For patients with recurrent/metastatic (R/M) head and neck squamous cell carcinoma (SCCHN) limited therapeutic options exist. Only a subset of patients is suitable for combination chemotherapy regimens. Biweekly docetaxel plus cetuximab might be an alternative option. Thus, we performed this retrospective analysis in unselected patients in order to investigate the efficacy and safety of this regimen. Thirty-one patients receiving off protocol docetaxel (50 mg/m2) plus cetuximab (500 mg/m2) biweekly were included. Data collection included baseline demographic, response rate (ORR), disease control rate (DCR), overall survival (OS), progression free survival (PFS) as well as toxicity. OS and PFS were 8.3 months (95% CI 4.8-11.8) and 4.0 months (95% CI 1.0-7.0), respectively. Three (9.7%) patients achieved a complete response and one patient (3.2%) a partial response. The DCR was 41.9% and we observed an ORR of 12.9%. The one-year survival rate was 25.8%. The therapy was well tolerated and the most common grade 3/4 adverse events were neutropenia (19.4%), hypomagnesaemia (12.9%) and acne-like rash (9.7%). Biweekly cetuximab/docetaxel is an effective regimen and well tolerated in R/M SCCHN patients not suitable for platinum doublet treatment. Further evaluation of this regimen in prospective clinical trials is warranted.

  11. Addressing the questions of tomorrow: melphalan and new combinations as conditioning regimens before autologous hematopoietic progenitor cell transplantation in multiple myeloma. (United States)

    Martino, Massimo; Olivieri, Attilio; Offidani, Massimo; Vigna, Ernesto; Moscato, Tiziana; Fedele, Roberta; Montanari, Mauro; Console, Giuseppe; Gentile, Massimo; Messina, Giuseppe; Irrera, Giuseppe; Morabito, Fortunato


    The role of high-dose chemotherapy (HDC) followed by autologous-progenitor cell transplantation (auto-HPCT) in the treatment of multiple myeloma (MM) continues to evolve in the novel agent era. Administration of high-dose melphalan (HDM) is considered the standard conditioning regimen. Nevertheless, several attempts have recently been made to improve the conditioning phase of the HDC procedure. We reviewed all the reported experiences and illustrated current knowledge in the field of conditioning regimens. For fit MM patients, HDC followed by auto-HPCT remains the standard of care. The available data confirm that melphalan (MEL) 200 mg/m(2) should continue to be considered the gold standard conditioning regimen, with dose reduction based on age and renal function. Targeting exposure to MEL by using area under the curve is a particularly appealing approach that could be explored to maximize efficacy and minimize toxicity of this drug. Other strategies are currently being evaluated in different trials, and the most interesting areas of research involve the incorporation of newer agents like bortezomib (BOR) into conditioning regimens. Moreover, intravenous busulfan has become available and this formulation may reduce toxicity and result in greater efficacy in association with MEL-based conditioning.

  12. Analysis of CD34+ cell collection using two mobilization regimens for newly diagnosed multiple myeloma patients reveals the separate impact of mobilization and collection variables. (United States)

    Abuabdou, Ahmed; Rosenbaum, Eric R; Usmani, Saad Zafar; Barlogie, Bart; Cottler-Fox, Michele


    Mobilization regimens for CD34+ cells have generally been judged successful based on the number of cells collected without evaluating mobilization separately from collection. Using retrospective data for patients who collected CD34+ cells on Total Therapy protocols 3a/3b (VTD-PACE) and Total Therapy 4/5 using a novel regimen that added low dose melphalan to VTD-PACE (MVTD-PACE), we analyzed mobilization and collection variables separately. A significant difference favoring MVDT-PACE was found in mean CD34+ cells/µL on day 2 of collection and in mean ratio of CD34+ cells/µL on day 2 to day 1. However, because apheresis variables and growth factor dose during collection were manipulated to optimize individual collections, the two regimens were not significantly different when the mean total CD34+ cells ×10(6) /kg collected was compared. Thus, when evaluating a chemotherapy regimen or new growth factor for mobilization, it is important to realize that total CD34+ cells collected is dependent on both mobilization and collection variables.

  13. [Analysis of the therapeutic efficacy and prognosis for acute myeloid leukemia M2a patients treated by IA and DA regimens]. (United States)

    Wang, Fan; Yuan, Hai-Long; Duan, Xian-Lin; Wang, Lei; Cao, Hai-Zhou; Xu, Jian-Li; Qu, Jian-Hua


    This study was purposed to compare the therapeutic efficacy and prognosis of acute myeloid leukemia M2a (AML-M2a) patients treated by idarubicin (IDA) combined with cytarabine (Ara-C) (IA) and daunorubicin (DNR) combined cytarabine (Ara-C) (DA) regimens. The clinical data of 65 patients with AML-M2a in our hospital were collected from May 2009 to May 2013 and analyzed. The results indicated the complete remission in IA group was slightly higher than that in DA group, there was no statistically significant difference(P > 0.05); leukocyte minimum value in IA group [(0.58 ± 0.40)×10(9)/L] was obviously lower than that in DA group [(0.99 ± 0.67)×10(9)/L] (P DA group [(0.21 ± 0.16)×10(9)/L] (P DA group (9.17 ± 7.04)d (P DA group (21.45 months) (P DA regimen, the IA regimen can prolong the median survival time and has better long-term therapeutic efficacy, thus it can be used as the first chemotherapy regimen for treatment of AML-M2a.

  14. The role of induction chemotherapy before radiation therapy in non-operative management of stage III NSCLC. (United States)

    Green, M R


    Radiation therapy alone has been 'standard' management of patients with Stage III non-small cell lung cancer for several decades. Palliative benefits are routinely achieved but significant survival benefits have not been documented. Patterns of failure in Stage III patients emphasize the need to pursue better treatment for both local macroscopic disease and distant micrometastatic sites. Improved control in both areas will be necessary to meaningfully enhance outcome for the universe of Stage III NSCLC patients. Several randomized trials show a significant survival benefit when cisplatin-containing induction chemotherapy is administered prior to locoregional treatment. In the favorable subset of Stage III patients selected for study by CALGB, the surviving fraction at 2-5 years post-therapy was > or = 2-fold larger in the chemoradiation group than in the cohort treated with radiation alone. The French trial documented a significant decrease in distant metastases rate among the chemotherapy treated patients. In all the trials where patterns of failure are discussed, local disease persistence is the overwhelming rule. Future trials must evaluate improved induction chemotherapy approaches. Stage III patients are an ethical population in which to test induction therapy with new drug combinations randomized against already 'active' regimens for comparative efficacy. End points would be initial response rates, patterns of failure, and overall survival. The feasibility of high-dose chemotherapy regimens with growth factor and hematopoietic support followed by aggressive radiation must be tested. If feasible, trials randomizing high dose versus conventional dose induction programs within the context of sequential multimodality therapy should follow. Intensified radiation approaches such as hyperfractionation or CHART should be paired with active concurrent chemotherapy following induction chemotherapy alone. Pursuit of these approaches over the next several years will

  15. What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis. (United States)

    Zhao, Jianli; Liu, Jieqiong; Chen, Kai; Li, Shunrong; Wang, Ying; Yang, Yaping; Deng, Heran; Jia, Weijuan; Rao, Nanyan; Liu, Qiang; Su, Fengxi


    To evaluate the incidence of chemotherapy-induced amenorrhea (CIA) and its therapeutic impact in premenopausal breast cancer patients. A systematic search was performed to identify clinical studies that compared the incidence of CIA with different chemotherapy regimens and oncological outcomes with and without CIA. The fixed-effects and random-effects models were used to assess the pooled estimates. Heterogeneity and sensitivity analyses were performed to explore heterogeneity among studies and to assess the effects of study quality. A total of 15,916 premenopausal breast cancer patients from 46 studies were included. The cyclophosphamide-based regimens, taxane-based regimens, and anthracycline/epirubicin-based regimens all increased the incidence of CIA with pooled odds ratios of 2.25 (95 % CI 1.26-4.03, P = 0.006), 1.26 (95 % CI 1.11-1.43, P = 0.0003) and 1.39 (95 % CI 1.15-1.70, P = 0.0008), respectively. The three-drug combination regimens of cyclophosphamide,anthracycline/epirubicin, and taxanes (CAT/CET) caused the highest rate of CIA compared with the other three drug combinations (OR 1.41, 95 % CI 1.16-1.73, P = 0.0008). Tamoxifen therapy was also correlated with a higher incidence of CIA, with an OR of 1.48. Patients with CIA were found to exhibit better disease-free survival (DFS) and overall survival (OS) compared with patients without CIA. With respect to molecular subtype, this DFS advantage remained significant in hormone-sensitive patients (HR 0.61, 95 % CI 0.52-0.72, P < 0.00001). The current meta-analysis has demonstrated that anthracycline/epirubicin, taxanes, cyclophosphamide, and tamoxifen all contributed to elevated rates of CIA, and CIA was not merely a side effect of chemotherapy but was a better prognostic marker, particularly for ER-positive premenopausal early-stage breast cancer patients. However, this topic merits further randomized control studies to detect the associations between CIA and patient prognosis after adjusting for age, ER

  16. Randomised Trial Comparing Two Combination Chemotherapy Regimens (HEXA-CAF VS CHAP-5) In Advanced Ovarian Carcinoma

    NARCIS (Netherlands)

    Neijt, J.P.; Vriesendorp, R.; Burg, M.E.L. van der; Lindert, A.C.M. van; Lent, M.; Oosterom, A.T. van; Kooyman, C.D.; Hamerlynck, J. V. T. H.; Houwelingen, J.C. van; Pinedo, H.M.; Bokkel Huinink, W.W. ten


    186 patients with advanced epithelial ovarian carcinoma were treated with either a combination of hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil (Hexa-CAF) or cyclophosphamide and hexamethylmelamine alternating with doxorubicin and a 5-day course of cisplatin (CHAP-5). Treatm

  17. [Combination chemotherapy of S-1, docetaxel and CDDP produces a remarkable response in a patient with metastases of supraclavicular lymph nodes and gingival carcinoma of the mandible]. (United States)

    Ishii, Shoichiro; Ueda, Takashi; Higuchi, Masataka; Mima, Takashi; Yakushiji, Noboru


    We report a 53-year-old female patient with an unresectable metastasis to the supraclavicular lymph node from a primary gingival carcinoma of the mandible. The patient had a history of tongue carcinoma and had undergone a radical neck dissection for the treatment of gingival carcinoma. She underwent combined chemotherapy consisting of S-1 (80 mg on days 1-14, followed by a 7-day rest), docetaxel (35mg/m2 by intravenous infusion on days 1 and 8), and CDDP (10mg/m2 by intravenous infusion on days 1 and 8) every 3 weeks. After three courses of the above chemotherapy regimen, a computerized tomography examination revealed a complete response. The patient did not experience any severe side effects during the course of chemotherapy. Combined S-1, docetaxel, and CDDP chemotherapy can thus be effective for unresectable recurrences of oral cancer in lymph nodes.

  18. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. (United States)

    Necchi, A; Miceli, R; Bregni, M; Bokemeyer, C; Berger, L A; Oechsle, K; Schumacher, K; Kanfer, E; Bourhis, J H; Massard, C; Laszlo, D; Montoro, J; Flechon, A; Arpaci, F; Secondino, S; Wuchter, P; Dreger, P; Crysandt, M; Worel, N; Kruger, W; Ringhoffer, M; Unal, A; Nagler, A; Campos, A; Wahlin, A; Michieli, M; Sucak, G; Donnini, I; Schots, R; Ifrah, N; Badoglio, M; Martino, M; Raggi, D; Giannatempo, P; Rosti, G; Pedrazzoli, P; Lanza, F


    Little is known about the prognostic impact of prior paclitaxel therapy and response to induction chemotherapy defined as the regimen preceding high-dose chemotherapy (HDCT) for the salvage therapy of advanced germ cell tumors. Twenty European Society for Blood and Marrow Transplantation centers contributed data on patients treated between 2002 and 2012. Paclitaxel used in either prior lines of therapy or in induction-mobilization regimens was considered. Multivariable Cox analyses of prespecified factors were undertaken on PFS and overall survival (OS). As of October 2013, data for 324 patients had been contributed to this study. One hundred and ninety-two patients (59.3%) had received paclitaxel. Sixty-one patients (19%) had a progression to induction chemotherapy, 234 (72%) a response (29 (9%) missing or granulocyte colony-stimulating factor without chemotherapy). Both progression to induction chemotherapy and prior paclitaxel were significantly associated with shorter OS univariably (P<0.001 and P=0.032). On multivariable analysis from the model with fully available data (N=216) progression to induction was significantly prognostic for PFS and OS (P=0.003), but prior paclitaxel was not (P=0.674 and P=0.739). These results were confirmed after multiple imputation of missing data. Progression to induction chemotherapy could be demonstrated as an independent prognostic factor, in contrast to prior paclitaxel.

  19. Efficacy of carboplatin-based preoperative chemotherapy for triple-negative breast cancer (United States)

    Wang, Li-Yang; Xie, Hua; Zhou, Hang; Yao, Wen-Xiu; Zhao, Xin; Wang, Yi


    Objectives: To evaluate the efficacy and safety of carboplatin-based preoperative chemotherapy in triple-negative breast cancer patients (TNBC). Methods: PubMed, EMBASE, the Web of Science, the Cochrane Library, major clinical trial registries, and abstract collections from major international meetings were systematically searched for relevant randomized controlled trials. Endpoints included rates of pathologic complete response (pCR), overall response (ORR), breast-conserving surgery (BCS) and toxicity. Pooled relative risk (RR) was calculated for each endpoint using a fixed- or random-effect model depending on the heterogeneity among included studies. Results: A total of 5 randomized controlled trials involving 1007 patients were included in the meta-analysis. Carboplatin-based chemotherapy was associated with a pooled pCR rate of 53.3%, which was significantly higher than the rate associated with non-carboplatin therapy (37.8%, RR: 1.41, 95% confidence interval [CI]: 1.23 to 1.62, p<0.00001). Compared with non-carboplatin therapy (48.1%), carboplatin-based chemotherapy increased BCS rate (59.7%, RR: 1.24, 95% CI: 1.06 to 1.46, p=0.007). Carboplatin-based chemotherapy was associated with similar ORR as non-carboplatin therapy. Carboplatin-based chemotherapy was associated with higher incidence of grade 3 or 4 anemia, neutropenia, febrile neutropenia, and thrombocytopenia than non-carboplatin therapy, while the 2 regimens were associated with similar incidence of fatigue, leucopenia, and nausea/vomiting. Conclusion: The available evidence suggests that carboplatin-based preoperative chemotherapy is associated with significantly better pCR and BCS rates than non-carboplatin-based therapy in TNBC patients. PMID:28042625

  20. Maintenance Chemotherapy for Advanced Non–Small-Cell Lung Cancer: New Life for an Old Idea (United States)

    Gerber, David E.; Schiller, Joan H.


    Although well established for the treatment of certain hematologic malignancies, maintenance therapy has only recently become a treatment paradigm for advanced non–small-cell lung cancer. Maintenance therapy, which is designed to prolong a clinically favorable state after completion of a predefined number of induction chemotherapy cycles, has two principal paradigms. Continuation maintenance therapy entails the ongoing administration of a component of the initial chemotherapy regimen, generally the nonplatinum cytotoxic drug or a molecular targeted agent. With switch maintenance (also known as sequential therapy), a new and potentially non–cross-resistant agent is introduced immediately on completion of first-line chemotherapy. Potential rationales for maintenance therapy include increased exposure to effective therapies, decreasing chemotherapy resistance, optimizing efficacy of chemotherapeutic agents, antiangiogenic effects, and altering antitumor immunity. To date, switch maintenance therapy strategies with pemetrexed and erlotinib have demonstrated improved overall survival, resulting in US Food and Drug Administration approval for this indication. Recently, continuation maintenance with pemetrexed was found to prolong overall survival as well. Factors predicting benefit from maintenance chemotherapy include the degree of response to first-line therapy, performance status, the likelihood of receiving further therapy at the time of progression, and tumor histology and molecular characteristics. Several aspects of maintenance therapy have raised considerable debate in the thoracic oncology community, including clinical trial end points, the prevalence of second-line chemotherapy administration, the role of treatment-free intervals, quality of life, economic considerations, and whether progression-free survival is a worthy therapeutic goal in this disease setting. PMID:23401441

  1. Adjuvant chemotherapy (Nedaplatin/UFT) after radiotherapy for locallu advanced head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Akira; Furukawa, Madoka; Kawano, Toshiro; Yamashita, Kohsuke; Sugiyama, Masato [Kanagawa Cancer Center (Japan)


    To evaluate the toxicity and efficacy of adjuvant chemotherapy after radiotherapy for patients with locally advanced head and neck squamous cancer, 40 patients, previously untreated (6 with stage III and 34 with stage IV; 26 with resectable, 10 with unresectable and 4 patients with inoperable) were treated with radiotherapy followed by adjuvant chemotherapy (Nedaplatin /tegafur-uracil (UFT)) at our outpatient clinic. The primary site was identified in the larynx or hypopharynx in 15, oral cavity or oropharynx in 11, sinuses in 6, nasopharynx in 4, unknown primary in 3, and parotis in 1 patient. Treatment consisted of 6 courses of Nedaplatin 80 mg/m{sup 2} repeated at 4 weeks intervals, and one-year oral administration of UFTE 400mg/day, after radiotherapy. Toxicities included leukopenia (grade 3, 20.5%, grade 4, 2.6%), thrombocytopenia (grade 3, 7.7%). There was one death due to gastric ulcer. Twenty-five patients (62.5%) received 6 courses of adjuvant chemotherapy. Two-year overall survival rate was 100% for stage III and 61.1% for stage IV. Over the same period, the progression-free survival rate was 83.3% for stage III and 46.1% for stage IV. 85.7% of complete response (CR) (12/14 patients) and 63.6% of partial response (PR) (14/22 patients) to radiotherapy showed that the effect of radiotherapy was maintained during adjuvant chemotherapy. If the effect of radiotherapy was maintained during adjuvant chemotherapy, the two-year progression free survival rate was not different between 81.8% for CR to radiotherapy and 81.3% for PR. The rate of distant failure was 2.5%, which was lower than that citedin previous reports. This adjuvant chemotherapy regimen is tolerable at outpatient clinics and might suppress distant metastasis after radiotherapy. (author)

  2. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira


    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  3. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  4. Strategies to eradicate minimal residual disease in small cell lung cancer: high-dose chemotherapy with autologous bone marrow transplantation, matrix metalloproteinase inhibitors, and BEC2 plus BCG vaccination. (United States)

    Krug, L M; Grant, S C; Miller, V A; Ng, K K; Kris, M G


    In the last 25 years, treatment for small cell lung cancer (SCLC) has improved with advances in chemotherapy and radiotherapy. Standard chemotherapy regimens can yield 80% to 90% response rates and some cures when combined with thoracic irradiation in limited-stage patients. Nonetheless, small cell lung cancer has a high relapse rate due to drug resistance; this has resulted in poor survival for most patients. Attacking this problem requires a unique approach to eliminate resistant disease remaining after induction therapy. This review will focus on three potential strategies: high-dose chemotherapy with autologous bone marrow transplantation, matrix metalloproteinase inhibitors, and BEC2 plus BCG vaccination.

  5. Relationship between quality of life and clinical outcomes in advanced non-small cell lung cancer: best supportive care (BSC) versus BSC plus chemotherapy. (United States)

    Thongprasert, S; Sanguanmitra, P; Juthapan, W; Clinch, J


    In a prospective randomized study, 287 patients with advanced non-small cell lung cancer (NSCLC) stage IIIb or IV with ECOG performance status (PS) 0-1 or 2 were randomly assigned to receive either best supportive care (BSC) or supportive care plus combination chemotherapy (IEP regimen: ifosfamide 3 gm/m2 IV with mesna uroprotection, epirubicin 60 mg/m2 IV on day 1 and cisplatin 60 mg/m2 IV on day 2; or MVP regimen: mitomycin-C 8 mg/m2, cisplatin 100 mg/m2 IV on day 1, vinblastine 4 mg/m2 IV on days 1 and 15). Serial assessment of Karnofsky performance status (KPS), modified Functional Living Index-Cancer (T-FLIC) and modified Quality of Life-Index (T-QLI) were used to estimate the quality of life. Interviews were done at entry, at the third month and at 2 months post complete treatment. At least two courses of chemotherapy were considered to be adequate for response evaluation. Patients were treated for a total of four to six courses or until progression of disease. Partial response rates were 40 and 41.7% in IEP and MVP arms. Median survival durations were 5.9 and 8.1 months for the IEP and MVP chemotherapy arms, and 4.1 months for BSC (log-rank test: P = 0.0003). One year survival was 13, 29.8 and 39.3% for the BSC, IEP and MVP regimens, respectively. Two years survival was 7.8, 6.4 and 13.1% for the BSC, IEP and MVP regimens, respectively. Improvement in quality of life (QOL) scores at the first, second and third interview were seen in chemotherapy arms only, not in the BSC arm. We conclude that combination chemotherapy improves the quality of life as well as prolonging the survival of patients with advanced NSCLC.

  6. [A case of metastatic esophageal cancer responding remarkably to combination chemotherapy of TS-1 and cisplatin]. (United States)

    Iwase, Hiroaki; Okeya, Masayuki; Shimada, Masaaki; Tsuzuki, Tomoyuki; Nakarai, Keiko; Kaida, Shogo; Doi, Reiko


    A 51-year-old male patient with esophageal cancer and cervical, thoracic and celiac artery lymph node metastases was treated by combination chemotherapy of TS-1 and cisplatin. TS-1 (80 mg/m2/day) was administered for 14 days followed by 14 days rest as 1 course. Cisplatin (70 mg/m2/day) was administered in 24-hour continuous intravenous infusion at day 8 after the start of TS-1. Before treatment, the tumor marker, CEA showed 27,060 ng/ml. After 5 courses of chemotherapy, endoscopy revealed that the primary tumor had disappeared and no cancer cells were detected by endoscopic biopsy. Chest and abdominal CT scan also showed almost total disappearance of the lymph nodes metastases. CEA decreased to 710 ng/ml. No high-grade toxicities (WHO grade 3 or 4) were seen during the chemotherapy. He is now very well. This TS-1/cisplatin chemotherapy regimen might be a useful treatment for metastatic esophageal cancer.

  7. A Novel and Selective Poly (ADP-Ribose) Polymerase Inhibitor Ameliorates Chemotherapy-Induced Painful Neuropathy (United States)

    Ta, Lauren E.; Schmelzer, James D.; Bieber, Allan J.; Loprinzi, Charles L.; Sieck, Gary C.; Brederson, Jill D.; Low, Philip A.; Windebank, Anthony J.


    Background Chemotherapy-induced neuropathy is the principle dose limiting factor requiring discontinuation of many chemotherapeutic agents, including cisplatin and oxaliplatin. About 30 to 40% of patients receiving chemotherapy develop pain and sensory changes. Given that poly (ADP-ribose) polymerase (PARP) inhibition has been shown to provide neuroprotection, the current study was developed to test whether the novel PARP inhibitor compound 4a (analog of ABT-888) would attenuate pain in cisplatin and oxaliplatin-induced neuropathy in mice. Results An established chemotherapy-induced painful neuropathy model of two weekly cycles of 10 intraperitoneal (i.p.) injections separated by 5 days rest was used to examine the therapeutic potential of the PARP inhibitor compound 4a. Behavioral testing using von Frey, paw radiant heat, cold plate, and exploratory behaviors were taken at baseline, and followed by testing at 3, 6, and 8 weeks from the beginning of drug treatment. Conclusion Cisplatin-treated mice developed heat hyperalgesia and mechanical allodynia while oxaliplatin-treated mice exhibited cold hyperalgesia and mechanical allodynia. Co-administration of 50 mg/kg or 25 mg/kg compound 4a with platinum regimen, attenuated cisplatin-induced heat hyperalgesia and mechanical allodynia in a dose dependent manner. Similarly, co-administration of 50 mg/kg compound 4a attenuated oxaliplatin-induced cold hyperalgesia and mechanical allodynia. These data indicate that administration of a novel PARP inhibitor may have important applications as a therapeutic agent for human chemotherapy-induced painful neuropathy. PMID:23326593

  8. A novel and selective poly (ADP-ribose polymerase inhibitor ameliorates chemotherapy-induced painful neuropathy.

    Directory of Open Access Journals (Sweden)

    Lauren E Ta

    Full Text Available BACKGROUND: Chemotherapy-induced neuropathy is the principle dose limiting factor requiring discontinuation of many chemotherapeutic agents, including cisplatin and oxaliplatin. About 30 to 40% of patients receiving chemotherapy develop pain and sensory changes. Given that poly (ADP-ribose polymerase (PARP inhibition has been shown to provide neuroprotection, the current study was developed to test whether the novel PARP inhibitor compound 4a (analog of ABT-888 would attenuate pain in cisplatin and oxaliplatin-induced neuropathy in mice. RESULTS: An established chemotherapy-induced painful neuropathy model of two weekly cycles of 10 intraperitoneal (i.p. injections separated by 5 days rest was used to examine the therapeutic potential of the PARP inhibitor compound 4a. Behavioral testing using von Frey, paw radiant heat, cold plate, and exploratory behaviors were taken at baseline, and followed by testing at 3, 6, and 8 weeks from the beginning of drug treatment. CONCLUSION: Cisplatin-treated mice developed heat hyperalgesia and mechanical allodynia while oxaliplatin-treated mice exhibited cold hyperalgesia and mechanical allodynia. Co-administration of 50 mg/kg or 25 mg/kg compound 4a with platinum regimen, attenuated cisplatin-induced heat hyperalgesia and mechanical allodynia in a dose dependent manner. Similarly, co-administration of 50 mg/kg compound 4a attenuated oxaliplatin-induced cold hyperalgesia and mechanical allodynia. These data indicate that administration of a novel PARP inhibitor may have important applications as a therapeutic agent for human chemotherapy-induced painful neuropathy.

  9. Novel strategies for improving hematopoietic reconstruction after allogeneic hematopoietic stem cell transplantation or intensive chemotherapy. (United States)

    Baron, Frédéric; Nagler, Arnon


    High-dose conditioning regimens for allogeneic hematopoietic cell transplantation (allo-HCT) as well as intensive poly-chemotherapy for acute myeloid leukemia (AML) induce prolonged periods of neutropenia. The duration of the neutropenia is particularly long following umbilical cord blood transplantation (UCBT). Areas covered: After briefly reviewing the impact of hematopoietic growth factors administration to hasten hematologic reconstitution after allo-HCT or intensive AML chemotherapy, this article summarizes recent approaches that have been investigated to prompt hematologic reconstruction after UCBT or intensive AML chemotherapy. Expert opinion: In the allo-HCT setting, administration of G-CSF or GM-CSF shortened the duration of the neutropenia but failed to decrease infection-related mortality or to improve survival. Novel approaches to hasten hematological reconstruction after UCBT such as double UCBT with expansion of one of the 2 UCB units with Notch ligand, mesenchymal stromal cells, nicotinamide, or StemRegenin 1, co-transplanting a single UCB unit with HLA-haploidentical CD34+ cells, or increasing UCB HSC homing to marrow niches via direct intra bone UCB administration, pulse treatment with dmPGE2 or enforced fucosylation are promising and deserve further investigations in prospective phase III studies. In the AML setting, G-CSF or GM-CSF administration after intensive chemotherapy decreased the duration of the neutropenia without improving survival.

  10. Analysis of Cardiotoxicity from rh-Endostatin Therapy Combined with Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Jing Qin; Penghai Zhang; Xinyu Qian; Aimin Li; Rongcheng Luo; Dingli Xu


    OBJECTIVE To evaluate the cardotoxicity from recombinant human endostatin (rh-endostatin) combined with chemotherapy.METHODS A total of 12 cancer patients treated with rh-endostatin combined with chemotherapy were selected, and their clinical data collected. Their symptoms, including cardiopalmus,chest distress, dyspnea and changes in their electrocardiogram (ECG), myocardium enzymogram and left ventricular ejection fraction (LVEF), were observed during the drug treatment. These indicators were used for early diagnosis of cardiotoxicity.RESULTS Compared with a pre-therapeutic value, there was a significant increase in the CK-MB value at one week after startingthe treatment as well as at the end of treatment (P<0.05). There was a significant change in the ECG at the end of treatment,compared to a pre-therapeutic condition (P < 0.05), but there was no significant difference when comparing the pre- and post-therapeutic LVEF values.CONCLUSION It was recognized that mild cardiac adverse reactions exist in the regimen of recombinant human endostatin combined with chemotherapy. This therapy caused definite injury to the cardiac muscle, but cardiac functions were not obviously changed. CK-MB and ECG may be used as indicators for early monitoring cardiac toxicity. Vigilance against cardiac adverse reactions should be heightened during a course of rh-endostatin combined with chemotherapy.

  11. Intra-arterial chemotherapy in combination with radiotherapy for invasive bladder cancer and prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sumiyoshi, Yoshiteru; Hashine, Katsuyoshi; Nakatsuji, Hiroyoshi [National Shikoku Cancer Center Hospital, Matsuyama (Japan)


    Forty-five patients with muscle-invasive bladder cancer treated with intra-arterial doxorubicin chemotherapy plus low-dose radiotherapy between September 1979 and March 1990 were retrospectively studied. Twenty-eight (62%) patients achieved a complete response (CR) and in all of them, a functional bladder could be preserved. The 10-year cause-specific survival rate of patients with CR was 95.5%, but that of patients not achieving a CR was 39%. These results demonstrate that in patients who achieve a CR with this treatment, we may be able to preserve a functional bladder. In a prospective study, we designed a new intra-arterial chemotherapy regimen in order to achieve a higher degree of effectiveness and to preserve a functional bladder. Twenty-three patients were treated with concurrent pirarubicin/cisplatin intra-arterial chemotherapy and radiotherapy after complete transurethral resection. Twenty-one (91%) patients achieved CR. One of these patients had relapse with lung metastases and was treated surgically. Two patients who did not achieve a CR died of cancer, and 21 patients are alive with preservation of functional bladder. For treatment of prostate cancer, we now administer only adjuvant intra-arterial chemotherapy plus irradiation for patients after radical prostatectomy. (author)

  12. [Is there alternative to FOLFOX adjuvant chemotherapy for stage III colorectal cancer patients?]. (United States)

    Esch, Anouk; Coriat, Romain; Perkins, Géraldine; Brezault, Catherine; Chaussade, Stanislas


    Being the second cancer for men and the third cancer for women in France, colorectal cancer represents a serious public health issue. Its incidence has increased these last years and despite new therapeutics being developed, it still has a bad prognostic. Thanks in part to Hemoccult national mass screening program, its diagnosis is made possible at an earlier stage, which makes a surgical curative resection and the carrying out of adjuvant chemotherapy possible. For stage III colic cancer that has been surgically removed, adjuvant chemotherapy by FOLFOX 4 has to be offered. Nevertheless, because of its toxicities, the patient's high age, important comorbidities or post-surgical complications, this chemotherapy occasionally cannot be done. What are the colorectal cancer prognostic factors which would guide the chemotherapy? TNM classification, number of examined lymph nodes, MSI status, and presence or not of a perforation or a perinervous, lymphatic or venous invasion is recognized prognostic factors. Also, what are the alternatives of FOLFOX 4 regimen as colorectal cancer adjuvant treatment?

  13. Preoperative docetaxel/cisplatin/5-fluorouracil chemotherapy in patients with locally advanced gastro-esophageal adenocarcinoma. (United States)

    Bayraktar, Ulas Darda; Bayraktar, Soley; Hosein, Peter; Chen, Emerson; Koniaris, Leonidas G; Rocha-Lima, Caio Max S; Montero, Alberto J


    Perioperative chemotherapy plus surgery improves survival compared to surgery alone in GE junctional (GEJ) and gastric adenocarcinomas. The docetaxel/cisplatin/5-fluorouracil (DCF) combination is superior to CF in patients with metastatic gastric cancer. We retrospectively evaluated the safety and efficacy of preoperative DCF chemotherapy in patients with locally advanced gastric and GEJ cancer. Twenty-one gastric and 10 gastroesophageal junctional (GEJ) cancer patients received 2-3 cycles of preoperative docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) on day 1, 5-FU 750 mg/m(2) (continuous infusion) on days 1-5 every 3 weeks. Clinical response was evaluated by comparing pre- and postchemotherapy CT scans. Overall survival (OS) and progression-free survival (PFS) were calculated from the initiation of chemotherapy. None of the patients achieved complete clinical remission while 11 (35%) patients achieved partial clinical remission. Ten patients with GEJ cancer (100%) and 13 with gastric cancer (62%) underwent curative surgery (P = 0.023). Seventeen (55%) patients experienced grade 3-4 chemotherapy-related adverse events. The most common adverse events were anemia, nausea/vomiting, diarrhea, and febrile neutropenia. At a median follow-up of 17.0 months, median OS and PFS were 26.1 months (95% CI: 22.7-29.5) and 18.8 months (95% CI: 9.9-27.7), respectively. The DCF regimen is active in patients with gastric and GEJ adenocarcinoma in the preoperative setting.

  14. Systemic chemotherapy for hepatocellular carcinoma in non-cirrhotic liver: A retrospective study

    Institute of Scientific and Technical Information of China (English)

    Julien Edeline; Jean-Luc Raoul; Elodie Vauleon; Anne Guillygomac'h; Karim Boudjema; Eveline Boucher


    AIM: To investigate the efficacy and toxicity of systemic chemotherapy in a retrospective study of patients with hepatocellular carcinoma (HCC) occurring in normal or fibrotic liver without cirrhosis. METHODS: Twenty-four patients with metastatic or locally advanced HCC in a normal or a fibrotic liver were given systemic chemotherapy (epirubicin, cisplatin and 5-fluorouracil or epirubicin, cisplatin and capecitabine regimens). Tumor response, time to progression, survival, and toxicity were evaluated. RESULTS: There were 7 women and 17 men, mean 6 had a fibrotic liver (F1/F2 on biopsy). Mean tumor size was 14 cm, 5 patients had portal vein thrombosis and 7 had metastasis. Patients received a median of 4 chemotherapy sessions. Overall tolerance was good. There were 5 partial responses (objective response rate = 22%), and tumor control rate was 52%. Second line surgical resection was possible in two patients. Median survival was 11 mo, and 1- and 2-year overall survival rates were 50% ± 10% and 32% ± 11%, respectively. ``CONCLUSION: In patients with HCC in a non-cirrhotic liver, chemotherapy was well tolerated and associated with an objective response rate of 22%, including two patients who underwent secondary surgical resection.

  15. Histopathologic tumor response after induction chemotherapy and stereotactic body radiation therapy for borderline resectable pancreatic cancer. (United States)

    Chuong, Michael D; Frakes, Jessica M; Figura, Nicholas; Hoffe, Sarah E; Shridhar, Ravi; Mellon, Eric A; Hodul, Pamela J; Malafa, Mokenge P; Springett, Gregory M; Centeno, Barbara A


    While clinical outcomes following induction chemotherapy and stereotactic body radiation therapy (SBRT) have been reported for borderline resectable pancreatic cancer (BRPC) patients, pathologic response has not previously been described. This single-institution retrospective review evaluated BRPC patients who completed induction gemcitabine-based chemotherapy followed by SBRT and surgical resection. Each surgical specimen was assigned two tumor regression grades (TRG), one using the College of American Pathologists (CAP) criteria and one using the MD Anderson Cancer Center (MDACC) criteria. Overall survival (OS) and progression free survival (PFS) were correlated to TRG score. We evaluated 36 patients with a median follow-up of 13.8 months (range, 6.1-24.8 months). The most common induction chemotherapy regimen (82%) was GTX (gemcitabine, docetaxel, capecitabine). A median SBRT dose of 35 Gy (range, 30-40 Gy) in 5 fractions was delivered to the region of vascular involvement. The margin-negative resection rate was 97.2%. Improved response according to MDACC grade trended towards superior PFS (P=061), but not OS. Any neoadjuvant treatment effect according to MDACC scoring (IIa-IV vs. I) was associated with improved OS and PFS (both P=0.019). We found no relationship between CAP score and OS or PFS. These data suggest that the increased pathologic response after induction chemotherapy and SBRT is correlated with improved survival for BRPC patients.

  16. The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Palli SR


    Full Text Available Swetha Rao Palli,1 Michael Grabner,1 Ralph A Quimbo,1 Hope S Rugo2 1HealthCore, Wilmington, DE, 2University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA Purpose: To determine the incidence of chemotherapy-induced nausea/vomiting (CINV and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA antiemetics. Materials and methods: This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC or moderately EC (MEC regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. Results: We identified 1,832 palonosetron and 2,387 other 5-HT3 RA (“other” patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026, and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001. Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019 and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019. Conclusion: Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with

  17. Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis: the New EPOC randomised controlled trial. (United States)

    Primrose, John; Falk, Stephen; Finch-Jones, Meg; Valle, Juan; O'Reilly, Derek; Siriwardena, Ajith; Hornbuckle, Joanne; Peterson, Mark; Rees, Myrddin; Iveson, Tim; Hickish, Tamas; Butler, Rachel; Stanton, Louise; Dixon, Elizabeth; Little, Louisa; Bowers, Megan; Pugh, Siân; Garden, O James; Cunningham, David; Maughan, Tim; Bridgewater, John


    Surgery for colorectal liver metastases results in an overall survival of about 40% at 5 years. Progression-free survival is increased with the addition of oxaliplatin and fluorouracil chemotherapy. The addition of cetuximab to these chemotherapy regimens results in an overall survival advantage in patients with advanced disease who have the KRAS exon 2 wild-type tumour genotype. We aimed to assess the benefit of addition of cetuximab to standard chemotherapy in patients with resectable colorectal liver metastasis. Patients with KRAS exon 2 wild-type resectable or suboptimally resectable colorectal liver metastases were randomised in a 1:1 ratio to receive chemotherapy with or without cetuximab before and after liver resection. Randomisation was done using minimisation with factors of surgical centre, poor prognostic tumour (one or more of: ≥ 4 metastases, N2 disease, or poor differentiation of primary tumour), and previous adjuvant treatment with oxaliplatin. Chemotherapy consisted of oxaliplatin 85 mg/m(2) intravenously over 2 h and fluorouracil bolus 400 mg/m(2) intravenously over 5 min, followed by a 46 h infusion of fluorouracil 2400 mg/m(2) repeated every 2 weeks (regimen one) or oxaliplatin 130 mg/m(2) intravenously over 2 h and oral capecitabine 1000 mg/m(2) twice daily on days 1-14 repeated every 3 weeks (regimen two). Patients who had received adjuvant oxaliplatin could receive irinotecan 180 mg/m(2) intravenously over 30 min with fluorouracil instead of oxaliplatin (regimen three). Cetuximab was given as an intravenous dose of 500 mg/m(2) every 2 weeks with regimen one and three or a loading dose of 400 mg/m(2) followed by a weekly infusion of 250 mg/m(2) with regimen two. The primary endpoint was progression-free survival. This is an interim analysis, up to Nov 1, 2012, when the trial was closed, having met protocol-defined futility criteria. This trial is registered, ISRCTN22944367. 128 KRAS exon 2 wild-type patients were randomised to chemotherapy

  18. The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after Nipple-Sparing Mastectomy. (United States)

    Frey, Jordan D; Choi, Mihye; Karp, Nolan S


    Nipple-sparing mastectomy is the latest advancement in the treatment of breast cancer. The authors aimed to investigate the effects of neoadjuvant and adjuvant chemotherapy in nipple-sparing mastectomy. Patients undergoing nipple-sparing mastectomy from 2006 to June of 2015 were identified. Results were stratified by presence of neoadjuvant or adjuvant chemotherapy. A total of 840 nipple-sparing mastectomies were performed. Twenty-eight were in those who received neoadjuvant chemotherapy and 93 were in patients receiving adjuvant chemotherapy. Patients receiving both neoadjuvant and adjuvant chemotherapy were included in the neoadjuvant group. Nipple-sparing mastectomies that received neoadjuvant (with or without adjuvant) chemotherapy were compared to those in patients who received adjuvant chemotherapy. Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have explantation (p = 0.0239) and complete nipple-areola complex necrosis (p = 0.0021). Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have implant explantation (p = 0.0015) and complete nipple-areola complex necrosis (p = 0.0004) compared to those with no chemotherapy. Compared to nipple-sparing mastectomies in patients with no chemotherapy, those with adjuvant chemotherapy were more likely to have a hematoma (p = 0.0021). Those that received both neoadjuvant and adjuvant chemotherapy were more likely to have complete nipple-areola complex necrosis compared with both the neoadjuvant chemotherapy-only and adjuvant chemotherapy-only groups (p < 0.0001). Nipple-sparing mastectomy is safe to perform in the setting of neoadjuvant and adjuvant chemotherapy. As a whole, neoadjuvant (with or without adjuvant) chemotherapy increases risk of complications. Therapeutic, III.

  19. High-dose intravenous vitamin C combined with cytotoxic chemotherapy in patients with advanced cancer: a phase I-II clinical trial.

    Directory of Open Access Journals (Sweden)

    L John Hoffer

    Full Text Available Biological and some clinical evidence suggest that high-dose intravenous vitamin C (IVC could increase the effectiveness of cancer chemotherapy. IVC is widely used by integrative and complementary cancer therapists, but rigorous data are lacking as to its safety and which cancers and chemotherapy regimens would be the most promising to investigate in detail.We carried out a phase I-II safety, tolerability, pharmacokinetic and efficacy trial of IVC combined with chemotherapy in patients whose treating oncologist judged that standard-of-care or off-label chemotherapy offered less than a 33% likelihood of a meaningful response. We documented adverse events and toxicity associated with IVC infusions, determined pre- and post-chemotherapy vitamin C and oxalic acid pharmacokinetic profiles, and monitored objective clinical responses, mood and quality of life. Fourteen patients were enrolled. IVC was safe and generally well tolerated, although some patients experienced transient adverse events during or after IVC infusions. The pre- and post-chemotherapy pharmacokinetic profiles suggested that tissue uptake of vitamin C increases after chemotherapy, with no increase in urinary oxalic acid excretion. Three patients with different types of cancer experienced unexpected transient stable disease, increased energy and functional improvement.Despite IVC's biological and clinical plausibility, career cancer investigators currently ignore it while integrative cancer therapists use it widely but without reporting the kind of clinical data that is normally gathered in cancer drug development. The present study neither proves nor disproves IVC's value in cancer therapy, but it provides practical information, and indicates a feasible way to evaluate this plausible but unproven therapy in an academic environment that is currently uninterested in it. If carried out in sufficient numbers, simple studies like this one could identify specific clusters of cancer type

  20. Outpatient chemotherapy, family-centered care, electronic information, and education in adolescents and young adults with osteosarcoma

    Directory of Open Access Journals (Sweden)

    Anderson P


    Full Text Available Pete Anderson, Patricia Wells, Theresa Lazarte, Laura Gore, Laura Salvador, Maritza Salazar-AbshireMD Anderson Cancer Center, Pediatrics, Houston TX, USAAbstract: Current osteosarcoma chemotherapy is “standard” (doxorubicin, cisplatin, high-dose methotrexate ± ifosfamide-mesna, and etoposide ± mifamurtide, but current regimens have many short-term, medium-term, and long-term side effects. Generally 12–15 cycles of chemotherapy are given in the hospital over 7–10 months. Even in the absence of new research protocols, improvement in quality of life is now possible, with all osteosarcoma chemotherapy agents now being able to be administered in the outpatient setting. Outpatient chemotherapy is not only less expensive, but in the adolescent and young adult population can result in better quality of life for some. In this paper, we share information to help reduce the frequency of hospitalization and review some tools and strategies to facilitate communication when providing outpatient chemotherapy, family-centered care, and information/education. These include antiemetics with both longer-acting 5HT antagonists and aprepitant, outpatient chemotherapy guidelines, and a 5-week editable calendar that is part of our electronic medical record. Sharing information on absolute lymphocyte count recovery is another means of maintaining hope and increasing understanding of the prognosis of osteosarcoma. Finally, this paper shares an advanced directive/palliative care “checklist” of issues for patients and caregivers to consider at end of life, ie, when “cure of cancer is not the answer”. In summary, better communication at all stages of osteosarcoma care can help reduce hospitalization, improve quality of life, and maintain hope in the adolescent and young adult population with osteosarcoma.Keywords: family-centered care, adolescent and young adult, flash drives, chemotherapy calendars, outpatient, osteosarcoma, chemotherapy

  1. Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer (United States)

    Venook, Alan P.; Niedzwiecki, Donna; Lenz, Heinz-Josef; Innocenti, Federico; Fruth, Briant; Meyerhardt, Jeffrey A.; Schrag, Deborah; Greene, Claire; O’Neil, Bert H.; Atkins, James Norman; Berry, Scott; Polite, Blase N.; O’Reilly, Eileen M.; Goldberg, Richard M.; Hochster, Howard S.; Schilsky, Richard L.; Bertagnolli, Monica M.; El-Khoueiry, Anthony B.; Watson, Peter; Benson, Al B.; Mulkerin, Daniel L.; Mayer, Robert J.; Blanke, Charles


    IMPORTANCE Combining biologic monoclonal antibodies with chemotherapeutic cytotoxic drugs provides clinical benefit to patients with advanced or metastatic colorectal cancer, but the optimal choice of the initial biologic therapy in previously untreated patients is unknown. OBJECTIVE To determine if the addition of cetuximab vsbevacizumab to the combination of leucovorin, fluorouracil, and oxaliplatin (mFOLFOX6) regimen or the combination of leucovorin, fluorouracil, and irinotecan (FOLFIRI) regimen is superior as first-line therapy in advanced or metastatic KRAS wild-type (wt) colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS Patients (≥18 years) enrolled at community and academic centers throughout the National Clinical Trials Network in the United States and Canada (November 2005-March 2012) with previously untreated advanced or metastatic colorectal cancer whose tumors were KRAS wt chose to take either the mFOLFOX6 regimen or the FOLFIRI regimen as chemotherapy and were randomized to receive either cetuximab (n = 578) or bevacizumab (n = 559). The last date of follow-up was December 15, 2015. INTERVENTIONS Cetuximab vs bevacizumab combined with either mFOLFOX6 or FOLFIRI chemotherapy regimen chosen by the treating physician and patient. MAIN OUTCOMES AND MEASURES The primary end point was overall survival. Secondary objectives included progression-free survival and overall response rate, site-reported confirmed or unconfirmed complete or partial response. RESULTS Among 1137 patients (median age, 59 years; 440 [39%] women), 1074 (94%) of patients met eligibility criteria. As of December 15, 2015, median follow-up for 263 surviving patients was 47.4 months (range, 0–110.7 months), and 82% of patients (938 of 1137) experienced disease progression. The median overall survival was 30.0 months in the cetuximab-chemotherapy group and 29.0 months in the bevacizumab-chemotherapy group with a stratified hazard ratio (HR) of 0.88 (95% CI, 0.77–1.01; P = .08). The

  2. Once-daily dose regimen of ribavirin is interchangeable with a twice-daily dose regimen: randomized open clinical trial

    Directory of Open Access Journals (Sweden)

    Balk JM


    Full Text Available Jiska M Balk,1 Guido RMM Haenen,1 Özgür M Koc,2 Ron Peters,3 Aalt Bast,1 Wim JF van der Vijgh,1 Ger H Koek,4 1Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, 2Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 3DSM Resolve, Geleen, 4Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: The combination of ribavirin (RBV and pegylated interferon (PEG-IFN is effective in the treatment of chronic hepatitis C infection. Reducing the frequency of RBV intake from twice to once a day will improve compliance and opens up the opportunity to combine RBV with new and more specific direct-acting agents in one pill. Therefore, the purpose of this study was to evaluate the pharmacokinetic profile of RBV in a once-daily to twice-daily regimen. The secondary aim was to determine tolerability as well as the severity and differences in side effects of both treatment regimens. Methods: In this randomized open-label crossover study, twelve patients with chronic type 1 hepatitis C infection and weighing more than 75 kg were treated with 180 µg of PEG-IFN weekly and 1,200 mg RBV daily for 24 weeks. The patients received RBV dosed as 1,200 mg once-daily for 12 weeks followed by RBV dosed as 600 mg twice-daily for 12 weeks, or vice versa. In addition to the pharmacokinetic profile, the hematological profile and side effects were recorded. The RBV concentrations in plasma were determined using liquid chromatography-tandem mass spectrometry. Results: Eight of twelve patients completed the study. Neither the time taken for RBV to reach peak plasma concentration nor the AUC0-last (adjusted for difference in dose was significantly different between the two groups (P>0.05. Furthermore, the once-daily regimen did not give more side effects than the twice-daily regimen (P>0

  3. The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

    Directory of Open Access Journals (Sweden)

    Branden A. Smeester


    Full Text Available Osteosarcoma is the most common malignant bone tumor found in children and adolescents and is associated with many complications including cancer pain and metastasis. While cancer patients often seek complementary and alternative medicine (CAM approaches to treat cancer pain and fatigue or the side effects of chemotherapy and treatment, there is little known about the effect of acupuncture treatment on tumor growth and metastasis. Here we evaluate the effects of six different electroacupuncture (EA regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3 beginning at postimplantation day 3 (PID 3. Twice weekly treatment produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7, starting at PID 7, there was a significant increase in tumor growth. We further demonstrate that EA-2X/3 treatment elicits significant reductions in tumor lymphatics, vasculature, and innervation. Lastly, EA-2X/3 treatment produced a marked reduction in pulmonary metastasis, thus providing evidence for EA’s potential antimetastatic capabilities. Collectively, EA-2X/3 treatment was found to reduce both bone tumor growth and lung metastasis, which may be mediated in part through reductions in tumor-associated vasculature, lymphatics, and innervation.

  4. Renal cell carcinoma: review of novel single-agent therapeutics and combination regimens. (United States)

    Amato, R J


    A search of the Medline database and ASCO 2003 conference proceedings was conducted to identify clinical trials currently underway using single-agent therapy for renal cell carcinoma (RCC). Combination trials were identified using the ASCO 2003 conference proceedings. Fourteen single-agent therapies employing different mechanisms of action were identified in the published literature: imatinib mesylate (Gleevec); bevacizumab (Avastin); thalidomide (Thalomid); gefitinib (ZD1839) (Iressa); cetuximab (IMC-C225) (Erbitux); bortezomib (PS-341) (Velcade); HSPPC-96 (Oncophage); BAY 59-8862; ABT-510; G250; CCI-779; SU5416; PTK/ZK; and ABX-EGF. Six distinct fields of clinical research have emerged: monoclonal antibodies, small molecules, vaccines, second-generation taxanes, nonapeptides and immunomodulators. Five combination regimens, primarily biological response modifiers (interleukin-2 or interferon-alpha), chemotherapy- or thalidomide-based, were identified. All therapies demonstrated acceptable toxicity profiles. Clinical benefit was assessed based on each study's reported criteria: antitumor response (regression or stability) ranged from 5% to 71%. In the past several years, significant advances in the underlying biological mechanisms of RCC, particularly the role of tumor angiogenesis, have permitted the design of molecularly targeted therapeutics. Based on preliminary and limited studies, combination therapies offer the greatest clinical benefit in the management of this malignancy, although additional basic research is still warranted.

  5. [Superhigh-dosage chemotherapy with the transplantation of autologous hemopoietic precursor cells in patients with a prognostically unfavorable relapse and resistant course of lymphogranulomatosis]. (United States)

    Ptuskin, V V; Uss, A L; Demina, E A; Chervonobab, Iu V; Milanovich, N F; Tupitsyn, N N; Larionova, V B; Batan, Z E; Kondrat'eva, N E; Zmachinskiĭ, V A; Andreeva, L A; Snegir', V M; Mkheidze, D M; Chimishkian, K L


    Eighteen patients with relapsed or refractory Hodgkin's disease (HD) have been treated with high-dose chemotherapy (BEAM regimen) followed by autologous peripheral stem cells and/or bone marrow rescue. There were no treatment-related deaths. Overall response rate was 82%. With a median follow-up of 10 months (3-24 months) overall survival and freedom from progression were 100 and 94% (95% confidence interval 58-97%), respectively. The use of peripheral stem cells in addition to bone marrow resulted in a significant shortening of the time to engraftment (p < 0.01). The BEAM regimen is an effective conditioning schedule which is well tolerated.

  6. A multicenter retrospective study of chemotherapy for recurrent intracranial ependymal tumors in adults by the Gruppo Italiano Cooperativo di Neuro-Oncologia. (United States)

    Brandes, Alba A; Cavallo, Giovanna; Reni, Michele; Tosoni, Alicia; Nicolardi, Linda; Scopece, Luciano; Franceschi, Enrico; Sotti, Guido; Talacchi, Andrea; Turazzi, Sergio; Ermani, Mario


    No data on the role of chemotherapy in recurrent ependymal tumors are available in adults. The aim of the current study was to investigate outcomes after salvage chemotherapy in this setting. A retrospective review was made of the charts of 28 adults (> or = 18 years) with progressive or recurrent ependymal tumors after surgery and radiotherapy, who received chemotherapy between 1993 and 2003 in 3 institutions of the Gruppo Italiano Cooperativo di Neuro-Oncologia network. Thirteen patients (46.3%) received cisplatin-based chemotherapy (Group A) and 15 (53.7%) received regimens without cisplatin (Group B). Platinum-based chemotherapy yielded 2 complete responses (CR) (15.4%) and 2 (15.4%) partial responses (PR), whereas 7 patients (53.8%) remained stable (SD). After regimens without cisplatin, there were no CR, 2 PR (13.3%), and 11 SD (73.3%). The overall median time to progression was 9.9 months (95% confidence interval [95% CI], 7.5-21.7 months), 9.9 months (5.2-not reached) for Group A and 10.9 months (95% CI, 7.17-23.9 months) for Group B. The overall median survival (OS) was 40.7 months (95% CI, 16-not reached), 31 months (21-not reached) for Group A and 40.7 months (13.4-not reached) for Group B. Cisplatin-based chemotherapy achieved a higher response rate, but did not prolong disease progression-free survival or OS. More active regimens for the salvage treatment of ependymal tumors have yet to be found.

  7. Chemotherapy

    Directory of Open Access Journals (Sweden)

    Ofer Merimsky


    Full Text Available Subjects and Methods: Seven patients with progressive localized or metastatic chemo-resistant osteosarcoma were treated by gemcitabine.The protocol included gemcitabine 1000 mg/m2/w for 7 consecutive weeks, followed by 1 week rest. If no progression was observed,maintenance by gemcitabine 1000 mg/m2/w for 3 weeks every 28 days was given until failure was clinically or radiologically evident.

  8. Chemotherapy (United States)

    ... tumor cells. Mitotic inhibitors—These agents are usually plant-based, natural substances that interfere with the production ... drugs Infertility Seizures Weakness Balance or coordination problems Memory or cognitive problems Brain swelling Damage to internal ...

  9. Evaluation of Outcome and Tolerability of Combination Chemotherapy with Capecitabine and Oxaliplatin as First Line Therapy in Advanced Gastric Cancer (United States)

    Mashhadi, Mohammad Ali; Sepehri, Zahra; Bakhshipour, Ali Reza; Zivari, Ali; Danesh, Hossein Ali; Metanat, Hasan Ali; Karimkoshteh, Azra; Hashemi, Seyed Mehdi; Rahimi, Hossein; Kiani, Zohre


    Background: Combination chemotherapy is accepted as a high efficacy treatment for gastric cancer, whereas choice of standard treatment is unclear. Multiple chemotherapeutic regimens have been used to achieve higher efficacy and lower toxicity. This study was designed to evaluate the treatment results of advanced gastric cancer with Capecitabine and Oxaliplatin regimen. Subjects and Methods : All cases with documented gastric adenocarcinoma and advanced disease were candidates for receiving Xelox regimen (Capecitabine – 750 mg/m2/twice daily/ 1-14 days and Oxaliplatin 125 mg/m2 in 1st day). Results: Twenty five cases with advanced gastric cancer entered in study while 24 cases continued treatment protocol and were evaluated. Mean age was 59.5 ± 12.1 years (range: 20-75), male and female cases were 66.7% and 33.3%, respectively. All cases received at least four cycles of Xelox regimen. Overall response rate was 74.99% with 29.16% complete response. Overall survival rate was 13 ± 0.53 months and DFS (disease-free survival) was 6 ± 1.09 months. Extremities neuropathy (62.5%), headache (45.8%) and muscle cramps (29.2%) were the most common complains. Haematological changes were rare and 16.7% of cases had mild cytopenia. Treatment related death was not observed. Conclusion: Xelox regimen is a safe and highly effective first line treatment for gastric cancer; however, considering it as first line therapy needs larger studies. PMID:27928475

  10. Chemotherapie-induzierte Neuropathien (CIN

    Directory of Open Access Journals (Sweden)

    Vass A


    Full Text Available Durch Chemotherapie induzierte Neuropathien manifestieren sich meist als überwiegend sensorische Neuropathien, die zu Koordinationsstörungen und neuropathischen Schmerzen führen. Da es keine kausale Therapie gibt, stellen sie eine dosislimitierende Nebenwirkung der Tumortherapie dar. Hervorgerufen werden sie durch fünf Substanzgruppen: Platinderivate, Taxane, Vinca-Alkaloide sowie Bortezomib und Thalidomid. In dieser Übersicht wird auf die kumulativen Dosen dieser Substanzen und die jeweilige Symptomatik und Häufigkeit der dadurch entstehenden Neuropathien eingegangen.

  11. Immunological aspects of cancer chemotherapy. (United States)

    Zitvogel, Laurence; Apetoh, Lionel; Ghiringhelli, François; Kroemer, Guido


    Accumulating evidence indicates that the innate and adaptive immune systems make a crucial contribution to the antitumour effects of conventional chemotherapy-based and radiotherapy-based cancer treatments. Moreover, the molecular and cellular bases of the immunogenicity of cell death that is induced by cytotoxic agents are being progressively unravelled, challenging the guidelines that currently govern the development of anticancer drugs. Here, we review the immunological aspects of conventional cancer treatments and propose that future successes in the fight against cancer will rely on the development and clinical application of combined chemo- and immunotherapies.

  12. EMA-CO chemotherapy for high-risk gestational trophoblastic neoplasia: a clinical analysis of 54 patients. (United States)

    Lu, W-G; Ye, F; Shen, Y-M; Fu, Y-F; Chen, H-Z; Wan, X-Y; Xie, X


    This study was designed to analyze the outcomes of chemotherapy for high-risk gestational trophoblastic neoplasia (GTN) with EMA-CO regimen as primary and secondary protocol in China. Fifty-four patients with high-risk GTN received 292 EMA/CO treatment cycles between 1996 and 2005. Forty-five patients were primarily treated with EMA-CO, and nine were secondarily treated after failure to other combination chemotherapy. Adjuvant surgery and radiotherapy were used in the selected patients. Response, survival and related risk factors, as well as chemotherapy complications, were retrospectively analyzed. Thirty-five of forty-five patients (77.8%) receiving EMA-CO as first-line treatment achieved complete remission, and 77.8% (7/9) as secondary treatment. The overall survival rate was 87.0% in all high-risk GTN patients, with 93.3% (42/45) as primary therapy and 55.6% (5/9) as secondary therapy. The survival rates were significantly different between two groups (chi(2)= 6.434, P =0.011). Univariate analysis showed that the metastatic site and the number of metastatic organs were significant risk factors, but binomial distribution logistic regression analysis revealed that only the number of metastatic organs was an independent risk factor for the survival rate. No life-threatening toxicity and secondary malignancy were found. EMA-EP regimen was used for ten patients who were resistant to EMA-CO and three who relapsed after EMA-CO. Of those, 11 patients (84.6%) achieved complete remission. We conclude that EMA-CO regimen is an effective and safe primary therapy for high-risk GTN, but not an appropriate second-line protocol. The number of metastatic organs is an independent prognostic factor for the patient with high-risk GTN. EMA-EP regimen is a highly effective salvage therapy for those failing to EMA-CO.

  13. [Adjuvant chemotherapy for patients with rectal cancer]. (United States)

    Qvortrup, Camilla; Mortensen, John Pløen; Pfeiffer, Per


    A new Cochrane meta-analysis evaluated adjuvant chemotherapy (5-fluorouracil (5FU)-based, not modern combination chemotherapy) in almost 10,000 patients with rectal cancer and showed a 17% reduction in mortality corresponding well to the efficacy observed in recent studies, which reported a reduction in mortality just about 20%. The authors recommend adjuvant chemotherapy which is in accordance with the Danish national guidelines where 5-FU-based chemotherapy is recommended for stage III and high-risk stage II rectal cancer.

  14. [Oral complications of chemotherapy of malignant neoplasms]. (United States)

    Obralić, N; Tahmiscija, H; Kobaslija, S; Beslija, S


    Function and integrity disorders of the oral cavity fall into the most frequent complication of the chemotherapy of leucemias, malignant lymphomas and solid tumors. Complications associated with cancer chemotherapy can be direct ones, resulting from the toxic action of antineoplastic agents on the proliferative lining of the mouth, or indirect, as a result of myelosuppression and immunosuppression. The most frequent oral complications associated with cancer chemotherapy are mucositis, infection and bleeding. The principles of prevention and management of oral complications during cancer chemotherapy are considered in this paper.

  15. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C


    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH D

  16. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C


    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH D

  17. Tuberculous meningitis: is a 6-month treatment regimen sufficient?

    NARCIS (Netherlands)

    Loenhout-Rooyackers, J.H. van; Keyser, A.J.M.; Laheij, R.J.F.; Verbeek, A.L.M.; Meer, J.W.M. van der


    SETTING: The British Thoracic Society and the American Thoracic Society advise 12 months treatment for tuberculous meningitis, with at least isoniazid (H), rifampicin (R) and pyrazinamide (Z). OBJECTIVE: To establish whether a 6-month treatment regimen for tuberculous meningitis is equally as effect

  18. Are calcineurin inhibitors-free regimens ready for prime time? (United States)

    Vincenti, Flavio


    The goal of research in transplant therapeutics is to achieve safe and effective immunosuppression strategies that allow durable engraftment free of toxicities. The calcineurin inhibitors (CNIs) regimens, because of their inherent toxicities (including nephrotoxicity), have been unable to meet these promises. Over the past decade acute cellular rejection decreased dramatically with a concomitant robust increase in 1-year graft survival; however, long-term graft outcome showed only modest improvement. This is due in part to the toxicities of the immunosuppressive drugs. The quest for a toxicity-free-CNI-free regimen has been both intense and frustrating. A turning point in CNIs-free therapy may have occurred with the recent approval of belatacept, which represents a new paradigm in immunosuppression: biological therapy for chronic immunosuppression devoid of the usual toxicities associated with the CNIs. Belatacept, a fusion receptor protein, blocks costimulation signals necessary for the activation of T cells. Although costimulation blockade has not been shown to induce tolerance, it can provide safe and effective immunosuppression without renal or cardiovascular toxicities. The approval of belatacept in both the United States and Europe for use in renal transplantation will finally push CNI-free regimens into prime time. Novel biologics such as ASKP1240 (a human anti-CD40 monoclonal antibody) and one small molecule, tofacitinib, may advance further the use of CNI-free regimens in organ transplantation.

  19. Gonzalez Regimen (PDQ®)—Health Professional Version (United States)

    The Gonzalez regimen is a specialized diet that uses enzymes, supplements, and other factors in cancer management based on a theory that involves the use of pancreatic enzymes to help the body get rid of toxins that lead to cancer. Read about existing clinical data in this expert-reviewed summary.

  20. Efficacy of Some Combination Regimens of Oral Hypoglycaemic ...

    African Journals Online (AJOL)

    Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights ... Hypoglycaemic Agents in Type 2 Diabetes Mellitus Patients ... levels induced by several OHA cobmination regimens were documented. ... highlighting the important benefits conferred by the use of multiple OHAs.

  1. A prospective and randomized study of radiotherapy, sequential chemotherapy radiotherapy and concomitant chemo therapy-radiotherapy in unresectable non small cell carcinoma of the lung

    Directory of Open Access Journals (Sweden)

    Dasgupta Anirban


    Full Text Available Purpose: Treatment of advanced Non small cell lung cancer (NSCLC often produces dismal results. Combination of available treatment modalities has reportedly improved the outcome. A prospectively randomized trial was conducted, comparing combined treatment modalities versus radiotherapy alone, in treatment of unresectable NSCLC. Materials and Methods: A total of 103 patients were randomized to three groups. In group ′A′, 32 patients received radiotherapy alone (6500 cGy/30 fraction. In group ′B′, 35 patients received neoadjuvant chemotherapy (Cisplatin 80 mg/m2 on day 1 and Etoposide 100 mg/m day 1-3 intravenously q3 weeks for 3 cycles, followed by radiotherapy (6000 cGy/30 fractions and 3 more cycles of Chemotherapy, with the same regimen. In group ′C′, 36 patients received radiotherapy (5000 cGy/25 fractions with concurrent chemotherapy (ciplatin 20 mg/m2 + Etoposide 75 mg/m2 intravenously on day 1-5 and day 22-26, followed by 2 more cycles of chemotherapy,q3 weeks with the same regimen. Results: Initial treatment responses were significantly higher in group ′B′ ( P P Conclusion: Addition of chemotherapy with radiation in unresectable NSCLC improves response rates, time to tumour progression and disease free survival, though the same effect is not translated in overall survival.

  2. Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature (United States)



    Thrombotic thrombocytopenic purpura (TTP) is a rare form of thrombotic microangiopathy that is characterized by microvascular thrombosis, thrombocytopenia, hemolysis and end organ damage. An extensive variety of drugs, including certain chemotherapeutic agents, have been associated with TTP. However, paclitaxel, cisplatin and ifosfamide regimen (TIP)-induced TTP has not previously been described. The present study reports the case of a 43-year-old patient with a refractory testicular germ cell tumor who developed acute TTP during TIP chemotherapy. Following the third cycle of TIP chemotherapy, the patient developed fever, anemia, thrombocytopenia and confusion. A diagnosis of TTP was established. Plasmapheresis was initiated as daily treatment in the first week, then continued every other day for 4 weeks. TIP chemotherapy was discontinued. The patient's clinical and neurological symptoms improved markedly after a week. Renal function and hemolysis improved, and the patient was discharged in a stable condition. The patient did not develop any complications and has been in remission for 5 months. The Naranjo adverse drug reaction probability scale indicated a likely association between TTP and the TIP chemotherapy regimen in this patient. This case is also investigated with regard to the associated literature to increase the awareness of TTP following chemotherapy. PMID:26622823

  3. FOLFIRI regimen in metastatic pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts

    Institute of Scientific and Technical Information of China (English)

    Cindy Neuzillet; Olivia Hentic; Beno(i)t Rousseau; Vinciane Rebours; Lé(i)la Bengrine-Lefèvre; Franck Bonnetain; Philippe Lévy


    AIM:To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts.METHODS:All consecutive patients with histologically confirmed,metastatic PAC and World Health Organization performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus,then 5-FU 2400 mg/m2 as a 46-h infusion,biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2,then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3,biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010.Tumor response,time to progression (TTP),overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied.Subgroup analyses were performed to search for prognostic factors.RESULTS:Sixty-three patients (52.4% male,median age 59 years) were analyzed.Among them,42.9% were PS 0,38.1% were PS 1 and 19.0% were PS 2.Fifty one patients (81.0%) had liver metastases.Before the FOLFIRI regimen,patients had received 1 line (n =19),2 lines (n =39) or 3 lines (n =5) of chemotherapy.Median TTP obtained with the line before FOLFIRI was 3.9 mo (95% CI:3.4-5.3 mo).A total of 480 cycles was completed (median:6 cycles,range:1-51 cycles).The main reason for discontinuing FOLFIRI was tumor progression (90.3%).Tumor control was achieved in 25 patients (39.7%) (partial response:n =5,stable disease:n =20) with FOLFIRI.Median TTP was 3.0 mo (95% CI:2.1-3.9 mo) and median OS was 6.6 mo (95% CI:5.3-8.1 mo).Dose adaptation was required in 36 patients (57.1%).Fifteen patients (23.8%) had grade 3-4 toxicities,mainly hematological (n =11) or digestive (n =4).Febrile neutropenia occurred in 3 patients.There was no toxic death.PS 2 was significantly associated with poor TTP [hazard

  4. Aggressive regimens for multidrug-resistant tuberculosis reduce recurrence. (United States)

    Franke, Molly F; Appleton, Sasha C; Mitnick, Carole D; Furin, Jennifer J; Bayona, Jaime; Chalco, Katiuska; Shin, Sonya; Murray, Megan; Becerra, Mercedes C


    Recurrent tuberculosis disease occurs within 2 years in as few as 1% and as many as 29% of individuals successfully treated for multidrug-resistant (MDR) tuberculosis. A better understanding of treatment-related factors associated with an elevated risk of recurrent tuberculosis after cure is urgently needed to optimize MDR tuberculosis therapy. We conducted a retrospective cohort study among adults successfully treated for MDR tuberculosis in Peru. We used multivariable Cox proportional hazards regression analysis to examine whether receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion from positive to negative was associated with a reduced rate of recurrent tuberculosis. Among 402 patients, the median duration of follow-up was 40.5 months (interquartile range, 21.2-53.4). Receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion was associated with a lower risk of recurrent tuberculosis (hazard ratio, 0.40 [95% confidence interval, 0.17-0.96]; P = .04). A baseline diagnosis of diabetes mellitus also predicted recurrent tuberculosis (hazard ratio, 10.47 [95% confidence interval, 2.17-50.60]; P = .004). Individuals who received an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion experienced a lower rate of recurrence after cure. Efforts to ensure that an aggressive regimen is accessible to all patients with MDR tuberculosis, such as minimization of sequential ineffective regimens, expanded drug access, and development of new MDR tuberculosis compounds, are critical to reducing tuberculosis recurrence in this population. Patients with diabetes mellitus should be carefully managed during initial treatment and followed closely for recurrent disease.