摘要:

The significance of a preoperative elevation of serum C-reactive protein (CRP) as an indicator of the malignant potential and prognosis in colorectal cancer is reported. The reduction of circulating lymphocytes reflects the immunosuppressive conditions of patients with neoplasms. The aim of the current study was to elucidate the significance of a preoperative elevation of serum CRP as an indicator of the impaired immunity of the patients with colorectal cancer. The subjects were 155 consecutive patients with colorectal cancer who were treated with surgical resection. The preoperative serum CRP level and the proportion of circulating lymphocytes in peripheral blood were measured and the relationship between these values was investigated. The mean value of lymphocytes percentages in patients with the preoperative elevation of serum CRP was 25.2 ± 8.7%, which was significantly lower than that (33.4 ± 9.3%) in patients without the preoperative elevation of serum CRP (p< 0.01). In summary, preoperative elevation of serum CRP was significantly related to the reduction of lymphocyte percentages in peripheral blood, and it can be an indicator of impaired immunity in the patients with colorectal cancer.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

To evaluate whether the incidence of emesis in patients undergoing cisplatin chemotherapy and receiving the standard antiemetic prophylaxis during daily clinical practice was similar to that obtained in antiemetic trials, a prospective study was carried out, adopting very wide eligibility criteria. In the first cycle of chemotherapy, 308 consecutive adult patients were evaluated, 112 in the second, and 89 in the third cycle. Results were compared with those obtained in three published randomized clinical trials. In the first cycle of chemotherapy, complete protection from acute vomiting/nausea was obtained by 78.9% (243/308) and 71.8% (221/308) of patients. These results were quite similar to those obtained in the three randomized studies: 79.7%/72.1%, 78.3%/71.4%, and 78.7%/77.2%. No significantly different results among these studies were obtained, even in the second and third cycles of chemotherapy. In conclusion, in patients undergoing cisplatin chemotherapy, the effectiveness of the same standard antiemetic prophylaxis is similar to the efficacy found in randomized clinical trials, regardless of the eligibility/exclusion criteria and the setting of the study.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Patients with non-Hodgkin’s lymphoma (NHL) who fail initial therapy have a poor prognosis. We conducted a phase II study to determine the efficacy and toxicity of didemnin B, a nonmyelosuppressive marine compound, in patients with NHL who relapsed or progressed after receiving one or two previous chemotherapy regimens. Fifty-one eligible patients were registered on this phase II study. Twenty-nine patients had intermediate or high grade (IG/HG) disease and 22 patients had low grade (LG) disease. Twenty-five patients received didemnin B at a dose of 6.3 mg/m2and the remainder received 5.6 mg/m2, administered intravenously every 28 days. The patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0–2 and biopsy-proven relapsed disease. Objective responses were observed in two (7%) patients (one complete remission [CR] and one partial remission [PR]) with IG/HG disease and five (23%) patients (one CR and four PR) with LG disease. Patients with IG/HG disease had a median time to treatment failure (TTF) of 1.6 months and a median survival of 8.0 months. In contrast, the group with LG disease had a median TTF of 4.6 months and a median survival of 2.7 years. There were five grade V, 12 grade IV, and 57 grade III toxicities. Didemnin B appears to have modest activity in low grade NHL. However, the drug has considerable toxicity in this population of patients.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

In a retrospective study, we showed that a monocyte count of <150/&mgr;l on days 6 to 8 might be a predictor of grade III or IV neutropenia during cancer chemotherapy given at 3- or 4-week intervals. In the present study, we investigated whether the administration of granulocyte colony-stimulating factor (G-CSF) when monocytopenia appears lessens neutropenia during chemotherapy for lung cancer. Between June 1997 and August 1998, 60 patients who received chemotherapy at 3- or 4-week intervals for unresectable lung cancer were randomized to receive G-CSF (2 &mgr;g/kg or 50 &mgr;g/m2) when monocytopenia (<150/&mgr;l) appeared on days 6 to 8 after chemotherapy (group A) or when neutropenia (<1,000/&mgr;l) or leukopenia (<2,000/&mgr;l) appeared after chemotherapy (group B). The administration of G-CSF was stopped when the leukocyte or neutrophil counts reached >10,000/&mgr;l or 5,000/&mgr;l, respectively. The blood cells counts were examined three times a week and the degree, duration, and frequency of chemotherapy-induced neutropenia of the two groups were compared. One patient in group A was excluded because whole brain irradiation during chemotherapy was required. Twenty-nine and 30 patients in groups A and B, respectively, received platinum-based chemotherapy and their chemotherapy-induced hematologic toxicities were analyzed. The mean neutrophil count nadir of group A (1,558 ± 1,771/&mgr;l) was significantly higher than that of group B (810 ± 639/&mgr;l,p= 0.032). The duration of grade III neutropenia in group A (1.4 ± 1.7 days) was significantly shorter than that in group B (2.9 ± 1.9 days,p= 0.004), and the frequency of grade III neutropenia in group A (48%) was significantly lower than that in group B (83%,p= 0.002). Infectious episodes occurred in five and eight patients in groups A and B, respectively. The durations of G-CSF therapy required by group A and B patients (4.8 ± 3.1 vs. 4.7 ± 2.7 days) were not significantly different. Prophylactic administration of G-CSF did not exacerbate anemia or thrombocytopenia induced by chemotherapy. We conclude that the prophylactic administration of G-CSF when monocytopenia appears can lessen neutropenia caused by chemotherapy for lung cancer without increasing the total G-CSF dose.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Oxidative DNA damage (ODD) can result from numerous endogenous metabolic processes as well as from exposure to environmental and dietary oxidants. One important type of ODD that may have a role in carcinogenesis is the formation of hydroxylated DNA bases. Our major purpose was to determine the potential for subject accrual for a multisite case–control study of ODD and breast cancer risk within a large urban university medical center. We examined the levels of a hydroxylated thymine residue, 5-hydroxymethyl-2′-deoxyuridine in DNA obtained from the peripheral blood of 26 women with breast cancer and an age-matched group of 29 control women without breast cancer. The isolated DNA was analyzed for levels of 5-hydroxymethyl-2′-deoxyuridine by gas chromatography with mass spectral detection. Our recruitment methods resulted in a relatively high yield of eligible cases (72%) and a lower yield of controls (46%). We evaluated the dose–response relationship of ODD level to breast cancer risk, using quartiles of ODD. The covariate-adjusted odds ratio of breast cancer exceeded 2.0 for women in the highest quartile of ODD (compared with the lowest quartile), although this result was not statistically significant. ODD levels were significantly more variable among African-American controls (SD = 224.1) than among white controls (SD = 57.5),p< 0.001. Overall, these results suggest a possible slight increase in breast cancer risk among women in the highest ODD quartile, after adjusting for race, menopausal status, and family history of breast cancer.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

We report the results of a chemotherapy regimen combining oxaliplatin, 5-fluorouracil, and folinic acid in patients with metastatic renal cell carcinoma. The objective of this pilot study was to define the potential efficacy of this second-line combination in patients previously treated with interleukin-2 alone or in combination with interferon alpha. Fourteen patients with metastatic renal cell carcinoma in failure after immunotherapy were included in this trial. During treatment, patients received six chemotherapy courses (Folfox regimen) administered every 2 weeks. Each cycle combined oxaliplatin day (D) D1 and folinic acid plus 5-fluorouracil D1 and D2. At completion of treatment, no objective response was observed and two patients presented stable disease. This chemotherapy schedule in patients with metastatic renal cell carcinoma previously treated with immunotherapy does not seem to be effective.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Bilateral synchronous testicular lymphoma is an uncommon presentation of non-Hodgkin’s lymphoma. A young man with non-Hodgkin’s lymphoma of both testes synchronously is described here. He underwent bilateral orchiectomy, received chemotherapy, and was in complete remission when there was a relapse in the kidneys. Salvage chemotherapy was given. The patient developed progression of the residual lesion subsequently and was started on palliation with chlorambucil and prednisolone. He was alive at 34 months after diagnosis with disease.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Patients with more than nine ipsilateral lymph node involvement or inflammatory breast cancer have a 5-year survival rate of approximately 50%. We studied the efficacy of high-dose intensification, comparing it with the standard dose chemotherapy for patients with high-risk primary breast cancer. Patients with inflammatory breast cancer or more than nine ipsilateral lymph node involvement without evidence of distant metastasis were randomized to receive either standard dose 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) every 3 weeks for nine courses (control) or six courses of FAC followed by two courses of cyclophosphamide (5.25 g/m2), etoposide (1,500 mg/m2), and cisplatin (165 mg/m2) (HDCVP). The study was terminated in 1998 because of slow accrual of patients. Forty-six patients were entered in the study. At 4 years, the overall survival was 72.8% (SE 11.9%) and 61.7% (SE 12.4%), and disease-free survival were 45.5% (SE 12.3%) and 33.7% (SE 11.9%) for the control and HDCVP groups, respectively (p= 0.757 and 0.720). With the small number of patients in our study, a small overall survival benefit of high-dose intensification compared with the standard therapy cannot be excluded. However, any substantial benefit is unlikely.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

New therapies are needed for patients with advanced ovarian cancer who relapse after initial treatment with platinum and/or paclitaxel-based regimens. This study sought to determine the toxicities of combined liposomal doxorubicin (Doxil) and topotecan, and to determine a regimen for future phase II testing in ovarian cancer. Nine patients with advanced malignancies were treated with topotecan 1.0 mg/m2/day × 5 days followed by liposomal doxorubicin at a starting dose of 30 mg/m2on day 5. Cycles were repeated every 28 days. A total of 13 cycles of therapy were administered. Grade IV neutropenia and grade IV thrombocytopenia developed in both of the two patients treated at the first dose level. Subsequent patients received only 20 mg/m2liposomal doxorubicin. At that dose level, three patients experienced dose-limiting toxicity (one grade IV neutropenia, two grade IV neutropenia and thrombocytopenia). No responses were observed. These data indicate that the described regimen of liposomal doxorubicin and topotecan is not feasible because of excessive hematologic toxicity. Escalation to doses of liposomal doxorubicin or topotecan that have previously demonstrated antitumor activity was not possible. Future strategies to minimize such toxicity may include limiting eligibility to patients with minimal prior therapy, reducing the number of days of topotecan administration, or use of oral topotecan.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A matched-control study comparing standard radiotherapy versus neoadjuvant chemotherapy and radiation was undertaken to clarify the effects of neoadjuvant systemic chemotherapy for locally advanced squamous cell carcinoma of the maxillary antrum. Thirty-four patients with inoperable maxillary cancer were treated with neoadjuvant chemotherapy and radiotherapy (Group II). Before starting radiotherapy, all patients in Group II received two or three cycles of neoadjuvant chemotherapy consisting of cisplatin and a 5-day continuous infusion of 5-fluorouracil with or without intravenous injection of vinblastine. Radiation doses ranged from 66 Gy to 75 Gy (median, 70 Gy). The response rate, patterns of failure, toxicity, and survival for Group II were compared with those for 34 stage-matched patients treated with radiation alone (Group I). Despite a higher response rate to neoadjuvant chemotherapy, the recurrence rate and patterns of treatment failure were not influenced by the addition of neoadjuvant chemotherapy. In most cases, neoadjuvant chemotherapy did not interfere with subsequent radiotherapy, and radiation-induced late complications occurred equally in both treatment groups. After a median follow-up of 48 months, there was no significant difference in 5-year actuarial survival or disease-free survival between the two treatment groups. Radiation alone for inoperable maxillary cancer was clearly suboptimal for improving local control and survival rate, but neoadjuvant chemotherapy in addition to standard radiotherapy failed to demonstrate any therapeutic advantage over radiation alone.

ISSN:0277-3732    

出版商:OVID    

年代:2000

数据来源: OVID