摘要:

Twenty-eight patients with stage III B-IV non-small-cell lung cancer were treated with mitomycin C, vinblastine and cisplatin (MVP) in a phase II – minimax 2-stage design – randomized trial (with cisplatin plus etoposide as control arm). As indicated by the study design, the accrual was stopped after the 11th responded and the combination was considered as active at the 40% level. Forty-six percent of patients had an improvement of their initial Karnofsky performance score, lasting a median of 24 weeks, and about 38 % had a complete relief of symptoms. Hematologic toxicity was moderate to severe in about 50% of patients, and neurologic toxicity in about 18%; no grade 4 toxicity was observed. The estimated median progression-free survival was of 25 weeks. The observed activity and manageability, together with the positive effect on patient quality of life, account for a positive evaluation of MVP as a palliative treatment in advanced non-small-cell lung can

ISSN:0030-2414    

DOI:10.1159/000227137

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Seventy-six patients with advanced non-small-cell lung cancer were randomly allocated to two groups and treated with cisplatin (CDDP; 80 mg/m2 on day 1) plus either vindesine (VDS; 3 mg/m2 on days 1 and 8) or mitomycin C (MMC; 8 mg/m2 on days 1 and 8) every 3-4 weeks. The objective response rates were 26% (10/38) for CDDP plus VDS and 32% (11/34) for CDDP plus MMC; the corresponding response rates in patients with adenocarcinoma were 7% (1/14) and 43% (6/14), respectively. The median survival times ofpatients treated with CDDP plus VDS and CDDP plus MMC were 33 and 30 weeks, respectively, the difference in survival times in the two groups not being significant. There was no significant difference in toxic effects in the two groups except that alopecia and leukopenia were more frequent in patients treated with CDDP plus VDS.

ISSN:0030-2414    

DOI:10.1159/000227138

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

MMM (mitomycin 7–8 mg/m2 i. v.) every 6 weeks; mitoxantrone 7-8 mg/m2 i. v. every 3 weeks; methotrexate 35 mg/m2 i.v. every 3 weeks) is a new combination chemotherapy regimen for advanced breast cancer. It has been compared in two complementary randomized trials with CMF (cyclophosphamide 100 mg orally, days 1–14; methotrexate 35 mg/m2 i.v. days 1 and 8; 5-fluorouracil 1 g i.v. days 1 and 8; courses repeated at 28-day intervals) and VAC (vincristine 1.4 mg/m2 every 3 weeks, anthracycline 30 mg/m2 every 3 weeks, cyclophosphamide 400 mg/m2 every 3 weeks) in patients with advanced metastatic breast cancer. In the first trial, which involved 227 patients, 53% of patients receiving MMM and 49% receiving VAC responded to treatment. There was no significant difference between treatment groups in median response duration or survival. Incidence of neuropathy, alopecia, and nausea and vomiting was significantly higher in patients receiving VAC. Hematologic toxicity was greater in the MMM group. In the second trial, which involved 120 patients, 51% of patients receiving MMM and 60% receiving CMF responded to treatment. Again, there was no significant difference between treatment groups in median response duration or survival. Both regimens were well tolerated with a low incidence of alopecia and serious nausea and vomiting, and there were no significant differences in toxicity. Significant reductions in serial left ventricular ejection fractions occurred in 4 patients given CMF and in 2 given MMM. MMM is an effective, well-tolerated regimen for advanced breast cancer, with toxicity similar to that of CMF and less than that of an anthracycline-contain-ing regi

ISSN:0030-2414    

DOI:10.1159/000227241

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Forty-seven patients with stage III nonsmall cell lung cancer (NSCLC) were treated with the sequential administration of combination chemotherapy consisting of cisplatin, epirubicin and etoposide and of irradiation plus lonidamine. The response rate was 49 % after chemotherapy with an improvement of 14% after radiation therapy and lonidamine. The median survival was around 15 months for responders and 9 months for nonresponders. Toxicity was moderate and acceptable. It is concluded that this schedule is active in the treatment of NSCLC.

ISSN:0030-2414    

DOI:10.1159/000227139

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

This study was performed to evaluate local tumour control and toxicity of chemoradiotherapy given to patients with primary or recurrent carcinoma of the anal canal. A total of 117 patients were admitted to the Norwegian Radium Hospital during the period of 1983-1989, of which 106 received a combination of radiotherapy (50 Gy to the pelvis) and chemotherapy (mitomycin C + 5-fluorouracil). Sixty-five percent of the patients with primary carcinomas presented with advanced tumours (T3 or T4). Good local tumour control was obtained as only 25% of the patients with advanced tumours (T3 and T4) and 7% of those with smaller tumours (T1, and T2) had a local relapse after treatment. Recurrent tumours following primary surgery did not respond as well; 50% of these patients still had carcinoma 1 month following therapy. All patients experienced acute toxicity (dermatitis/mucositis, diarrhoea and general fatigue), and 50% needed as split course. There was, however, no therapy-related mortality. Survival data seem promising, but further follow-up is necessary to make conclusions. Eight percent of the patients had serious anal insufficiency after treatment. We conclude that the present regimen provides good local tumour control and well-preserved anal function, but has considerable acute toxicity.

ISSN:0030-2414    

DOI:10.1159/000227140

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The combination chemotherapy regimen of mitomycin/vinblastine has been used in the treatment of metastatic breast cancer since the early 1980s. We report results of use of mitomycin/vinblastine in 35 women with metastatic breast cancer who had failed prior treatment with one to four chemotherapeutic regimens. Despite heavy prior treatment and significant tumor burdens, 34% of patients achieved a partial remission and another 14% had disease stabilization with a very acceptable toxicity profile. This regimen was also used for the first time as first-line chemotherapy in 11 women with metastatic breast cancer. Response was observed in 9 of 11 patients (82%). Hemolyticuremic syndrome occurred in 6 of the 46 women (13%) treated in the two protocols and is the most serious potential complication. Mitomycin/vinblastine is an effective salvage regimen and an excellent first-line chemotherapeutic treatment for women with metastatic breast cancer.

ISSN:0030-2414    

DOI:10.1159/000227243

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Injection of ethyl alcohol in high concentrations into tissues produces coagula-tive necrosis. The benefits of direct injection of 98 % ethanol into hepatic metastases from 1,2-dimethylhydrazine (DMH)-induced colonic cancer was investigated in groups of 20 Sprague-Dawley rats of either sex. At 10 weeks of age, rats were subcutaneously injected every week with 10 mg/kg DMH for 28 weeks. They were then housed for 3 months. At the end of this period all the animals had developed colonic carcinoma with multiple hepatic metastases. Total colectomy and the fashioning of an ileostomy coupled with direct injection of 0.1–0.2 ml of ethanol into each of the hepatic metastases, after mobilizing the liver by dividing its fascial attachments to facilitate easier tumour detection by inspection and palpation, afforded a significant survival advantage relative to colectomy alone (20.1 + 0.2 months of age, vs, 12.8 ± 0.2 months of age, mean + SEM, n = 20, p < 0.01 by the Mann-Whitney U test). The clinical implications of these observations were, therefore, examined in a pilot study carried out on 6 patients (2 women and 4 men with an age range of 43–71 years, mean 56) who had adenocarcinoma of the sigmoid colon with multiple hepatic secondaries. The colonic tumour was resected and an end-to-end anastomosis effected, then all palpable hepatic metastases were slowly injected with 1–1.5 ml of 98% ethanol. Two weeks post-operatively and thereafter once every 2 months any hepatic lesions detected ultrasonically were similarly treated per-cutaneously. This treatment produced no adverse effects of any significance. None of the patients died during the first post-operative year. Death was due to disease spread in all the patients. The mean survival measured from the time of tumour resection until death from any cause was 20 months (range 17-26 months). It thus appears that chemonecrosis for the treatment of liver metastases from colonic cancer is a simple and safe therapeutic modality which offers a surviva

ISSN:0030-2414    

DOI:10.1159/000227141

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A phase 2 study of cisplatin was performed in 28 previously untreated patients with unresectable hepatocellular carcinoma. The drug was given intravenously at a dose of 80 mg/m2 50% reduction in serum AFP levels after treatment. The current study indicates that cisplatin is an anticancer agent worthy of further testing in patients with this disease

ISSN:0030-2414    

DOI:10.1159/000227142

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Mitomycin has proven to be among the most active drugs available for the single-agent treatment of non-small cell lung cancer (NSCLC). In combination with vinca alkaloids and cisplatin, mitomycin can produce response rates greater than or equal to 50% in properly selected patients. In our experience, such responses were achieved using moderate doses (7 or 8 mg/m2) of mitomycin, which also resulted in fewer hematologic and other toxicities. Delivery of MVP (mitomycin/vinca alkaloid/cisplatin) to 150 patients with stages III and IV NSCLC during the last decade showed maximal response was achieved after two or three cycles of therapy. A comparative analysis of results reported using MVP regimens suggests that high response rates are associated with greater dose-intensive use of cisplatin and lesser dose-intensive use of mitomycin. Although the role of MVP in the treatment of advanced NSCLC is unclear, use of mitomycin-containing regimens as part of a multidisciplinary approach to stage IIIA NSCLC has yielded high response rates and has successfully downstaged patients prior to surgery. Randomized clinical trials will be required to validate these findings, but the focus of future research should be on discovering new agents with greater activity and on developing new approaches wherein these agents can be delivered with maximum efficacy and minimum toxicity.

ISSN:0030-2414    

DOI:10.1159/000227244

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Circulating immune complexes (CIC) have been detected in several autoimmune diseases, and studies have also suggested that CIC provide a useful tool as tumor markers. In order to identify differences or similarities in antigenic composition, CIC from 23 patients with gastrointestinal (GI) tumors, from 20 patients with stage III and IV melanoma and from 6 patients with inflammatory bowel disease (IBD) were studied. Serum from all GI, melanoma and IBD patients showed higher levels of CIC than controls. SDS/PAGE electrophoresis under reducing conditions revealed some differences between cancer and IBD patients as far as the CIC protein composition was concerned. In melanoma patients, two fast-migrating bands, in the regions of 71–74 and 30–49 kD, were found, consistent with previously isolated and characterized antigens described in the literature.

ISSN:0030-2414    

DOI:10.1159/000227143

出版商:S. Karger AG    

年代:1993

数据来源: Karger