No abstract available.
Cyclophosphamide* ; Doxorubicin* ; Drug Therapy, Combination* ; Etoposide* ; Small Cell Lung Carcinoma*

BACKGROUND: HbA1c measurement is currently routinely used to predict long term outcome of diabetes, thus playing a fundamental role in the management of diabetes. The relationship between HbA1c value and long term diabetic complications has been established by a randomised control Diabetes Control and Complications Trial (DCCT) which used high performance liquid chromatography (HPLC) as a reference method for HbA1c assay. To ensure that HbA1c results from a variety HbA1c assay methods are similar to the DCCT values, the American Diabetes Association (ADA) recommended that all laboratories should use methods certified by the National Glycohemoglobin Standardization Programme (NGSP) with interassay coefficient variation (CV) of < 5% (ideally < 3%). The International Federation of Clinical Chemistry (IFCC) working group on HbA1c standardisation has set a CV < 2.5% as a criteria for its reference laboratories. OBJECTIVES: To evaluate the performance of Arkray Adams HA-8160 HbA1c analyser which uses a cation exchange HPLC method and its correlation to HbA1c assay on Cobas Integra 800 which is an immunoturbidimetric method. METHODS: For the imprecision study, patient samples and control material of two levels were analysed on HA-8160 analyser 20 times in a single run (within-run imprecision) and twice a day on five consecutive days (between-run imprecision). For the recovery study, two samples each with high and low values were selected and mixed in ratios of 1:3, 1:1 and 3:1, and were analysed by HA-8160. Sixty samples were analysed by both Cobas Integra 800 and HA-8160 for method comparison study. Ten uraemic samples and ten thalassaemic samples were assayed on Cobas Integra 800 and HA 8160 for interference study. RESULTS: Within-run CVs were 0.6% and 0.7% for medium and high value samples respectively, 0.6% and 0.7% for low and high level controls respectively. Between-run CVs were 0.5% and 0.4% for medium and high value samples respectively, 0.5% and 0.6% for low and high level controls respectively. The mean recovery was 100.1%. A good correlation between the 2 methods (Adams = 1.00 Cobas - 0.11, r = 0.98) was observed. CONCLUSIONS: The Akray Adams HA-8160 HbA1c analyser performed within the target CV of < 2.5% and showed a good correlation with the Cobas Integra 800.
Glycosylated hemoglobin A ; Sjogren's syndrome B antibody ; Adams ; Performance ; cyclophosphamide/etoposide

The major portion of Hodgkin lymphoma (HL) patients, even at an advanced stage can be cured with optimal initial treatment. ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) is the standard treatment regimen for the advanced stage HL, while Stanford V (doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, and prednisone) and escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) can be reasonable alternatives for selected patients. Although radiotherapy is the key component in Stanford V regimen, radiotherapy should be applied only at the residual lymphoma in patients who received ABVD and BEACOPP therapy. These three representative treatments for advanced HL have individual advantages and disadvantages, so that the choice of the initial treatment should be dependent on patients' relapse risk, comorbidity, and age.
Bleomycin ; Comorbidity ; Cyclophosphamide ; Doxorubicin ; Etoposide ; Hodgkin Disease ; Humans ; Lymphoma ; Mechlorethamine ; Procarbazine ; Recurrence ; Vinblastine ; Vincristine

BACKGROUND: The objective responses of cisplatin and etoposide (PVP) combination chemotherapy as second-line therapy following CAV was high (40~50%) and, in several reports, PVP yields survival results that are at least as good as those obtained with cyclophosphamide or doxorubicin-based regimens and with less host-related toxicity in chemotherapy-naive patients. We conducted a phase II study to evaluate the effect of a combination of cisplatin and etoposide as a first-line therapy in patients with small cell lung cancer. METHODS: Sixty-one previously untreated small cell lung cancer patients with measurable lesion(s) received cisplatin(30 mg/m2 IV, day 1~3) and etoposide(100 mg/m2 IV, day 1~3). In patients with limited disease, after completion of 6 cycles of PVP chemotherapy, chest and prophylatic brain irradiation was performed in case of complete responder, chest irradiation only in partial responder. RESULTS: 1) Of 55 evaluable patients, 13(24%) had a complete response and 29(53%) had a partial response. 2) The median survival time was 55.8 weeks for all patients(N=55), 61.1 weeks for limited disease(N=31), 51.3 weeks for extensive disease(N=24). 3) The response duration was 29.1 weeks for responders(N=42). 4) There was no significant prognostic factors iufluencing response rates. 5) The toxicity was tolerable and there was no treatment-related deaths. CONCLUSION: The PVP combination chemotherapy as a first-line therapy was effective and well-tolerated in patients with small cell lung cancer.
Brain ; Cisplatin* ; Cyclophosphamide ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Small Cell Lung Carcinoma* ; Thorax

Background: Recent studies have shown poorer outcomes for patients with prognostic score above 12. Authors have proposed categorizing these patients as ultra high-risk to emphasize the need for a different treatment regimen. Objectives: This study was conducted to compare the clinical response of high-risk and ultra high-risk Gestational Trophoblastic Neoplasia (GTN) patients who were managed at the Philippine General Hospital, from January 1, 2010 to December 31, 2015, after receiving the EMACO regimen as first line treatment. Methods: All patients diagnosed with metastatic high-risk GTN who were managed at the Philippine General Hospital from January 1, 2010 to December 31, 2015 and given the EMACO regimen as first-line treatment were included in the study. Patients were divided into high-risk disease or patients with a WHO prognostic score of 7-11 and ultra high-risk disease or patients with WHO prognostic score of 12 and above. Using the Z-test on two proportion, treatment outcome between the two groups were compared. Results: A total of 57 patients diagnosed with metastatic high-risk GTN were included in the study. Of these, 35 or 61% were classified as high-risk while 22 or 39% were ultra high-risk. The primary remission rate of the high-risk group was 89% compared to 77% for the ultra high-risk group. The difference was not statistically significant (p=0.2542). Out of the 57 patients included in the study, 48 patients achieved remission after being treated with EMACO. An additional 4 patients achieved remission after being shifted to EPEMA due to resistance to the first line agent. All patients were alive after one year of follow-up, giving a one-year survival rate of 91.2%. Conclusion The result of this study showed a relatively higher remission rate for high-risk (89%) than ultra highrisk GTN (77%) with EMACO as first line chemotherapy regimen, but statistical analysis revealed no significant difference. This finding suggests that EMACO may still be used as first line regimen for ultra high-risk GTN to attain remission.
Gestational Trophoblastic Disease ; EMA-CO protocol ; Etoposide ; Dactinomycin ; Antineoplastic Combined Chemotherapy Protocols ; Cyclophosphamide ; Methotrexate ; Vincristine

BACKGROUND: The CHOP regimen has been the standard therapy for non-Hodgkin's lymphoma (NHL) for the past 30 years, but its effect on complete response and long-term survival rates were unsatisfactory. Therefore, more effective chemotherapeutic regimens are required. We attempted to treat non-Hodgkin's lymphoma with a newly developed cyclophosphamide, adriamycin, etoposide, prednisolone (CHEP) combination chemotherapy which substitutes etoposide for vincristine in a preexisting cyclophosphamide, adriamycin, prednisolone, vincristine (CHOP) regimen. METHODS: Between March 1997 and April 2003, 36 patients with a histologically confirmed NHL were enrolled in the study. All patients received CHEP chemotherapy as a first-line treatment. Tratment courses were repeated every 34 weeks for at least 4 cycles, pending response to the treatment. RESULTS: The overall response rate achieved was 86.1% for all of the patients. The complete response (CR) and partial response (PR) rates were 72.2% and 13.9%, respectively. The CR rate was significantly higher in patients with stage III disease, and a PS score of 02 (p<0.0001, p=0.017, respectively). The three year overall (OS) and failure-free survival (FFS) rates were 61.2%, 58.2%, respectively. Stage, extranodal involvement, and the attainment of CR influenced OS significantly (p=0.027, p=0.047, p=0.0001, respectively) as determined by univariate analysis. Stage, serum LDH level, extranodal involvement, the international prognostic index (IPI), and the attainment of CR influenced FFS significantly (p=0.0013, p=0.048, p=0.020, p=0.018, p=0.0001, respectively) as determined by univariate analysis. The dose-limiting toxicity was due to myelosuppression. Nno neurologic side effects were seen, which frequently occur after using vincristine. CONCLUSIONS: The CHEP regimen in patients with aggressive NHL is effective as a first-line therapy, and possesses an acceptable toxicity profile. We suggest a trial that adds rituximab to the CHEP regimen as afirst-line therapy for aggressive NHL in the future.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Prednisolone ; Survival Rate ; Vincristine ; Rituximab

PURPOSE: Radiotherapy is effective in local treatment for retinoblastoma. However, asymmetric facial hypoplasia after radiation is a serious late effect. This study was performed to investigate the effects of enucleation and chemotherapy with or without radiotherapy in advanced intraocular and intraorbital retinoblastoma. METHODS: Between 1985 October and 2006 December, the records of thirty five patients who were diagnosed as retinoblastoma at Yeungnam University Hospital were reviewed. Advanced intraocular and intraorbital retinoblastoma patients classified as Reese-Ellsworth group III, IV, and V and Grabowski- Abramson class II were selected for the study. RESULTS: Eighteen patients were enrolled in this study. All patients were enucleated and had received chemotherapy. Nine patients received radiotherapy and nine patients didn't receive radiotherapy. Tumor cells were found on resection margin of optic nerve in five of nine patients who received radiotherapy, but none of nine who didn't receive radiotherapy. Chemotherapy included vincristine, adriamycin, cyclophosphamide, VM-26, cisplatin before 2001, and vincristine, etoposide, and carboplatin after 2001. There were no recurrences or metastases in nine patients who didn't receive radiotherapy. But two of nine patients who received radiotherapy had metastases to brain. However, all survivors who received radiotherapy had significant facial asymmetry. CONCLUSION: In advanced intraocular and intraorbital retinoblastoma without tumor cell on resection margin of optic nerve, enucleation and chemotherapy without local radiotherapy appears to be safe for long-term survival. However, in those with tumor cells on resection margin of optic nerve, enucleation and chemotherapy with local radiotherapy seems to be necessary to improve survival.
Brain ; Carboplatin ; Cisplatin ; Cyclophosphamide ; Doxorubicin ; Etoposide ; Eye Enucleation ; Facial Asymmetry ; Humans ; Neoplasm Metastasis ; Optic Nerve ; Recurrence ; Retinoblastoma ; Survivors ; Teniposide ; Vincristine

Background: Combination chemotherapy is now considered to be the cornerstone of small cell lung cancer (SCLC). management but the optimal management of limited SCLC is not well defined. The role of thoracic radiotherapy (TRT) is less well established. Recent meta-analyses reports revealed that TRT combined with chemotherapy produce "good" local control and prolonged survival. But other reports that survival was not changed. The timing, dose, volume and fractionation for TRT with the combined chemotherapy of SCLC remains unsettled. In this study, we analyzed the effects according to the timing of thoracic radiotherapy in limited SCLC. Method: All fifty one patients received cytoxan, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(VPP) every 3 weeks for 6 cycles were randomized prospectively into two groups: concurrent and sequential. 27 patients received 4500cGy in 30 fractions(twice daily 150cGy fractional dose) over 3 weeks to the primary site concurrent with the first cycle of VPP(concurrent gorup). 24 patients received 4000 to 5000cGy over 5 or 6 weeks after completion of sixth cycles of chemotherapy(sequential group). Results: 1. Response rates and response duration: Response rates were not significantly different between two groups(p=0.13). But response duration was superior in the concurrent group(p=0.03). 2. Survival duration was not different between two groups(p=0.33). 3. Local control rate was superior in the concurrent group(p=0.00). 4. Side effects and toxicities: Hematologic toxicides, especially leukopenia, infection and frequency of radiation esophagitis were higher in the concurrent group(p=0.00, 0.03, 0.03). Conclusion: The concurrent use of TRT with chemotherapy failed to improve the survival of limited stage SCLC patients compared with the sequential use of TRT but response duration and local control rate were superior in the concurrent group. Frequency of radiation esophagitis, life threatening hematologic toxicities and infection were more frequent in the concurrent group than sequential group. So, the selection of an optimal schedule of chemotherapy combined with TRT that would lead to a major increase in survival with minimal toxicity is remained to be validated in large scale study in the future.
Appointments and Schedules ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Esophagitis ; Etoposide ; Humans ; Leukopenia ; Prospective Studies ; Radiotherapy ; Small Cell Lung Carcinoma*

Neuroblastoma is the most common intraabdominal malignant tumor of childhood, with 40% arising from the adrenal gland. Bilateral adrenal involvement from synchronous development or metastatic spread of tumor is rarely seen in children with neuroblastoma. The patient was born with a spontaneous vaginal delivery. Birth weight was 3,200 g. Fetal ultrasonography showed a left adrenal cystic mass. At two weeks of age, she was admitted due to a massive abdominal distension and tachypnea. Percutaneous ultrasonography guided biopsy of the left adrenal mass was performed. The result of the biopsy was neuroblastoma. Vincristine and cyclophosphamide were administerd intravenously and 450 cGy of irradiation was added. Left adrenalectomy was accomplished and postoperative course was uneventful. The patient received cancer chemotherapy with a combination of carboplatin, ifosfamide and VP-16 and is now being followed up for three months. We have experienced a case of congenital bilateral neuroblastoma and report the case with brief review of related literatures.
Adrenal Glands ; Adrenalectomy ; Biopsy ; Birth Weight ; Carboplatin ; Child ; Cyclophosphamide ; Drug Therapy ; Etoposide ; Humans ; Ifosfamide ; Neuroblastoma* ; Tachypnea ; Ultrasonography ; Ultrasonography, Prenatal ; Vincristine

OBJECTIVE: We evaluated the effects and toxicities and cost effectiveness of iv etoposide-carboplatin- cyclophosphamide (ECC) combination chemotherapy against persistent or recurrent ovarian cancer who were previously heavily treated with one or more lines of chemotherapy which included platinum-paclitaxel- cyclophosphamide-topotecan based regimens. METHODS: Fifteen patients with a persistent or recurrent ovarian cancer, previously received first or more line chemotherapy, had been treated with ECC combination chemotherapy at Konsin Medical Center from September 2000 to October 2002. The ECC (iv etoposide-carboplatin-cyclophosphamide) combination chemotherapy consists of 100 mg/m2 etoposide iv and 500 mg/m2 cyclophosphamide iv in first day and 100 mg/m2 etoposide iv, 450 mg/m2 carboplatin iv in second day and 100 mg/m2 etoposide iv in third (and 4th-5th day if necessary) every 3-4 weeks. The response of patients was evaluated with the tumor marker (serum CA-125) and imaging studies (ultrasonogram, CT, MRI). The toxicities were defined according to the WHO toxicity criteria. RESULTS: The overall response rate by WHO criteria is 47%. In detail, partial response is 47%, Stable disease is 40% and progressive disease is 13%. The serologic CA-125 response rate is 64%, in detail serologic partial response is 64%, and serologic stable disease is 22% and serologic progressive disease is 14%. The median response duration is 9 months (4 to 12 months), the median time to response is 1 month (2 weeks to 2 months) and the median time to progression is 9 month (4 to 12 months). The most common side effect is nausea and vomiting and the bone marrow suppression is proved as a most serious side effect (grade 3 or more-13%). CONCLUSION: The iv etoposide-carboplatin-cyclophosphamide chemotherapy as a 2nd or more lines regimen against persistent or recurrent ovarian cancer is considerable.
Bone Marrow ; Carboplatin* ; Cost-Benefit Analysis ; Cyclophosphamide* ; Drug Therapy* ; Drug Therapy, Combination* ; Etoposide* ; Humans ; Nausea ; Ovarian Neoplasms* ; Vomiting