OBJECTIVETo evaluate the effects and the toxicity of the protocol of CDV combined with CiE as pre-operative chemotherapy in childhood stage IV neuroblastoma.

METHODSThe clinical data of 27 children aged from 1.2 to 8 years with neuroblastoma in stage IV was retrospectively studied. The primary sites of the diseases were abdomen (n = 21), posterior mediastinum (n = 4) and pelvic cavity (n = 2). Twenty three patients had bone marrow metastasis. Twelve patients had bone metastasis. All patients were treated with the CDV protocol (cyclophosphamide + doxorubicin + vincristine) for 3 cycles and the CiE protocol (cisplatin + etoposide) for 2 cycles. Neuroblastoma therapeutic response evaluation criterion and common terminology criteria for adverse events of National Cancer Institute were used to evaluate effects and chemotherapy related toxicity.

RESULTSAll patients received the pre-operative chemotherapy. The overall response rate was 82%. After chemotherapy, 24 patients received operations. Total resection of primary tumor was found in 14 patients (58%) and part resection in 10 patients (42%). The most common chemotherapy related toxicity was bone marrow suppression: grade IV suppression of neutrophils (n = 27), reduction in hemoglobin (III grade, n = 7; IV grade, n = 20) and reduction in platelet (III grade, n = 2; IV grade, n = 25). Infection was found in all patients and was controlled with antibiotics. I or II grade lesions of digestive, liver and kidney were found and could be recovered after therapy. Grade I neurotoxicity occurred in 2 patients (7%). The heart function damage was not found in any of patients.

CONCLUSIONSThe protocol of CDV combined with CiE as pre-operative chemotherapy might be effective in children with stage IV neuroblastoma.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Cisplatin ; administration & dosage ; adverse effects ; Cyclophosphamide ; administration & dosage ; adverse effects ; Dacarbazine ; administration & dosage ; adverse effects ; Etoposide ; administration & dosage ; adverse effects ; Female ; Humans ; Infant ; Male ; Neuroblastoma ; drug therapy ; Retrospective Studies ; Vincristine ; administration & dosage ; adverse effects

This study was performed to evaluate the efficacy and toxicity of low-dose paclitaxel/cisplatin chemotherapy in patients with metastatic or recurrent gastric cancer that had failed 5-fluorouracil/platinum-based chemotherapy. Thirty-two patients with documented progression on or within 6 months after discontinuing 5-fluorouracil/platinum-based chemotherapy were enrolled. As a second-line treatment, paclitaxel (145 mg/m2) and cisplatin (60 mg/m2) was administered on day 1 every 3 weeks. Among 32 patients enrolled, 8 (25%) responded partially to paclitaxel/cisplatin, 8 (25%) had stable disease, and 14 (44%) had progressive disease. Two patients (6%) were not evaluable. The median time to progression (TTP) and overall survival for all patients were 2.9 months and 9.1 months, respectively. The most common hematologic toxicity was anemia (47%). Grade 3 neutropenia developed in three patients (9%), but no other grade 3/4 hematologic toxicity occurred. The most common non-hematologic toxicities were emesis (31%) and peripheral neuropathy (38%). Three cases (9%) of grade 3/4 emesis and 2 cases (6%) of grade 3 peripheral neuropathy developed. In conclusion, low-dose paclitaxel and cisplatin chemotherapy showed moderate activity with favorable toxicity profiles. However, relatively short TTP of this regimen warrants the development of more effective paclitaxel-based regimens other than combination with cisplatin in these patients as second-line therapies.
Adenocarcinoma/*drug therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse ; Cisplatin/administration & dosage/adverse effects ; Female ; Fluorouracil/administration & dosage/adverse effects ; Humans ; Leucovorin/administration & dosage/adverse effects ; Male ; Middle Aged ; Organoplatinum Compounds/administration & dosage/adverse effects ; Paclitaxel/administration & dosage/adverse effects ; Stomach Neoplasms/*drug therapy/mortality ; Survival Rate ; Treatment Failure

The ESHAP regimen, a combination of the chemotherapeutic drugs etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C), and cisplatin, has been shown to be active against refractory or relapsed non-Hodgkin's lymphoma (NHL) in therapeutic trials. We undertook this study to determine whether this regimen would be effective and tolerable in Korean patients. A total of 40 patients with refractory or relapsed NHL (8 indolent and 32 aggressive) were enrolled in this study. The overall response rate was 70% (95% confidence interval; 59.8-89.7%); 22.5% of patients achieved a complete response and 47.5% a partial response. The median survival duration was 12 months (95% confidence interval; 5.9-18.1 months) and the median duration of progression-free survival was 9 months (95% confidence interval; 1.1-16.9 months). The median survival duration of patients with relapsed NHL was longer than that of patients with refractory lymphoma (15 months vs 4 months, p=0.02). Myelosuppression was the most frequent complication and treatment-related mortality was noted in two patients. These results suggest that the ESHAP regimen is effective in patients with relapsed NHL who have a sensitive disease. The role of ESHAP chemotherapy in discriminating patients who are more likely to benefit from a subsequent transplant should be evaluated in the future.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse effects ; Bone Marrow/drug effects ; Cisplatin/*administration & dosage/adverse effects ; Cytarabine/*administration & dosage/adverse effects ; Disease-Free Survival ; Drug Tolerance ; Etoposide/*administration & dosage/adverse effects ; Female ; Humans ; Lymphoma, Non-Hodgkin/*drug therapy ; Male ; Methylprednisolone/*administration & dosage/adverse effects ; Middle Aged ; Recurrence ; Retrospective Studies ; Salvage Therapy

OBJECTIVETo observe the correlation between long term efficacy/safety and treatment cycles of rh-endostatin (endostar) combined with TP (paclitaxel plus cisplatin/carboplatin) or NP (navelbine plus cisplatin/carboplatin) regimens in patients with advanced non-small cell lung cancer (NSCLC).

METHODSTwenty-five patients with advanced NSCLC confirmed by histopathology and/or cytology were enrolled in this study. Twenty-one patients underwent endostar combined with NP regimen and other four patients underwent endostar combined with TP regimen (all repeated 21 days) treatment. The therapeutic effects, quality of life (QOL) and adverse effects were evaluated according to RECIST criteria, Karnofsky performance scores and WHO grading of adverse effects, respectively. Our intention was to make knowledge of the therapeutic effects, median time to progression, one-year survival rate, median overall survival and adverse reactions. The amount of circulating endothelial cells (CEC) in peripheral blood was measured by flow cytometry.

RESULTSAll the 25 patients were evaluable for efficacy and safety. They were comprised of 5 cases of PR, 14 cases of SD and 6 cases of PD. Of the 25 cases, RR was obtained in 5 cases (20.0%), CBR in 19 cases (76.0%), mTTP was 8 months and mOS was 19 months. Of the 14 patients with short treatment cycles (< 4), PR was obtained in 2 cases, SD in 6 cases and PD in 6 cases, RR was 14.3%. Of the 8 patients who obtained PR or SD, the median TTP was 6 months and median overall survival was 18 months. Of the 11 patients with long treatment cycles (≥ 4), PR was obtained in 3 cases, SD in 8 cases, RR was 27.3%, mTTP was 17 months and mOS was 26 months. After treatment, the amount of activated CECs was increased by (293 ± 12)/10(5) in patients with short treatment cycles, and decreased by (243 ± 181)/10(5) in patients with long treatment cycles. A positive correlation was found between the changes of activated CECs after therapy, time to progression (TTP) and treatment cycles (r = 0.970, P = 0.001; r = 0.829, P = 0.042, respectively). The quality of life (QOL) was improved in 12 cases (48.0%), stable in 10 cases (40.0%), and decreased in 3 cases (12.0%). Grade 3 and 4 toxicities were mainly related with chemotherapeutics, including neutropenia in 4 cases (16.0%), vomiting in 3 cases (12.0%) and arrhythmia in 1 case. No hypertension was observed. All the adverse reactions did not affect the following treatment, and there was no significant difference in incidence rate of grade 3 and 4 adverse events between the patients treated with long-term and short-term cycles.

CONCLUSIONSEndostar combined with TP or NP regimen chemotherapy is effective and safe in the treatment of advanced NSCLC, especially in patients with long term treatment cycles which can effectively prolong TTP and reach long term survival, but not increase adverse events. The QOL of patients can be improved or remain stable. The changes of CECs may be used as a useful maker in predicting the efficacy of the combination treatment.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; adverse effects ; Disease Progression ; Endostatins ; administration & dosage ; adverse effects ; Endothelial Cells ; drug effects ; pathology ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Paclitaxel ; administration & dosage ; adverse effects ; Quality of Life ; Recombinant Proteins ; administration & dosage ; adverse effects ; Remission Induction ; Vinblastine ; administration & dosage ; adverse effects ; analogs & derivatives ; Vomiting ; chemically induced

Adolescent ; Adult ; Aged ; Agranulocytosis ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; administration & dosage ; adverse effects ; Cyclophosphamide ; administration & dosage ; adverse effects ; Doxorubicin ; administration & dosage ; adverse effects ; Etoposide ; administration & dosage ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Lymphoma, T-Cell, Peripheral ; drug therapy ; Male ; Middle Aged ; Nausea ; chemically induced ; Prednisone ; administration & dosage ; adverse effects ; Remission Induction ; Vincristine ; administration & dosage ; adverse effects ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of cisplatin and capecitabine combination (XP) therapy for patients with metastatic triple negative breast cancer (TNBC) progressing after anthracycline and taxane treatment.

METHODSTwenty-nine metastatic TNBC patients were prospectively enrolled to receive capecitabine (1, 000 mg/m(2) twice daily on days 1-14) and cisplatin (75 mg/m(2) on day 1) , repeated every 3 weeks.

RESULTSWith a median of 6 cycles of XP, all 29 patients were evaluable for response, including 18 PR (62.1%), 6 SD (20.7%), 5 PD (17.2%) and no CR. The response rate was 62.1%. Patients with earlier stage at diagnosis (stage I to IIIA), longer post-operative disease free survival (>2 years) and less metastatic sites (≤ 3) obtained significantly higher response rate than patients with later stage at diagnosis (stage IIIB to IV), shorter post-operative disease free survival (≤ 2 years) and more metastatic sites (>3). The leading side effects were grade 1/2 gastrointestinal and hematological toxicities. Grade 3/4 toxicities included neutropenia (34.5%), leukocytopenia (31.0%), anemia (6.9%), thrombocytopenia (3.4%), nausea/vomiting (20.7%), stomatitis (3.4%), and hand-foot syndrome (3.4%).

CONCLUSIONCisplatin and capecitabine combination therapy is an active and well-tolerated doublet treatment in metastatic TNBC patients progressing after anthracycline and taxane treatments.

Anthracyclines ; administration & dosage ; Antibiotics, Antineoplastic ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Bridged-Ring Compounds ; administration & dosage ; Capecitabine ; administration & dosage ; adverse effects ; Cisplatin ; administration & dosage ; adverse effects ; Disease-Free Survival ; Female ; Hand-Foot Syndrome ; Humans ; Leukopenia ; chemically induced ; Neutropenia ; chemically induced ; Prospective Studies ; Taxoids ; administration & dosage ; Treatment Outcome ; Triple Negative Breast Neoplasms ; drug therapy ; pathology

To determine the contribution of metoclopramide to the efficacy of ondansetron in control of cisplatin-induced emesis, ondansetron was compared with ondansetron plus metoclopramide for antiemetic efficacy in a randomized double-blind trial. Enrolled 66 patients were treated with cisplatin(60mg/m2) in combination with etoposide, flourouracil, or vinblastine, and randomized to receive either ondansetron alone or ondansetron plus metoclopramide. Sixty patients were evaluable. Complete or major control of acute emesis was achieved in 96.6% (29/30) of patients given ondansetron plus metoclopramide and in 80% (24/30) receiving ondansetron alone, with no statistical significance (P = 0.07). However, delayed emesis (days 2-6) was better controlled by combination therapy than by ondansetron alone with 22 of 30 (73.4%) and 11 of 30 (36.7%), respectively (P = 0.03). No major drug-related side effects were observed. These results suggest that ondansetron plus metoclopramide is superior to ondansetron alone in the control of cisplatin induced delayed emesis without significant side effects.
Adult ; Aged ; Cisplatin/*adverse effects ; Comparative Study ; Double-Blind Method ; Drug Therapy, Combination ; Eating/drug effects ; Female ; Human ; Male ; Metoclopramide/*administration & dosage/adverse effects ; Middle Age ; Nausea/*prevention & control ; Ondansetron/administration & dosage/adverse effects/*therapeutic use ; Vomiting/*prevention & control

BACKGROUNDThe combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer (NSCLC). But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting.

METHODSFrom a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin (75 mg/m(2)) and gemcitabine (1250 mg/m(2)) between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records.

RESULTSA total of 132 patients met the criteria and were included in the study, 96 were male (72.7%) and 36 were female (27.3%). Median age was 60.5 years old, range 29 - 75 years, and 41.7% of patients were ≥ 65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg (83.3% of the planned dose) and cisplatin 248 mg (82.7% of the planned dose). There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients (35.6%) and was the predominant hematologic toxicity. Common grade 3/4 non-hematologic toxicities were nausea/vomiting (22.0%), infection (12.3%), and febrile neutropenia (11.4%).

CONCLUSIONCisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerability compared with published data on cisplatin and vinorelbine.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cisplatin ; administration & dosage ; adverse effects ; Deoxycytidine ; administration & dosage ; adverse effects ; analogs & derivatives ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo evaluate the efficacy and adverse effects of irinotecan combined with cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC).

METHODSFifteen patients (10 males and 5 females) aged from 32 to 58 years (median age of 47 years) with KPS>70 and the diagnosis of advanced NSCLC by pathology or cytology were treated with cisplatin 80 mg/m(2) plus irinotecan 60 mg/m(2) by intravenous infusion on 1, 8, 15 days, and the treatment was repeated every 4 weeks. After treatment for at least 2 cycles, the therapeutic effects and adverse drug reactions were evaluated.

RESULTSOf all the cases, PR was achieved in 4 (26.7%), SD in 9 (60%), and PD in 2 (13.3%), with an overall response rate of 26.7%. The median survival time was 11 months and 1-year survival rate was 46.7% (7/15). The main toxicities were delayed diarrhea and granulocytopenia.

CONCLUSIONIrinotecan plus cisplatin is an effective and tolerable treatment for advanced NSCLC with low incidence of adverse effects.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Camptothecin ; administration & dosage ; adverse effects ; analogs & derivatives ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cisplatin ; administration & dosage ; adverse effects ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged

OBJECTIVES: To determine the effectiveness and toxicity when levamisole was added to the adjuvant combination chemotherapy in patients with operable gastric cancer. METHODS: After en bloc resection of gastric cancer without gross or microscopic evidence of residual disease from April 1991 to December 1992, 100 patients were randomized to 6 months of 5-fluorouracil 1,000 mg/m2/day administered as continuous infusion for 5 days, cisplatin 60 mg/m2/day as intravenous infusion for 1 day with or without levamisole (50 mg every eight hours P.O for a period of three days every 2 weeks for 6 months). This chemotherapy treatment was begun within 2 to 4 weeks after the surgery. The chemotherapy consisted of discrete 5-day courses administered at 4-weeks intervals. All 100 patients are assessable. RESULTS: The fifty patients were assigned to each treatment group. There was no statistical difference and no bias in the distribution of characteristics of the 100 evaluable patients between the two groups. A total of 274 courses of treatment were given in the levamisole group and 260 courses of treatment in non-levamisole group. Eleven patients in each group did not finish planned 6 courses of treatment mainly due to non-compliance. At median follow up of 39 months, 32 patients relapsed 19 in the levamisole group and 13 in the non-levamisole group (p = 0.284). Twenty five patients died of relapsed diseases, 15 in the levamisole group and 10 in the non-levamisole group. The levamisole group tended to show more risk of overall death rate and recurrence than the non-levamisole group. However, this result was not statistically significant at 3 years. The treatment was well tolerated in both treatment groups. The grade 2-3 toxicities were nausea/ vomiting (levamisole, non-levamisole group; 31.7%, 29.3% of treatment courses respectively), diarrhea (7.6%, 8.4%), mucositis (11.6%, 12.3%), and leukopenia (9.8%, 9.6%). CONCLUSION: Levamisole had negative effects on disease-free survival and overall survival when added to adjuvant combination chemotherapy of cisplatin and 5-fluorouracil in patients with operable gastric cancer. Both treatment arms were generally well tolerated and the toxicity profile was similar with or without levamisole.
Adjuvants, Immunologic/administration & dosage* ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use* ; Antineoplastic Agents, Combined/adverse effects ; Cisplatin/administration & dosage ; Comparative Study ; Female ; Fluorouracil/administration & dosage ; Human ; Levamisole/administration & dosage* ; Male ; Middle Age ; Stomach Neoplasms/mortality ; Stomach Neoplasms/drug therapy*