No abstract available.
Drug Therapy* ; Humans* ; Leukopenia*

PURPOSE: We wanted to compare the efficacy and toxicity of chemotherapy with methotrexate, vinblastine, adriamycin, cisplatin(M-VAC) versus gemcitabine and cisplatin(GC) for patients with advanced or metastatic urothelial carcinoma. MATERIALS AND METHODS: Forty-nine patients diagnosed with advanced urothelial cell carcinoma and who were started on chemotherapy were divided into two groups. All of them had a 0-1 Eastern Cooperative Oncology Group performance status. 19 patients received M-VAC chemotherapy and 30 patients received the GC regimen. Among them, the subjects who completed more than 3 cycles of their recommended formula (13/19 for M-VAC, 28/30 for GC) were included in this study. They were evaluated for their overall response rate, the 5-year survival rate, toxicities and the drop-out rate. RESULTS: The overall response rate and median survival period of the M-VAC and G-C groups were 38%(5/13 cases) and 46%(13/28 cases), and 16.7 months and 43.9 months, respectively. The 5-year survival rates in the two groups were 10% in the M-VAC group and 46% in the G-C treated group(p=0.013). The main hematologic complication was leukopenia and this occurred in 10/19 patients and more than grade 3 leukopenia was noted in 4/10 patients in the M-VAC group and in 19/30 patients and more than grade 3 was noted in 10/19 patients in the GC group.The common non-hematologic side effects between the two groups were nausea/vomiting(84.2% vs 47.7%), alopecia(47.4% vs 26.7%), diarrhea(15.8% vs 16.7%), and nephrotoxicity(15.8% vs 6.7%), respectively. The drop-out rates were 31.6% in the M-VAC group and 6.7% with the GC group. CONCLUSIONS: For patients with a good performance status with advanced or metastatic urothelial carcinoma, GC chemotherapy is more effective and it has more tolerable toxicities than does the M-VAC regimen.
Doxorubicin ; Drug Therapy* ; Humans ; Leukopenia ; Methotrexate ; Survival Rate ; Vinblastine

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

For evaluation of the response and toxicity of the combination chemotherapy, forty six patients with malignant ovarian tumors who had prior surgery were treated with combination chemotherapy from January 1985 to March 1991 at the Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. The results were as follows : 1. The responses were in complete 20 cases(43.5%), in partial 9 cases(19,6%), in stable 6 cases(13.0%), in progressive 11 cases(23.9%) among 46 patients. 2. By the response rates of various combination chemotherapy regimens, the response rate of CAP was 64%(16/25), CP 57.1%(8/14), VAC 100%(3/3), VBP 50%(1/2), FAM 0%(0/1), and Melphalan 100%(1/1) respectively. 3. As the chemotoxicities of combination chemotherapy, leukopenia 20 cases(46.5%), thrombocytopenia 2 cases(4.7%), anemia 20 cases(46.5%), nephrotoxity 6 cases(14.6%), hepatotoxicity 7 cases(18.4%) were observed.
Anemia ; Drug Therapy* ; Drug Therapy, Combination ; Gynecology ; Humans ; Leukopenia ; Melphalan ; Obstetrics ; Thrombocytopenia

PURPOSE: Platinum-based chemotherapy has conferred a modest but significant survival benefit and the introduction of newer drugs has led to achieve higher response rate in patients with advanced non-small cell lung cancer (NSCLC). We performed a phase II trial in order to evaluate the efficacy and toxicity of combination chemotherapy with vinorelbine (Navelbine) and cisplatin in advanced NSCLC. MATERIALS AND METHODS: Patients with previously untreated, unresectable stage IIIB or IV NSCLC with measurable lesion (s) were eligible for entry into the study. NP chemotherapy consisted of intravenous vinorelbine 25 mg/m2, on day 1 and 8, and intravenous cisplatin 80 mg/m2 on day 1; this cycle was repeated every three weeks. RESULTS: A total of 33 patients were enrolled in the study between July 1999 and Feb 2000. Of the 30 patients deemed eligible for analysis, thirteen patients achieved a partial response and thirteen showed a stable disease. The overall response rate was 43.3%. The median duration of response was 5.7 months (95% CI: 2.8~8.5 months). The median time to progression was 7.6 months (95% CI: 5.5~9.7 months) and the overall median survival time was 15.1 months (95% CI: 9.8~20.4 months) in the intent-to-treat analysis. Chemotherapy-related grade 3 or 4 toxicities were anemia in 1.5%, leukopenia in 4.5%, nausea/vomiting in 2.3%, alopecia in 13.3%, and neurotoxicity in 3.3%. CONCLUSION: The combination of vinorelbine and cisplatin chemotherapy seems to be active and fairly tolerable in patients with advanced NSCLC.
Alopecia ; Anemia ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Leukopenia

BACKGROUND: There are few therapeutic options in patients with colorectal cancer that progressed or recurred after initial 5-fluorouracil (5-FU) therapy. Many different 5-FU-based regimens and biochemical modulations that can potentiate the cytotoxic effects of 5-FU have been investigated in these patients. We evaluated the efficacy and toxicity of combination of 5-FU, leucovorin, levamisole and cisplatin(FLLP) salvage combination chemotherapy in progressive or recurrent colorectal cancer after 5-FU/leucovorin chemotherapy. METHODS: Twenty-eight patients were enrolled in this study from April 1995 to July 1999. Patients received cisplatin (60 mg/m2) administerd on day 1, followed by leucovorin (20 mg/m2) and 5-FU (375 mg/m2) by rapid intravenous push for 5 consecutive days on day 1~5. Levamisole was given orally at a dose 50 mg three times a day on day 1~3 & day 15~17. Treatment courses were repeated in 4-week intervals. RESULTS: Twenty-two patients were evaluable after treatment. Objective tumor response was in 4 of 22 (18.2%). The complete response, partial response, stable disease were 4.5% (1/22), 13.7% (3/22), 31.8% (7/22) respectively. The median response duration was 5.5 months. The median time to progression was 5.8 months. The overall median survival duration was 8.7 months and response group lived significantly longer than non-response group (not yet reached vs. 7.9 month, p=0.03). WHO grade 3-4 leukopenia occurred in 14%, nausea and vomiting 9%, but there was no treatment related death. CONCLUSION: We concluded that evaluation of this regimen appears relatively safe, with modest response as a salvage chemotherapy in patients who were previously exposed to 5-FU containing regimen.
Cisplatin ; Colorectal Neoplasms* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Leucovorin ; Leukopenia ; Levamisole ; Nausea ; Vomiting

PURPOSE: To evaluate the response and toxicity of gemcitabine and cisplatin combination chemotherapy in advanced transitional cell carcinomas. MATERIALS AND METHODS: Twenty two patients with advanced transitional cell carcinoma received gemcitabine combined chemotherapy. Nineteen of them were scheduled to receive 1,000mg/m2 gemcitabine intravenously for 30 minutes on days 1, 8, and 15 and 70mg/m2 cisplatin for 1 hour on day 1 of a 28-day cycle. In addition, 3 patients with decreased renal function were scheduled to receive 1,200mg/m2 gemcitabine on day 1, 8, and 15. The toxicity of each cycle and the response after more than 4 cycles were evaluated. RESULTS: There were 5 complete responses and 4 partial responses in the 15 assessable patients, giving an overall response rate 60%. The toxicity was primarily hematologic, with 3 out of 22 patients (14%) with grade 3 thrombocytopenia, 10 out of 22 patients (45%) with grade 1 & 2 leukopenia and 10 out of 22 patients (45%) having grade 1 & 2 anemia. The most common non-hematologic toxic response was nausea and vomiting. CONCLUSIONS: Gemcitabine based chemotherapy for advanced transitional cell carcinoma has larger response rate compared to M-VAC. Furthermore, it has much less systemic toxicity than M-VAC combination chemotherapy.
Anemia ; Carcinoma, Transitional Cell ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Leukopenia ; Nausea ; Thrombocytopenia ; Vomiting

Backgrouad & Aims: Cyclophosphamide, adriamycin and cisplatin(CAP) combination chemo- therapy improved the response rate in the treatment of advanced epithelial ovarian cancer, and it has been the gold standard. However, adriamycin is a rather toxic drug, and there is still confusion concerning the choice of adriamycin to be included in optimal regimen. The present study was designed to compare the activity and toxicity of combination regimens in advanced epithelial ovarian cancer between CAP and CTP which substitutes adriamycin with pirarubicin(THP- adriamycin). PATIENTS AND METHODS: From March 1995 to December 1997, 47 patients with FIGO stage III-IV epithelial ovarian cancer who were diagnosed after initial cytoreductive surgery were divided into two groups at random: (1) The case group were treated with CTP(500/40/50 mg/m2) as a first line chemotherapy. (2) The control group were treated with CAP(500/50/50 mg/m2) as that of case group. Clinical characteristics, response rates and toxicities according to Gynecologic Oncology Group criteria were compared between those treated with CAP and CTP respectively. RESULTS: Forty one patients out of 47 were evaluable and the number of patients in case and control group was 22 and 19 respectively. There was no significant differences in patient characteristics such as age, stage, histologic type between two groups. Clinical complete response rate was 50.0%(11/22) in patients treated with CTP regimen and 47.4%(9/19) with CAP regimen and there was no significant difference between two groups. Second look operation was undergone in 10 patients of CTP group and 7 patients of CAP group who showed clinical complete response and the pathologic complete response rate was 27.3%(6/22) with CTP and 21.1%(4/19) with CAP. The incidence of leukocytopenia of grade 3 or 4 was more frequently occurred in CAP group(52.6%, 10/19) than CTP group(22.7%, 5/22). There was no significant difference in the incidence of other toxicitied such as hepatic, renal and G-I toxicities. Suspicious cardiac toxicity according to the finding of EKG was seen in 15.8%(3/19) only with CAP regimen and all of them showed decreased cardiac function in gated blood pool scan. There were no significant differences in risponse rates between two groups, but the incidence of cardiac toxicity and leukocytopenia o f grade 3 or 4 was more frequently occurred in CAP group than CTP group. CONCLUSION : CTP regimen has comparable response rates to CAP regimen, with lower incidence of hematolohic and cardiac toxicity.
Cyclophosphamide* ; Cytidine Triphosphate ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Electrocardiography ; Humans ; Incidence ; Leukopenia ; Ovarian Neoplasms*

PURPOSE: There is no effective treatment for patients with advanced gastric cancer having failed to respond to first line chemotherapy. The aim of this study was to evaluate the therapeutic activity, and safety, of a FEP regimen in patients with a recurrence of, or metastatic, gastric cancer that had been unresponsive to primary chemotherapy. MATERIALS AND METHODS: Recurred or metastatic gastric cancer patients that did not respond to a 5-fluorouracil based regimen were entered into this trial. The patients were treated with FEP (5-FU, etoposide and cisplatin) as salvage chemotherapy. The treatment regimen was 5-FU (900 mg/m2/day) by continuous infusion for 3 days, etoposide (90 mg/m2/day) on days 1, 2 and 3, and cisplatin (60 mg/m2/day) on day 2. This treatment was repeated every 3 weeks. RESULTS: Between December 1997 and October 2001, 28 patients were enrolled to the study. The response rate was 32.1% (95% CI 15.5~57.8%). The median times to progression and survival duration were 23~33 weeks, respectively. Among a total of 187 cycles of chemotherapy, the grade 3 and 4 hematological toxicities were leukopenia (6.4%), thrombocytopenia (1.6%), and grade 3 non-hematological side effects of nausea/vomiting (17.9%). CONCLUSION: FEP combination chemotherapy seems to be an effective treatment regimen for gastric cancer as salvage chemotherapy. To confirm these results, large scale of clinical trials will be required.
Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Leukopenia ; Polytetrafluoroethylene* ; Recurrence ; Salvage Therapy ; Stomach Neoplasms* ; Thrombocytopenia

PURPOSE: This study was conducted to evaluate the efficacy and safety of combination chemotherapy, with docetaxel and cisplatin, as a first line treatment for advanced non-small cell lung cancer. MATERIALS AND METHODS: Between March 1998 and December 2001, 35 patients with advanced non-small cell lung cancer were enrolled in this study. The patients were treated at 3-week intervals, with one course of a regimen consisting of docetaxel (75 mg/m2 IV for 1 hours) on day 1 and cisplatin (60 mg/m2 IV) on day 2. RESULTS: The median age of the patients was 60.3 years. Of the 35 patients, 20 and 15 had stage IIIb and stage IV diseases, respectively. A complete response was observed in 1 patient and partial response in 15, with an overall response rate of 46%. The overall median survival duration was 40.3+/-25.2 weeks. The median time to progression and response duration were 21.6+/-5.5 and 15.1+/-5.9 weeks, respectively. The survival duration was statistically significantly longer in the response group (50.6 weeks) than in the non-response group (31.6 weeks) (p<0.05). Of the hematological side effects, grades III and IV leukopenia were observed in 4.8% of patients. Grades III and IV nausea and vomiting were observed in 48.5%, and grades I and II neuropathy in 11.4% of the treated patients. These toxicities were well tolerable and reversible. There were no hypersensitivity reactions. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is relatively effective and safe in advanced non-small cell lung cancer patients.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy, Combination* ; Humans ; Hypersensitivity ; Leukopenia ; Nausea ; Vomiting