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At least 721 records · Page 40Linked to original sources
PubMed2002

Intensified PCV-chemotherapy with optional stem cell support in recurrent malignant oligodendroglioma.

Six patients with recurrent or progressive anaplastic oligodendroglial tumors after surgical treatment and irradiation were treated with six/seven cycles of intensified PCV: Vincristine (1 mg/m(2)), CCNU (50 mg/m(2)) d.1,15 and procarbazine (75 mg/m(2)) d.2 to 29. If leukocytopenia (< 2.500/microl) or thrombocytopenia (< 75.000/microl) developed, 1 x 10(6) CD34(+) autologous stem cells/ kg body weight were reinfused three days after completion of subsequent cycles. Complete response was seen in 2/6 and partial response in 4/6 patients. Median follow up from time of recurrence was 35 months, progression free survival was 18 to > 39 months and overall survival 23 to > 39 months. We conclude that intensified PCV with stem cell support is feasable in recurrent/progressive anaplastic oligodendroglial tumors and appears to be sufficiently well tolerated to allow further study.

Adult↗
PubMed2006

[Palliative therapy in glioblastoma multiforme: a multimodal concept].

We report on a 72-year-old patient with a glioblastoma multiforme, who after initial operation underwent concomitant radiation (60 Gy) and chemotherapy (CCNU), which had to be stopped due to toxicity. After an interval without antineoplastic therapy lasting for several months, disease progressed. In this situation we decided to start second-line chemotherapy (Temozolomid). Because of cystic tumoural lesions an additional operative procedure was performed (Rickham reservoir). The latter had no major impact on quality of life for our patient. These procedures lead to an improvement of symptoms lasting for several months. Nevertheless our patient died 11 months after initial diagnosis due to a progression of the disease. This case report shows that multimodal therapeutic approaches should be taken into account in patients in a palliative situation.

Aged↗
PubMed2006

Phase II study of mitomycin-C, adriamycin, cisplatin (MAP) and Bleomycin-CCNU in patients with advanced cancer of the anal canal: An eastern cooperative oncology group study E7282.

Metastatic anal cancer is a rare disease in the Western hemisphere and current treatment modalities are not effective. In this study, patients with advanced epithelial cancer of the anal canal received MAP followed by Bleomycin and CCNU upon progression of disease. Twelve out of twenty eligible patients had a partial response 60%, (95% CI {36% -81%}). No complete responses were observed. The median survival was 15 months (95% CI {6-20} months). The median time to progression or death was 8 months (95% CI {4-9 months}). Toxicities were moderate and tolerable with routine supportive care; there were 2 cases of grade 3 vomiting, 2 cases of respiratory distress (one grade 1 and one grade 3), one case each of grade 3 leg cramps and cardiac arrhythmia. Of particular note were 7 cases of grade 3 hematologic toxicity. Two patients had grade 4 leukopenia and thrombocytopenia, respectively, that resolved without sequelae. The combination therapy of MAP followed by Bleomycin and CCNU for patients with advanced anal cancer, not amenable to radiotherapy or surgery, results in a moderate objective response but with moderate toxicities. This regimen and sequence is worthy of further study especially in combination with colony stimulating factors, however, its tolerability may be most applicable for patients who have had minimal prior therapy.

Antineoplastic Agents↗
PubMed2005

P450 enzyme inducing and non-enzyme inducing antiepileptics in glioblastoma patients treated with standard chemotherapy.

The co-administration of antiepileptic drugs (AED) and chemotherapeutic agents in patients with glioblastoma multiforme (GBM) is common. Interactions of chemotherapeutic agents and AED have not been investigated sufficiently. The purpose of this study is to evaluate the effects of enzyme inducing (EI-AED) and non-EI-AED in patients with GBM treated with standard chemotherapeutic agents on survival and haematotoxicity. One hundred and sixty eight glioblastoma patients with standard treatment including surgery, radiotherapy and chemotherapy were retrospectively analysed. Patients were separated into three groups: Group A patients without AED (n=88), Group B patients with EI-AED (n=43), and Group C patients with non-EI-AED (n=37). CCNU was the most frequently used first-line drug in all three groups (Group A: 77%; Group B: 81%; Group C: 78%). Second line treatment, mainly temozolomide, was applicated in 58 of patients and third-line treatment in 9. Carbamazepine was the most frequently administered AED in Group B (81%) and valproic acid in Group C (85%). For statistical analysis, only patients with CCNU first line treatment were calculated. A significant difference regarding survival was detected between Group B (10.8 month) and Group C (13.9 month), as well as increased haematotoxicity for Group C. These results indicate that AED influence the pharmacokinetics of chemotherapeutic drugs in patients with GBM. Valproic acid might be responsible for increasing haematotoxicity. Whether the difference regarding survival between Group B and Group C is due to a decrease of efficacy of chemotherapeutic agents by EI-AED, or due to increased efficacy of chemotherapeutic agents caused by the enzyme inhibiting properties of valproic acid, has to be evaluated in future studies.

Adult↗
PubMed2005

Semi-quantification of methionine uptake and flair signal for the evaluation of chemotherapy in low-grade oligodendroglioma.

UNLABELLED: 11C-Methionine (MET) is a useful positron emission tomography (PET) tracer for the evaluation of low-grade gliomas. Among these tumors, a high percentage of low-grade oligodendrogliomas (ODG) are sensitive to chemotherapy with procarbazine, CCNU, and vincristine (PCV). We aimed at: (1) objectively assessing ODG response to PCV by a metabolic index (the Activity Volume Index or AVI) generated from an automated semi-quantification of PET with MET (PET-MET); (2) comparing AVI and quantitative magnetic resonance imaging (MRI) measurements of response to PCV. METHODS: seven patients with ODG were followed for a period of 19.9+/-6.6 months after the completion of PCV chemotherapy. Regions of interest (ROI) were generated by covering all voxels with count values above a threshold level set at 120% of the mean cerebellar activity. On each slice, ROI volume and mean count values were calculated. AVI was calculated as the sum over all ROI of tumor volumex(tumor mean count/cerebellum count). Tumor volume measurements on MRI, were based on signal abnormalities visually detected on fluid-attenuated inversion recovery (FLAIR) sequences. RESULTS: PCV therapy was associated with a drastic decrease in AVI (mean+/-SD, cm3): AVI post-PCV=0.80+/-1.45 vs. AVI prior PCV=12.94+/-11.46 (P=0.03). Likewise, we observed a decrease in tumor volume estimated from the FLAIR signal (31.37+/-11.99 post-PCV vs. 67.95+/-39.96 prior PCV, P=0.03) although AVI decrease after PCV was significantly more pronounced (P=0.015). CONCLUSION: This study, based on limited number of patients and follow-up period indicates that AVI may be a sensitive and observer-independent method applicable to the assessment of ODG responsiveness to PCV treatment and may offer a major added value to both clinical assessment and MRI evaluation of chemotherapeutic outcomes.

Adult↗
PubMed2001

Adults with newly diagnosed high-grade gliomas.

Despite tremendous advances in brain tumor molecular biology and several emerging novel therapies, multimodality therapy that includes surgery, radiation therapy (RT), and chemotherapy is still the cornerstone of high-grade glioma treatment. The first step in high-grade glioma therapy is surgery and a maximal resection should be attempted to reduce the tumor burden before initiation of other adjuvant therapies. External beam radiation therapy (EBRT) generally follows surgery, using conventional dosage, and fractionation, and ideally a three-dimensional conformal technique. Stereotactic radiosurgery (SRS) to maximize cytoreduction may be used in selected cases. Because no curative chemotherapy exists for high-grade glioma, we always consider an investigational agent either before or concurrently with RT. However, the use of a standard cytotoxic agent, such as temozolomide alone or combined with 13-cis-retinoic acid also is a rational choice particularly for patients with relatively good prognostic factors for whom an investigational agent would not be available. The management of anaplastic oligodendroglioma does not differ significantly from other high-grade gliomas in terms of surgery, RT, or investigational or protocol agent; however, these tumors appear to respond to chemotherapy that includes a combination of procarbazine, CCNU, and vincristine (PCV) [1**]. The vincristine provides more toxicity than benefit and it is our practice to only use a combination of procarbazine and CCNU (PC). A single agent, such as temozolomide is an increasingly used and rational choice for anaplastic oligodendroglioma. It is our belief that early, aggressive multimodality treatment still provides the best chance for long-term control of high-grade gliomas, particularly in patients with good prognostic factors. However, despite best therapy and state-of-the-art technology, most patients with high-grade glioma will experience progression or recurrence and will require either a change in the ongoing therapeutic strategy or additional treatment. Better therapies are necessary and progress will only be made through investigation of promising agents in well-designed clinical trials.

Adult↗
PubMed2003

Oligodendroglioma.

Oligodendroglial tumors have historically been a fatal disease, despite maximum medical and surgical treatment. However, in the past 10 years, effective adjuvant therapies have been developed that have been found to significantly prolong patient survival and, in some instances, provide a cure. Improvements in our understanding of the molecular biology of these tumors, refinements in surgical technique, and advances in chemotherapeutic treatment have combined to produce this improvement in survival with little additional toxicity to patients. At the time of diagnosis, patients should undergo maximum surgical resection or needle biopsy if maximum surgical resection is not possible. Patients with low-grade lesions may be followed, receiving radiation only at the time of progression. Patients with high-grade lesions should be irradiated up front. In addition, selected patients should receive chemotherapy. Clinical trials remain critical to advancing our understanding of these tumors and improving our ability to cure these patients.

Antineoplastic Agents, Hormonal↗
PubMed2003

Medulloblastomas and central nervous system primitive neuroectodermal tumors.

Significant advances in the treatment of medulloblastoma and primitive neuroectodermal tumors have been made in the past three decades. Maximal surgical resection is a mainstay of therapy. However, unlike many other central nervous system neoplasms, medulloblastoma and primitive neuroectodermal tumors are radiation and chemotherapy responsive. Despite this response, the prognosis for patients with these tumors remains variable and is relatively poor in infants and patients with metastatic disease. These tumors most commonly arise in children, thus most clinical trials emphasize the reduction of long-term sequelae, in addition to improving survival. All newly diagnosed patients who are eligible should be offered participation in a clinical trial. If a patient is ineligible or declines consent/assent for a clinical trial, the best current treatment approach is surgical resection, followed by radiation therapy (except for children younger than 3 years) with weekly vincristine. For high-risk patients, 36 Gy of craniospinal irradiation should be delivered plus a boost of 19.8 Gy to the posterior fossa/primary tumor bed and sites of bulk metastatic disease. For average-risk patients, the craniospinal irradiation dose may be lowered to 23.4 Gy plus 32.4 Gy to the posterior fossa/tumor bed. After radiation therapy, intensive multimodal chemotherapy should be used for all patients.

Antineoplastic Agents↗
PubMed1977

Primary adenocarcinoma of the small intestine.

Eighteen cases of primary adenocarcinoma of the small intestine have been reviewed, which demonstrated the relative frequency of symptoms common to this disease. The clinical features, pathology, and treatment of small bowel adenocarcinoma have been presented and the literature reviewed.

Adenocarcinoma↗
PubMed1976

Effects of nitrosoureas on human DNA polymerase activities from acute and chronic granulocytic leukemia cells.

In vitro DNA synthesis by isolated cytoplasmic DNA polymerases of human leukemic cells was found to be inhibited by 1,3-bis(2-chloroethyl)-1-nitrosourea, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea and 1-(2-chloroethyl)-3-(trans-4-methyl-cyclohexyl)-1-nitrosourea. 2-Chloroethyl isocyanate and cyclohexyl isocyanate, the decomposition products of 1,3-bis(2-chloroethyl)-1-nitrosourea and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, respectively, are as effective as their parent nitrosoureas in inhibiting the enzyme activity. Preincubation studies indicated that these compounds inhibit DNA synthesis primarily by altering the enzyme DNA polymerases without significantly affecting the DNA template activities.

Acute Disease↗
PubMed1985

Exposure of HeLa cells to 0(6)-alkylguanines increases sensitivity to the cytotoxic effects of alkylating agents.

Exposure of HeLa S3 cells to 0.4mM 0(6)-methylguanine or 0(6)-n-butylguanine for 24 h led to a substantial decrease in the activity of 0(6)-alkylguanine-DNA alkyltransferase. Such pretreatment caused a marked increase in the sensitivity of the cells to the cytotoxic effects of the cross-linking alkylating agent 1-(2-chloroethyl)-1-nitroso-3-cyclohexylurea and a smaller increase in the sensitivity to N-methyl-N'-nitro-N-nitrosoguanidine. These results indicate that the repair of DNA by the alkyltransferase plays an important role in the protection of cells from the cytotoxic effects of certain alkylating agents particularly those such as 1-(2-chloroethyl)-1-nitroso-3-cyclohexylurea which ultimately lead to the formation of lethal interstrand cross-links.

Cell Division↗