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At least 793 records · Page 44Linked to original sources
PubMed1987

Cyclic alternating polychemotherapy with or without upper and lower half-body irradiation in small cell anaplastic lung cancer. A randomized study.

Ninety-six patients with small cell anaplastic lung carcinoma were given monthly chemotherapy with vincristine-doxorubicin-cyclophosphamide alternating with CCNU-methotrexate-etoposide for 18 months or until evidence of progressive disease. Forty-four patients were randomized to chemotherapy alone and 52 patients to chemotherapy plus 600 cGy of both upper and lower half-body irradiation given day 60 and 100, respectively. In 78 evaluable patients surviving more than 100 days the overall response rate was identical in the two arms of the study, 68% vs. 66%. However, time to progression was significantly shorter in the irradiated patients (P = 0.05). Only 25% of the irradiated patients tolerated greater than or equal to 75% of the scheduled dose of chemotherapy, against 91% of the non-irradiated patients (P = 0.0001). Thus, half-body irradiation was associated with a shorter time to progression and a decreased ability to give maintenance chemotherapy at proposed doses.

Adult↗
PubMed1987

The prognostic value of response to the first cycle of chemotherapy in small cell lung cancer. Results of a multicenter German trial.

The prognostic significance of evaluation of response according to chest X-ray after only one cycle of treatment was investigated in patients with small cell lung cancer (SCLC). Three hundred and six patients entered a multicenter randomized German trial testing alternating vs. sequential chemotherapy. Decrease of tumor size after the first cycle was seen to be 78% in the alternating group and 70% in the sequential group. Stable disease occurred in 25% of the sequentially treated and 19% of the alternatingly treated patients. No substantial differences in pretreatment characteristics were noticed between patients with stable disease in sequential and alternating treatment. In sequential therapy, median survival was 323 days for patients with decrease of tumor size after the first cycle and 219 days for patients with no change. Only five out of 21 patients with no change after one cycle responded to continuous administration of this regimen including one complete remission. In alternating therapy, median survival was 347 days for patients with decrease in tumor size after the first cycle and 378 days for patients with no change indicating no difference in prognosis. Twelve out of 18 patients with no change responded to continuous administration of alternating treatment including six complete remissions. We concluded that response to the first cycle according to chest X-ray is a reliable and prognostically valid response criterion if sequential therapy is used. In this treatment modality no change in tumor size after the first cycle indicates poor prognosis, and improvement of the patients' outcome may be achieved by a switch to a second non-cross resistant drug combination.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Non small cell lung cancer (NSCLC). A prospective randomized trial with alternating chemotherapy CEP/MEC' versus no treatment.

From April 1985 to September 1987, 92 patients with advanced NSCLC were randomized to receive cytotoxic chemotherapy, Arm A (treated), or supportive care, Arm B (control). Chemotherapy consisted of the CEP combination (cyclophosphamide 500 mg/m2 i.v. day 1; epirubicin 50 mg/m2 i.v. day 1; cisplatin 80 mg/m2 i.v. day 1) alternated every 4 weeks with the MEC' combination (methotrexate 30 mg/m2 i.v. day 1; etoposide 200 mg/m2 i.v. day 1; CCNU 70 mg/m2 per os, day 1) until progression. Eight-nine patients (44 treated and 45 controls) were eligible for survival and 77 evaluable for response (38 treated and 39 controls). Response rate was: in Arm A, 8/38 (21%) partial response, 20/38 (53%) stable disease and 10/38 (26%) progressive disease; in Arm B, 18/39 (46%) stable disease and 21/39 (54%) progressive disease. Median time to progression was 4 months (range = 1-14) for treated and 2 months (range = 1-9) for controls (P = 0.001). Median survival was 8.5 months (range = 1+ to 25) for Arm A versus 5 months (range = 1+ to 28+) for Arm B; this difference was not statistically significant (Breslow test: chi-square = 2.75, P = 0.097; Mantel-Cox: chi-square = 0.32, P = 0.56). Treatment related toxicity was gastrointestinal WHO grade 3 in 22/102 (22%) CEP courses and in 10/91 (11%) MEC' courses respectively. Other observed side-effects were not clinically important. From these data our treatment was not clearly superior to supportive care in prolonging survival. This suggests the need for the inclusion of a control group in future chemotherapeutic trials of NSCLC.

Adult↗
PubMed1988

Brief chemotherapy associated with extended field radiotherapy in Hodgkin's disease. Long-term results in a series of 102 patients with clinical stages I-IIIA.

From 1972 to 1976, 102 patients with stages I-IIIA Hodgkin's disease (HD) were treated by chemotherapy with cyclophosphamide, vinblastine, procarbazine and prednisone (CVPP: two courses) associated with extended field radiotherapy. Staging included neither laparotomy nor splenectomy (clinical staging). Treatment included neither splenic irradiation nor maintenance therapy. Complete remission was achieved for 98 patients and 11 of them recurred up to 94 months after treatment. Median follow-up of this controlled study is 13 years. Disease free survival (DFS) is 87% at 6 years and 84% at 10 and 15 years. Overall survival is 77% at 10 and 74% at 15 years. Disease specific survival is better (91% at 10 and 87% at 15 years) since only 38% (10/26) deaths were due to HD. The other deaths (16/26) with no evidence of HD were due to second cancer and intercurrent disease. Prognostic analysis of DFS by log-rank test gives significance to the following factors: contiguous extra-nodal involvement (P = 0.008), more than 3 involved sites (P = 0.01), signs of compression (P = 0.02), clinical stage IIIA (P = 0.03), infradiaphragmatic stages I-II (P = 0.04). The potential risk of secondary cancer is difficult to assess.

Adult↗
PubMed1989

Acral erythema and systemic toxicity related to CHA induction therapy in acute myeloid leukemia.

Seventy-two adult patients with previously untreated acute myeloid leukemia received the CHA regimen as induction chemotherapy: CCNU 80 mg/m2 on day 1, Adriamycin 35 mg/m2 i.v. on days 1, 2 and 3, and continuous infusion of cytarabine 100 mg/m2/24 h from day 1 to 10. Forty-nine patients (68%) presented at least one of the following symptoms: acral erythema with dysesthesias in the palms and/or soles (39%); cholestatic hepatitis (39%); profuse sterile diarrhea associated with abdominal distention (33%); acute cerebellar dysfunction (32%) and non-cardiogenic pulmonary edema (21%). Most of these toxic symptoms appeared 8-20 days after the first dose. As these clinical features were absent or exceptional in patients treated with another regimen within a controlled trial, they are reported as toxic-side-effects of the chemotherapy regimen. Acral erythema was found to be predictive of complete remission (P less than 0.01, odds ratio: 6.33); neurotoxicity was prognostic for death in aplasia (P less than 0.05); the absence of any of the five symptoms was associated with failure of the induction regimen (P less than 0.02).

Adolescent↗
PubMed1983

Massive BACT chemotherapy with autologous bone marrow transplantation in 17 cases of non-Hodgkin's malignant lymphoma with a very bad prognosis.

A group of 12 children and 5 adults, all with diffuse non-Hodgkin's malignant lymphoma (NHML), received massive chemotherapy regimens. The stages of the disease were as follows: 7 patients were in second complete remission; 6 in a progressive phase of the disease; and 4 in first complete remission which occurred late in the course of the disease. All patients received BACT (BCNU+aracytine+cyclophosphamide+thioguanine) or TACC (idem with CCNU) at different dose levels: 6/17 received 10 Gy total-body irradiation (TBI) after BACT treatment; 16/17 received autologous bone marrow transplantation (ABMT) previously stored in liquid nitrogen to combat the medullary effects of chemotherapy. Direct therapy-related deaths occurred in 4/17 patients (1 Aspergillus endocarditis; 1 Moskowitz syndrome; 1 veno-occlusive disease of the liver; and 1 Escherichia coli pneumopathy) and 6/17 patients relapsed between days 25 and 70 of treatment. Seven out of these 17 patients are still alive NED 102-900 days (mean, 475 days) after the beginning of therapy without receiving maintenance treatment. Massive chemotherapy could thus be the best treatment for NHML in relapse, but the high percentage of early therapy-related deaths is a strong limiting factor for patients before relapse.

Adolescent↗
PubMed1985

Long-term survival and recurrence-free interval in combined surgical, radio- and chemotherapy of malignant brain gliomas.

A prospective randomized study has been conducted since 1978 to judge the value of combined radio- and chemotherapy (CCNU) in the postoperative treatment of grade III and IV supratentorial gliomas. Inoperable or recurrent tumors were excluded from these series, but evaluated in addition. Increase in median survival time (18 months) for the entire series (62.2% glioblastomas) was only small compared to other series mentioned in literature, but there was a significant prolongation of the recurrence-free interval (16.5 months) and in the total survival time from the onset of symptoms in 46.4% of cases living more than 18 months. If 'useful recovery' is the major goal of present treatment of cancer, the recurrence-free interval and the fraction of long-term survivors may be more important statistical parameters than median survival time. To improve the 'quality of life' in a number of patients (so-called long-term survivors) and the length of recurrence-free intervals should be the therapeutic goal, even if overall survival time remains essentially unaffected. We conclude that combined therapy, including radio- and chemotherapy, following surgical resection is of value in most cases of malignant glioma.

Adolescent↗
PubMed1986

Effects of CCNU on monocyte phagocytosis.

The effect of CCNU on human monocyte phagocytosis of yeast cells was measured in vitro. 'Therapeutic' CCNU concentrations had no measurable effect on monocyte phagocytosis. Higher concentrations of CCNU had a slight but statistically significant effect on the engulfment phase of monocyte phagocytosis. The results suggest that CCNU treatment is of minor importance for monocyte function.

Cells, Cultured↗
PubMed1995

The effect of topical CCNU(1-(2-chloroethyl)-3 cyclohexyl 1 nitrosurea) treatment on lipid peroxidation of glial tumours transplanted on rat brain.

1. The effect of topical CCNU treatment on lipid peroxidation of glial tumors transplanted on rat brain has been investigated in 22 rats. 2. Four groups have been selected as normal brain tissue, normal brain tissue+CCNU, tumour tissue, tumour tissue+CCNU. In these groups malondialdehyde (MDA) levels have been measured as a marker of lipid peroxidation. 3. Lipid peroxidation was high in tumour tissue in respect to controls (P < 0.05). In normal tissues topical CCNU treatment caused increase in lipid peroxidation (P < 0.05). In tumor tissues, topical CCNU decreased lipid peroxidation (P < 0.05). It is concluded that further studies have to be performed in order to determine whether increases in lipid peroxidation on CCNU treated normal brain tissues is a result of the inhibitory effect on cellular defence systems or promotion of free radical production.

Administration, Topical↗