Alternative therapeutic approaches after induction chemotherapy for tonsil squamous cell carcinomas

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17010-e17010
Author(s):  
F. Huguet ◽  
M. Gratacap ◽  
J. Ménard ◽  
S. Perie ◽  
B. Angelard ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Predictive Factor ◽  
Survival Rates ◽  
Complete Response ◽  
Squamous Cell Carcinomas ◽  
Pathological Response ◽  
Primary Site ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

e17010 Background: The role of induction chemotherapy (ICT) in the treatment of head and neck squamous cell carcinomas (SCC) remains controversial. This retrospective study aims to evaluate the outcome of patients with tonsil SCC treated with ICT followed by surgery and/or external beam radiotherapy (EBRT). Methods: Between 1997 and 2007, 103 patients (pts) with tonsil SCC received an ICT in Tenon Hospital. Most of pts (88%) received cisplatin (25 mg/m2) and 5-fluorouracil (1,000 mg/m2) for 4 days with a mean of 2.5 cycles. After ICT, 85 pts were operated. After surgery, 69 pts received a dose of 50 to 70 Gy on the primary site depending on pathological findings (Group 1). Sixteen pts with negative margins and no lymph node metastasis didn't receive any EBRT (Group 2). The remaining 17 pts were treated by EBRT without surgery (Group 3). The mean follow-up was 38 months. Results: No significant difference appears between our different groups except for the TNM stage and the tumour pathological response to ICT. After ICT, pathological complete response was observed in 18 pts (25%) for the primary site and 20 pts (34%) for lymph nodes. Clinical and radiological assessment of response after ICT was not predictive of the pathological response. The TNM stage was the only predictive factor for complete response. The 5-year disease-free survival rates were 68% for the whole population, 73% for the Group 1, 43% for the Group 2, 68% for the Group 3 (p = 0.5). A poor pathological response after ICT was the single independent predictive factor of tumour relapse (p = 0.04). In the Group 2, 6 pts had a relapse, among them 4 had EBRT in a second time. The 5-year specific survival rates were 78% for the whole population, 76% for the Group 1, 76% for the Group 2, 39% for the Group 3 (p = 0.03). The radio-clinical evaluation of response, the surgery and the pathological response were predictive factors of specific survival. Conclusions: Pts with a complete pathological response after ICT who were not irradiated had a non significant increase of the relapse rate with a specific survival identical to the group of irradiated pts. This data have to be confirmed by a prospective trial. No significant financial relationships to disclose.

scholarly journals FRI0276 EARLY TREATMENT WITH ANTI-TNF IS ASSOCIATED WITH HIGHER RESPONSE RATES IN PATIENTS WITH ACTIVE AXSPA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 725.2-725
Author(s):  
S. Gulle ◽  
İ. Sari ◽  
E. Durak Ediboglu ◽  
H. Candan ◽  
F. Onen ◽  
...  
Keyword(s):  
Survival Rates ◽  
Response Rates ◽  
Retention Rates ◽  
Symptom Duration ◽  
Early Disease ◽  
Drug Retention ◽  
Predictors Of Response ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background:Treatment options for axial spondyloarthritis (axSpA) is currently limited, and up to 40% of the patients require biologic therapies to control symptoms. Early commencement of biologics suggested to have higher response rates but data regarding this subject is limited.Objectives:The primary aim was to investigate tumor necrosis factor inhibitor (TNFi) response and retention rates in axSpA patients who were treated in the early disease period (symptom duration (≤5 years). Our secondary aim was to identify factors predicting response to TNFi.Methods:Adult axial SpA patients who started TNFi treatments within the five years of their symptoms were identified and defined as “Group 1”. Patients whose TNFi treatments started five years after their initial symptoms served as a control group (Group 2: 5-10 years and Group3: ≥10 years). Response and survival rates at 6, 12, and 24 months were calculated. Predictors of response on TNFi survival at 24 months were also analyzed.Results:There was a total of 364 axiSpA (Group 1: 95, Group 2: 82 and Group 3: 187) patients in the study (69.8% male, 46.8±12.6 years). Group 1 patients tended to be younger, with a lower baseline CRP titers and lower HLA–B27 rate compared to the other groups. Drug survival rates were similar between the groups. This finding also remained similar when AS and nraxSpA patients analyzed separately. However, regardless of symptom duration, the drug retention rates were significantly higher in the AS group than in nraxSpA (Table 2). ASAS40 responses were higher in Group 1 than in Group 3 both at 12 and 24 months. Predictors of response based on ASAS40 at 24 months were treatment within the five years of the symptoms (OR:2.2) and age at baseline (OR:0.97) in univariate analysis. However, baseline ASDAS (OR:1.4) was the only factor in multiple regression.Conclusion:In this study we showed the following: 1) TNFi started in the early disease course resulted in a better ASAS40 response at both 12 and 24 months, 2) TNFi timing (started in the early or late disease period) seems not affecting drug retention rates, and 3) baseline disease activity is the most important predictor in achieving ASAS40 response at 24 months.Disclosure of Interests:None declared

scholarly journals Comparative Analysis of Peri-Implant Bone Loss in Extra-Short, Short, and Conventional Implants. A 3-Year Retrospective Study

2020 ◽  
Vol 17 (24) ◽  
pp. 9278
Author(s):  
Daycelí Estévez-Pérez ◽  
Naia Bustamante-Hernández ◽  
Carlos Labaig-Rueda ◽  
María Fernanda Solá-Ruíz ◽  
José Amengual-Lorenzo ◽  
...  
Keyword(s):  
Bone Loss ◽  
Survival Rates ◽  
Marginal Bone Loss ◽  
Posterior Maxilla ◽  
Group 3 ◽  
Group 2 ◽  
Wide Neck ◽  
Implant Length ◽  
Functional Loading ◽  
Group 1

Objective: To evaluate the influence of implant length on marginal bone loss, comparing implants of 4 mm, 6 mm, and >8 mm, supporting two splinted crowns after 36-month functional loading. Materials and Methods: this retrospective clinical trial evaluated the peri-implant behavior of splinted crowns (two per case) on pairs of implants of the same length placed in the posterior maxilla (molar area). Implants were divided into three groups according to length (Group 1: extra-short 4 mm; Group 2: short 6 mm; Group 3: conventional length >8 mm). Marginal bone loss was analyzed using standardized periapical radiographs at the time of loading and 36 months later. Results: 24 patients (19 women and 5 men) were divided into three groups, eight rehabilitations per group, in the position of the maxillary first and second molars. The 48 Straumann® Standard Plus (Regular Neck (RN)/Wide Neck (WN)) implants were examined after 36 months of functional loading. Statistical analysis found no significant differences in bone loss between the three groups (p = 0.421). No implant suffered biological complications or implant loss. Long implants were associated with less radiographic bone loss. Conclusions: extra-short (4 mm); short (6 mm); and conventional length (>8 mm) implants in the posterior maxilla present similar peri-implant bone loss and 100% survival rates in rehabilitation, by means of two splinted crowns after 36 months of functional loading. Implants placed in posterior positions present better bone loss results than implants placed in anterior positions, regardless of the interproximal area where bone loss is measured. Conventional length (>8 mm) implants show better behavior in terms of distal bone loss than short (6 mm) and extra-short (4 mm) implants.

Clinical efficacy of tumor-treating fields for newly diagnosed glioblastoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 2046-2046
Author(s):  
Yang Liu ◽  
Margie Richardson ◽  
Kwanza Warren ◽  
Myla S. Strawderman ◽  
Nimish Mohile ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rates ◽  
Extent Of Resection ◽  
Newly Diagnosed ◽  
Cox Models ◽  
Tumor Treating Fields ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Group Comparisons

2046 Background: Recent clinical trials have shown that adding tumor treating fields (TTF) to the Stupp protocol (SP) has increased survival after glioblastoma (GBM) diagnosis. However, whether this regimen improves population-based survival for patients with GBM remains unknown. Methods: We retrospectively identified adult patients with newly diagnosed GBM treated at our institution from January 2000 to July 2017 (n = 438, median age: 63 years).We grouped patients into three time periods for comparison: 2000-2004 (group 1, prior to SP), 2005-2013 (group 2, SP) and 2014-2017 (group 3, adding TTF to SP). The Kaplan-Meier method was used to estimate survival. Statistical analysis included unadjusted group comparisons by Chi-square and Log-rank tests and adjusted group comparisons using logistic and Cox models. Results: Thirty-seven percent (43/117) of patients with GBM in group 3 received TTF with SP therapy; when compared to those who received SP only, these patients had significant improvements in 6-month and 1-year overall survival (OS) rates (100.0% vs. 82.4%, p < 0.01; 86.0% vs. 66.2%, p < 0.05, respectively) (unadjusted for prognostic factors including sex, age, KPS and extent of resection) and an increased trend of median OS (479.0 vs. 448 days, p = 0.269). However, after adjusting for those prognostic factors, we didn’t find a statistically better survival for patients treated with TTF (OR: 6.156, p = 0.097, OR: 2.102, p = 0.185, respectively). Furthermore, multivariate Cox proportion hazards model after adjusting for those prognostic factors showed no significant survival benefits for patients treated with TTF and SP compared to those treated with SP only (HR = 0.797, p = 0.648). In addition, we didn’t find significant increases of 6-month, 1-year survival rates and median OS for patients in group 3 when compared to those in group 2 who had seen increased trends of survival trends when compared to those in group 1. Conclusions: Although adding TTF to SP appeared to benefit patients with GBM, this effect might be due to selection bias, e.g., TTF was offered to those patients with better prognostic factors. Ascertaining the long-term benefits of TTF requires further investigation.

Management of Acute Myeloid Leukemia (AML) in First Relapse: Retrospective Analysis about 101 Adults Cases Receiving Homogeneous First-Line Therapy. Impact of Prognostic Factors and Treatment.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 882-882
Author(s):  
Cecile Fohrer ◽  
Brigitte Witz ◽  
Jean Luc Harousseau ◽  
Francis Witz ◽  
Shanti Ame ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Median Survival ◽  
Complete Response ◽  
Intensive Chemotherapy ◽  
Group 4 ◽  
Line Therapy ◽  
First Relapse ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract We retrospectively analyzed impact of prognostic factors and salvage therapy in 101 patients (pts) with AML in 1st relapse. All pts were treated as 1st line according protocols GOELAMs 1 (87–94) or 2 (95–99). They all achieved complete remission after one (85%) or two (16%) induction with a combination of anthracycline and cytarabine. Consolidation therapy included one course of high-dose cytarabine (HiDAC) and a second consolidation (amsacrine-VP16) or, for a subset of pts, intensification with allogeneic or autologous stem cell transplantation (SCT). Data were collected in 3 of the centers participating to these trials. Main characteristics of pts at initial diagnosis were: median age : 39 y (range 17–64); sex : 55 male, 46 female; WBC count > 30 000/μl in 42 (42%) pts; 16/85 (18%) pts had unfavorable karyotype. Median duration of 1st complete remission (CR1) was 10 months (range: 1–101). Duration of CR1 was shorter than 6 months in 22 (22%) pts, between 6 and 12 months in 41 (40%) pts and longer than 12 months in 38 (38%) pts. At time of 1st relapse, median age was 40 y (range 18–66) and 10/38 (26%) unfavorable karyotype. There were no specific recommendations in the GOELAMs protocols for the second line therapy: modalities of treatment were therefore left to investigator’s decision. First step of relapse treatment was based on intensive chemotherapy in 79 (79%) pts including 55 pts who received a regimen containing HiDAC (Group 1) and 24 pts who received a chemotherapy without HiDAC (Group 2). Eight pts received an autologous SCT (4 pts) or an allogeneic SCT (4 pts) without any previous salvage chemotherapy (Group 3). One pt received gemtuzumab ozogamicin and thirteen pts received only oral chemotherapy and/or supportive care (Group 4). Fifty-seven pts (56%) achieved a second CR. Response rate and median survival according to initial therapy of relapse are shown in the following table. Differences are not significant. Complete response (%) Median survival (months) Group 1 (n = 55) 39 (71%) 11.5 Group 2 (n = 24 10 (42%) 8 Group 3 (n = 8) 6 (75%) 7.5 Group 4 (n = 14) 2 (14%) 3.5 Twenty seven pts out of the 49 pts who achieved a CR2 after intensive chemotherapy (Group 1 and 2) received subsequent intensification with either an allogeneic SCT (7 pts) or an autologous SCT (20 pts). Median survival of these pts subsequently transplanted was 18 months compared to only 10 months in the 22 pts of group 1 and 2 who did not receive a subsequent transplantation. Difference is not significant (log rank test, p = 0.65). Nine (33%) of the 27 transplanted pts are alive more than 36 months after relapse (range 41–120). Univariate analysis demonstrated that adverse prognosis factors on survival at 1st relapse were duration of RC1 shorter than 12 months (p= 0.005)and complex cytogenetic abnormalities (p= 0.0086). Conclusion: Intensive chemotherapy including HiDAC at 1st relapse in AML in adults provided a high rate of complete response. Intensification with SCT after CR2 was obtained can provide a very long survival in a limited number of pts. At 1st relapse, adverse prognostic factors on survival were short CR1 and unfavorable karyotype. Risk-adapted of AML in first relapse may therefore be warranted. Figure Figure

scholarly journals The pathogenicity of rmpA or aerobactin-positive Klebsiella pneumoniae in infected mice

2019 ◽  
Vol 47 (9) ◽  
pp. 4344-4352 ◽  
Author(s):  
Guili Li ◽  
Shuhong Sun ◽  
Zhong Yuan Zhao ◽  
Yunfang Sun
Keyword(s):  
Klebsiella Pneumoniae ◽  
Survival Rates ◽  
Gene Detection ◽  
Group 4 ◽  
High Virulence ◽  
Bacterial Enumeration ◽  
String Test ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives To investigate the pathogenicity of Klebsiella pneumoniae (KPN) possessing rmpA or the aerobactin gene in infected mice. Methods BALB/c mice were divided into four groups (n = 10 per group) and infected with: string test-positive and rmpA-positive or aerobactin-positive KPN (group 1), string test-negative but rmpA-positive KPN (group 2), string test-negative but aerobactin-positive KPN (group 3), or string test- and rmpA/aerobactin-negative KPN (group 4). Mouse survival time was compared among groups, and the infection of livers, spleens, lungs, and kidneys and KPN growth were assessed in infected mice. Results Compared with the negative group (group 4), the survival rates of mice infected with rmpA- or aerobactin-positive KPN (groups 1–3) were significantly lower, their multi-organ injuries were significantly more severe, and bacterial enumeration was significantly higher. Conclusions Despite being string test-negative, aerobactin- or rmpA-positive KPN still exhibit high virulence and anti-immune effect activity. Therefore, the combination of the string test and gene detection of aerobactin and rmpA will be helpful in screening hypervirulent KPN.

Brain metastases and testicular tumors: need for aggressive therapy.

1984 ◽  
Vol 2 (12) ◽  
pp. 1397-1403 ◽  
Author(s):  
S G Lester ◽  
J G Morphis ◽  
N B Hornback ◽  
S D Williams ◽  
L H Einhorn
Keyword(s):  
Brain Metastases ◽  
Complete Response ◽  
Entire Group ◽  
Indiana University ◽  
Testicular Tumors ◽  
Chemotherapeutic Regimen ◽  
Chemotherapy Group ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In late 1974, the combination of cisplatin, vinblastine, and bleomycin (PVB) became the standard chemotherapeutic regimen for treatment of disseminated nonseminomatous germ cell testicular tumors (NSGCT) at Indiana University Hospital. A retrospective analysis of the treatment records of all patients with brain metastases from NSGCTs treated at the Indiana University Radiation Oncology Department from 1975 through 1982 was undertaken. These 22 patients were divided into four groups. Group 1 (n = 5) consisted of those patients who presented initially with brain metastases and had no prior systemic treatment. Group 2 (n = 4) were referred to Indiana University after failing systemic therapy other than PVB chemotherapy. Group 3 (n = 5) consisted of those patients who after achieving a complete response with PVB developed a relapse confined to the brain. Group 4 (n = 8) consisted of those patients who were initially treated with PVB and eventually developed progressive disease and brain metastases. The survival by group is 80%, 0%, 60%, and 0%, respectively, with the overall survival for the entire group being 31.8%. All patients currently alive have a range of follow-up of 22 to 96 months from diagnosis and 12 to 83 months from whole brain irradiation (WBRT). Group 1 was treated with PVB +/- doxorubicin plus WBRT. Group 3 was treated with surgical excision, when feasible, followed by WBRT and platinum-containing chemotherapy. Group 2 and 4 were usually treated with palliative intent WBRT. The CNS is a site of sanctuary from PVB. Patients with brain metastases who may achieve a complete response should be treated with curative intent and receive aggressive WBRT (5,000 rad/25 fractions) with concomitant chemotherapy.

Enhancement of radiation-induced downstaging of rectal cancer by fluorouracil and high-dose leucovorin chemotherapy.

1992 ◽  
Vol 10 (1) ◽  
pp. 79-84 ◽  
Author(s):  
B D Minsky ◽  
A M Cohen ◽  
N Kemeny ◽  
W E Enker ◽  
D P Kelsen ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lower Incidence ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
High Dose ◽  
Preoperative Radiation ◽  
Unresectable Disease ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PURPOSE To determine if fluorouracil (5-FU) plus high-dose leucovorin (LV) enhances local response in patients receiving preoperative radiation therapy (RT) for adenocarcinoma of the rectum, we compared the degree of downstaging in patients receiving preoperative RT with or without chemotherapy. PATIENTS AND METHODS For this comparison, three groups of patients who were treated with identical doses and techniques of preoperative pelvic RT (total dose of 5,040 cGy) were examined. Group 1 included 20 patients with unresectable disease who received combined RT and LV/5-FU. Group 2 included 11 patients with unresectable disease who received preoperative RT. Group 3 included 21 patients with invasive, resectable, primary disease who received preoperative RT. RESULTS Patients with unresectable disease who received LV/5-FU had a higher rate of pathologic complete response (20% v 0%) and a lower incidence of positive nodes (30% v 64%) compared with those who did not receive chemotherapy. Even when the most favorable group of patients was included (group 3), patients who received LV/5-FU still had a higher complete response rate (20% v 6%) and a lower incidence of positive nodes (30% v 53%) compared with those who received RT without LV/5-FU. Of those patients with initially unresectable disease, the resectability rate was higher in those who received LV/5-FU compared with those who did not receive LV/5-FU (90% v 64%). Patients who received LV/5-FU experienced slightly more grade 1 to 2 fatigue, stomatitis, nausea, and grade 3 diarrhea, tenesmus, and dysuria. CONCLUSIONS Despite the fact that patients who received chemotherapy (group 1) had more advanced disease compared with those with resectable disease (group 3), the addition of LV/5-FU increased the resectability and downstaging rates. The ultimate impact of a complete response as well as a decrease in the incidence of pelvic nodes on local control and survival remains to be determined. However, given the enhancement of down-staging in patients with unresectable rectal cancer, we are encouraged by the combined modality approach.

Effect of Timing of Pulmonary Metastases Identification on Prognosis of Patients With Osteosarcoma: The Japanese Musculoskeletal Oncology Group Study

2002 ◽  
Vol 20 (16) ◽  
pp. 3470-3477 ◽  
Author(s):  
Hiroyuki Tsuchiya ◽  
Yoshimitsu Kanazawa ◽  
Mohamed E. Abdel-Wanis ◽  
Naohiro Asada ◽  
Satoshi Abe ◽  
...  
Keyword(s):  
Lung Metastasis ◽  
Lung Metastases ◽  
Survival Rates ◽  
Treatment Modalities ◽  
Oncology Group ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Musculoskeletal Oncology ◽  
Group 1

PURPOSE: The prognostic value of the time of identification of lung metastasis was investigated in 280 patients with metastatic lung osteosarcoma as a multi-institutional study of the Japanese Musculoskeletal Oncology Group. PATIENTS AND METHODS: The 280 patients with lung metastasis were divided into four groups: group 1, patients with lung metastasis identified at initial presentation; group 2, those with lung metastasis identified during preoperative chemotherapy; group 3, those with lung metastasis identified during postoperative chemotherapy, and group 4, those with lung metastasis identified after completion of treatment. Survivals of the four groups were compared. Additionally, the effects of number of metastatic nodules, metastasectomy, and the effect of chemotherapy on the primary tumor on survival of the four groups were analyzed. RESULTS: There were 46 patients in group 1, 30 in group 2, 94 in group 3, and 110 in group 4. The overall 2-year survival rates from the time of identification of lung metastasis were 33%, 31%, 24%, and 40% for groups 1, 2, 3, and 4, respectively, whereas the 5-year survival rates were 18%, 0%, 6%, and 31%, respectively. Patients in group 4 thus demonstrated significantly better prognosis than any of the other patients (P < .0001). CONCLUSION: Time of identification of lung metastasis is an important prognostic factor. In terms of clinical behavior, groups 2 and 3 are completely different than group 4. These data ensure the need to stratify stage III osteosarcomas into subgroups according to the time of diagnosis of lung metastases. To improve the survival of osteosarcoma patients, new treatment modalities should be introduced into the treatment armamentarium for lung metastasis from osteosarcoma, especially in groups 1, 2, and 3.

A comprehensive echocardiographic method for risk stratification in pulmonary arterial hypertension

2020 ◽  
Vol 56 (3) ◽  
pp. 2000513
Author(s):  
Stefano Ghio ◽  
Valentina Mercurio ◽  
Federico Fortuni ◽  
Paul R. Forfia ◽  
Henning Gall ◽  
...  
Keyword(s):  
High Risk ◽  
Prognostic Value ◽  
Survival Rates ◽  
Intermediate Risk ◽  
Chi Squared ◽  
Risk Patients ◽  
Pulmonary Arterial ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Question addressedEchocardiography is not currently considered as providing sufficient prognostic information to serve as an integral part of treatment goals in pulmonary arterial hypertension (PAH). We tested the hypothesis that incorporation of multiple parameters reflecting right heart function would improve the prognostic value of this imaging modality.Methods and main resultsWe pooled individual patient data from a total of 517 patients (mean age 52±15 years, 64.8% females) included in seven observational studies conducted at five European and United States academic centres. Patients were subdivided into three groups representing progressive degrees of right ventricular dysfunction based on a combination of echocardiographic measurements, as follows. Group 1 (low risk): normal tricuspid annular plane systolic excursion (TAPSE) and nonsignificant tricuspid regurgitation (TR) (n=129); group 2 (intermediate risk): normal TAPSE and significant TR or impaired TAPSE and nondilated inferior vena cava (IVC) (n=256); group 3 (high risk): impaired TAPSE and dilated IVC (n=132). The 5-year cumulative survival rate was 82% in group 1, 63% in group 2 and 43% in group 3. Low-risk patients had better survival rates than intermediate-risk patients (log-rank Chi-squared 12.25; p<0.001) and intermediate-risk patients had better survival rates than high-risk patients (log-rank Chi-squared 26.25; p<0.001). Inclusion of other parameters such as right atrial area and pericardial effusion did not provide added prognostic value.Answer to the questionThe proposed echocardiographic approach integrating the evaluation of TAPSE, TR grade and IVC is effective in stratifying the risk for all-cause mortality in PAH patients, outperforming the prognostic parameters suggested by current guidelines.

scholarly journals Comparison of Three Different Chemotherapy Regimens Containing Epirubicin in Hormone-Refractory Prostate Cancer Patients

2008 ◽  
Vol 8 ◽  
pp. 586-597 ◽  
Author(s):  
Hamit Ersoy ◽  
Orhan Yigitbası ◽  
Levent Sagnak ◽  
Hikmet Topaloglu ◽  
Ahmet Kiper
Keyword(s):  
Prostate Cancer ◽  
Treatment Protocol ◽  
Response Rates ◽  
Complete Response ◽  
Survival Times ◽  
Group 3 ◽  
Hormone Refractory ◽  
Group 2 ◽  
And Performance ◽  
Group 1

We compared three different chemotherapy regimens containing epirubicin in hormonerefractory prostate cancer (HRPC) patients. Sixty-nine patients with HRPC were randomized into three groups. The first group (22 patients) received 30 mg/m2/week i.v. epirubicin for 8 weeks. The second group (24 patients) received 30 mg/m2/week i.v. epirubicin for 8 weeks followed by monthly maintenance therapy for 4–6 months. The third group (23 patients) received oral estramustine phosphate (EMP) at a dose of 840 mg/day together with weekly and monthly maintenance epirubicin. The response rates, mean survival times, and toxicity were determined. Within the first 3 months, pain and performance scores were improved by at least one degree in all the groups. One patient in group two and three patients in group three had complete response. Partial response rates were 23% in group 1, 25% in group 2, and 17% in group 3. Stable disease rates were 41% in group 1, 33% in group 2, and 26% in group 3. The progression rates within the first 3 months were 36% in group 1, 38% in group 2, and 44% in group 3. None of the patients developed complications that were significant enough to terminate the treatment. Two patients in group 3 died of cardiotoxicity. The mean survival times were 10.1, 15.8, and 16.1 months in groups 1, 2, and 3, respectively. It was determined that weekly and maintenance epirubicin treatment protocol, and estramustine treatment protocol in addition to this treatment, was only meaningfully more effective against weekly epirubicin treatment in the statistical sense (0.01 < p < 0.05). However, due to the complications of EMP, which influence the quality of life, we believe that this was usable only when measures were adopted against these effects.

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