ABSTRACT
The aim of the present study is to document the antitumor activity of the combination of gemcitabine and cisplatin for the treatment of advanced NSCLC, assess the nature and severity of the side effects and elicit the impact of the combination chemotherapy on progression free survival and overall survival. From August 1997 to August 2001 we conducted a phase II study of gemcitabine and cisplatin in 60 chemonaive patients [21 stage IIIB and 39 stage IV]. For the first 34 cases, gemcitabine was given at a dose of 1,000 mg/m[2] IV on days 1, 8 and 15 with cisplatin 100 mg/m[2] on day 15, every 28 days. In the following 26 patients, the regimen was modified to gemcitabine 1,250 mg/m[2] days 1 and 8 and cisplatin 80 mg/m[2] day 1, every 21 days. Patients included 53 males and 7 females [median age. 52 years [range, 28-69]]. Twenty-nine had adenocarcinoma, 18 large-cell carcinoma and 13 squamous-cell carcinoma. Thirty-one patients had a performance status [PS] of 2 and 22 presented with weight loss. All patients were evaluable for response. Three patients achieved a complete response [CR] and 22 had partial response [PR], giving an overall response of 41.7%, with a median duration of 10 months [range, 4-46 months]. The time to progression [TTP] was 8 months [range, 2-46 months], with a median overall survival of 9 months [range, 2-46 months]. The one-year survival rate was 30.3% for the entire study population, 44% for responders, and statistically improved in patients with a PS of 1 and those with no weight loss. A total of 255 cycles were administered [median, four cycles/patient]. Myelosuppresion was significant [but manageable] with grade 3/4 neutropenia in 32.6% of cases, anemia in 18.6% and thrombocytopenia in 20.4%, Nonhematologic toxicity was limited to grade 3/4 nausea and vomiting in 28.8% of cases and impaired liver enzymes in 13.6%. Inspite of the relatively poor prognostic characteristics in the study population, gemcitabine and cisplatin was an effective combination with tolerable, manageable toxicity in advanced NSCLC
Subject(s)
Humans , Male , Female , Cisplatin/toxicity , Drug Combinations , Treatment OutcomeABSTRACT
This study was done on 180 patients with histopathologically proven invasive bladder cancer associated with bilharziasis. They were subjected to radical cystectomy or anterior pelvic excentration. After surgery, the patients were regularly followed up for a minimum of two years. Squamous cell carcinoma was the commonest type and most of the tumors were grade II. One hundred and seventy-three patients had their tumors operable, while seven patients were inoperable. Five operative related mortalities were recorded. Free and overall survival rates of the whole group of the patients were 31.44 + 5.9% and 32.5 + 6.8%, respectively. Tumor pathologic stage, grade and nodal affection were the only significant factors that affected the survival. These three prognostic indices were used to design a model to predict an individual patientgyptians risk factor for recurrence. Then, the patients were assigned to one of four risk groups according to the score achieved in this prognostic index [0 = low risk, 1 = intermediate risk and 2 or 3 = higher risk]. These four risk groups had distinctly different rates of disease free survival, being 91.7%, 53%, 13% and 7% for low risk, intermediate risk and higher risk groups, respectively