Docetaxel and cisplatin [DC] versus epirubicin, cisplatin and 5 fluorouracil [ECF] as systemic chemotherapy treatment for advanced gastric carcinoma [AGC]

Docetaxel and Cisplatin [DC] versus Epirubicin, Cisplatin and 5 fluorouracil [ECF] as Systemic Chemotherapy Treatment for Advanced Gastric Carcinoma [AGC]. Our study was performed to compare between DC and ECF combination chemotherapy as regard the clinical activity in terms of toxicity and response [primary objective] and the survival [secondary objective] trying to reach to a new effective and well tolerated regimen to improve the poor treatment results for palliative chemotherapy in advanced gastric cancer. Forty patients [pts] with AGC [unresectable and/or metastatic], bi-dimentionally measurable disease, performance status is >/= 70%, normal blood counts, hepatic and renal functions and no prior chemotherapy were randomized to receive DC [Docetaxel 75mg/m[2] dl and Cisplatin 75mg/m[2] dl] every 3w or ECF [Epirubicin 50mg/m[2] dl/3w and Cisplatin 60mg/m[2] dl/3w and 5 fluorouracil 200mg/m[2]/d continuous intravenous infusion for a total of 6 cycles for each regimen. The overall response was 45% for DC [n=9] [8 partial response + 1 complete response] and 30% for ECF [n=6] [all are partial responses]. Median time to progression was 7.0 months for DC and 5 months for ECF p=0.03. Median overall survival time was 10.5 months for DC and 8.5 months for ECF p=0.67. The most frequent G3 and 4 events per patient was neutropenia [DC=85%, ECF=30%]. Febrile neutropenia was recorded in 20% with DC versus 5% with ECF. Grade >/= 3 for other events with DC were anemia 15%, thrombocytopenia 10%, vomiting 10%, Diarrhea 10%, Stomatitis 0%, peripheral neuropathy 10% and lethargy 20% versus 5%, 5%, 20%, 20%, 10%, 0% and 5%, with ECF, respectively. There was no treatment related deaths. DC tends to be more effective in AGC with a higher response rate and better median time to progression and overall survival than ECF but with significantly higher neutropenia which was manageable. Use of primary prophylaxis with G-CSF is reasonably recommended

Long term results of conservative management in T1 and T2 breast cancer among 170 cases

This retrospective study included 170 patients with histologically proven early breast carcinoma [T1 and T2 /<4 cm]. All patients underwent a conservative surgical resection of the primary tumor and axillary dissection. Postoperative radiation therapy was given as whole breast irradiation to a total dose of 50 Gy over 5 weeks in 25 fractions, followed by a boost 16 Gy over 1 and 1/2 weeks in 8 fractions to the tumor bed. Among the whole group, only 122 patients received adjuvant chemotherapy. At the end of the study with a median follow up period of 60 months, treatment failure was documented in 70 patients. Isolated local recurrence was detected in 26 patients and regional recurrence was reported in only 4 patients. Distant dissemination was recorded in 40 patients. Univariate analysis revealed that age group, menopausal status and adjuvant chemotherapy were significant factors influencing the relapse rate [0.006, 0.006 and 0.032, respectively]. The overall actuarial 5- and 10-year survival rates for the whole group were 80% and 60%, respectively. The overall actuarial 5 and 10-year survivals for patients developing local recurrence were significantly higher than the survival of patients who developed regional or distant relapse denoting a successful salvage treatment. While, the 5- and 10-year distant metastasis free survival rates of the whole group were 64.5% and 49.2%, respectively. Cox regression multivariate analysis showed that the relapse site, adjuvant chemotherapy, age group and number of involved axillary lymph nodes were independent prognostic factors that significantly influenced the over survival. On the other hand, the relapse site and age group were the significant factors that affected the distant metastasis free survival

Advanced low grade non hodgkin's lymphoma [LGL]; treatment results using cyclophosphamide, fludarabine, and prednisone [CFP]

Fludarabine has been shown to be an effective agent in the treatment of low grade lymphoma; either used alone or in combination with other chemotherapeutic agents. It maintains its efficacy both for newly diagnosed cases as well as for patients with recurrent progressive low grade Non Hodgkin's Lymphoma [RPLGL]. This an open phase II study of CFP chemotherapy regimen conducted in patients with advanced LGL to explore the efficacy of this regimen and its toxicity profile. Between January 1998 and March 2000 41 patients aged 42-69 years [median 54] were enrolled to this multicenter study. All of the 37 evaluable patients, were allocated to receive 6 cycles of cyclophosphamide 300 mg/m[2] intravenously [IV.] day 1-3[DI-3], Fludarabine 25 mg/m[2] I.V.D 1-3 and prednisone 40 mg/m[2] PO, Dl-5. Chemotherapy cycles were repeated every 28 days for 6 cycles. Of the 37 evaluable patients. 20 patients [54%] had recurrent progressive disease [RPLQL], while 17 patients [46%] were newly diagnosed advanced LGL [stage; II bulky. III, and IV]. Clinical response to treatment was evaluated immediately after the completion of the chemotherapy schema, and defined according to categories; complete remission [CR], partial remission [PR]. The overall response rate for the whole group was 86% [32/37 patients]. Eleven patients [3 0%] achieved CR, and 21 patients [56%] achieved PR. Patients with newly diagnosed LGL had better