Evaluation of different treatment modalities in dukes B and C rectal adenocarcinoma

A retrospective analysis of 291 eligible patients with carcinoma of rectum and rectosigmoid was undertaken. The patients were assigned to one of four treatment groups: Preoperative chemoradiotherapy [CRT], followed by postoperative chemotherapy [POCT], postoperative radiotherapy [PORT], postoperative chemotherapy [POCT] and postoperative CRT. The results showed that with a median follow up of 57.2 months, the 5-year overall survival was 47.8%, the 5-year DFS was 42.4%. The 5-year OS was 48.3% in the preoperative CRT group, 42.4% in PORT group, 34.3% for POCT group and 55% in the POCRT group. The 5-year DFS was 44.8%, 39.4%, 31.5% and 50% in the four treatment groups, respectively. Local failure [LF] occurred in 14.1% of the patients and distant metastasis [DM] was observed in 28.9%

Comparison of accelerated hyperfractionated and conventional radiotherapy for high grade glioma

The objective of this study was to compare accelerated hyperfractionated radiotherapy with conventional fractionation in patients with high grade glioma regarding its effect on the survival complications, time, convenience and progression during treatment. Between March 1998 and February 2000, 36 patients with high-grade glioma [groups III and IV] were treated with either accelerated hyperfractionated radiotherapy [1.5 Gy twice daily to a total dose of 60 Gy, treatment time 4 weeks, n = 18] or with conventional radiotherapy [1.8-2 Gy daily to a total dose of 60 Gy, treatment time 6-6.5 weeks, n = 18]. The results showed that the median survival time [MST] was 14.4 months for AHF group and 13.5 months for CF group. The 1- and 2-year survival rates were 61.1% and 27.8% versus 55.6% and 22.2%. The median time to progression [MTP] was 13 months for AHF group and 10.9 months for CF group and the 2-year progression free survival was 22.2% versus 16.7%. Thus, there was no significant difference between the two groups

Irinotecan combined with fluorouracil and leucovorin compared with fluorouracil, leucovorin as first-line treatment for unreaectable, locally advanced and metastatic colorectal cancer

CPT-11 is a topoisomerase I inhibitor that prolongs survival in patients with CRC refractory to 5-FU and LV. This demonstrated activity of CPT-1 1 as effective second-line therapy for CRC led to evaluation of combination CPT-11/5-FU/Ly as first-line therapy for patients with locally advanced and metastatic disease. To evaluate the efficacy of CPT-11/5-FU/LV combination compared to 5-FU/Ly alone in the management of locally advanced and metastatic colorectal cancer. Patients were assigned to receive CPT-11 180 mg/rn2 as 60-minute IVI on day 1 followed by LV 200 mg/m2/day as a 2 hour IVI followed by 5-FU as an IV bolus at 400 mg/m2/day and then as 22 hour CI at 600 mg/m2/day, repeated on 2 consecutive days [30 patients] every 2 weeks, or 5-FU and LV at the same doses and administration as in the CPT-l I arm [32 patients]. End points included RR, PFS and Os. As compared with treatment with 5-FU/Ly, treatment with CPT-l 1/5-FU/Ly resulted in significantly a higher rate of response [43.4% vs 18.8%, P=0.03], longer PFS [median 8 vs 4.3 months; p0.02] and longer OS [median 17 vs 12 months, p=0.04]. Grade 3 [severe] diarrhea was more common during treatment with CPT-l 1/5-FU/Ly than during treatment with 5-FU/Ly. Grade 4 [life-threatening] diarrhea was infrequent in the two groups. Grade 3 or 4 mucositis were infrequent. Grade 4 neutropenia and neutropenic fever were more frequent during treatment with CPT-1 1/5-FU/Ly. Toxic effects were predictable, reversible, non-cumulative and manageable. The combination of CPT-1115-FU/Ly is superior to 5-FU/Ly alone as first-line therapy for patients with locally advanced and metastatic colorectal cancer, offering statistically significant better response rate, PFS and OS and a comparable toxicity

Conservative treatment versus mastectomy in the treatment of stage I and II breast cancer

Analysis of the patterns of failure for breast cancer patients who underwent modified mastectomy, or lumpectomy with axillary dissection and radiation therapy, as well as the prognostic factors that have an independent effect on treatment failures and overall survival. Sixty six patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary, dissection and radiation therapy. All patients with positive nodes received adjuvant systemic therapy. Annual mammography was an integral component of the follow-up program. Diagnostic studies for systemic disease were performed as clinically indicated. At five years, overall survival was 79% for patients assigned to mastectomy and 91% for those assigned to lumpectomy [P=0. 97]. Disease-free survival was 74% for patients assigned to mastectomy and 72% for those assigned to lumpectomy [P=0.7]. The rate of local recurrence was 8.8% after mastectomy and 12.5% after lumpectomy [P=0.92]. Breast conservation with lumpectomy and irradiation offers results at five years that are equivalent to those obtained with mastectomy