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1.
Article in English | WPRIM | ID: wpr-763507

ABSTRACT

Ewing sarcoma is the second most frequently occurring malignant tumor of the bone and soft tissue in adolescents and young adults. Genetically, Ewing sarcoma is characterized by balanced chromosomal translocation in which a member of FET gene family is fused with an ETS transcription factor, with the most common fusion being EWSR1-FLI1 (85% of cases). Treatment of Ewing sarcoma is based on multidisciplinary approach (local surgery, radiotherapy and multiagent chemotherapy), which are associated with chronic late effects that may compromise quality of life of survivors. First line treatment includes combination of drugs incorporating doxorubicin, vincristine, cyclophosphamide, ifosfamide, etoposide, and dactinomycin. The beneficial role of high dose chemotherapy has been suggested in high-risk localized Ewing sarcoma patients, and the studies are being performed to investigate the role in metastatic disease. The 5-year overall survival for localized Ewing sarcoma has improved to reach 65% to 75%. But patients with metastatic disease have a 5-year survival rate of <30%, except for those with isolated pulmonary metastasis (approximately 50%). Patients with recurrent tumor have a dismal prognosis. Novel therapeutic strategies based on understanding of molecular mechanisms are needed to improve the outcome of Ewing sarcoma and to lessen the treatment-related late effects.


Subject(s)
Adolescent , Cyclophosphamide , Dactinomycin , Doxorubicin , Drug Therapy , Etoposide , Humans , Ifosfamide , Neoplasm Metastasis , Neuroectodermal Tumors, Primitive, Peripheral , Prognosis , Quality of Life , Radiotherapy , Sarcoma, Ewing , Survival Rate , Survivors , Transcription Factors , Translocation, Genetic , Vincristine , Young Adult
2.
Article in English | WPRIM | ID: wpr-715838

ABSTRACT

PURPOSE: The aim of this study was to compare asparaginase-related toxicities in two asparaginase preparations, namely native Escherichia coli L-asparaginase (L-ASP) and pegylated asparaginase (PEG-ASP) in combination with ifosfamide, methotrexate, etoposide, and prednisolone (IMEP) in natural killer (NK)/T-cell lymphoma (NTCL). MATERIALS AND METHODS: A total of 41 NTCL patients who received IMEP plus native E. coli L-ASP or PEG-ASP at Seoul National University Hospital were included in this study between January 2013 and March 2016. IMEP/ASP treatment consisted of ifosfamide, methotrexate, etoposide, plus native E. coli L-ASP (6,000 IU/m2 on days 1, 3, 5, 7, 9, and 11) or PEG-ASP (2,500 IU/m2 on day 1) every 3 weeks. ASP-related toxicities, toxicity patterns, length of hospital stay, and clinical outcomes were compared between the different treatment groups. RESULTS: The frequency of ASP-related toxicities was similar between the IMEP plus native E. coli L-ASP group and the PEG-ASP group apart from hypofibrinogenemia (native E. coli L-ASP vs. PEG-ASP group, 86.4% vs. 36.8%; p=0.001). Although post-treatment transaminase and albumin levels were significantly high and low, respectively, hepatotoxicity gradients before and after treatment did not differ significantly between the groups. Since PEG-ASP was given at an outpatient clinic in some patients, length of hospital stay was significantly shorter in the IMEP plus PEG-ASP group (median, 4.0 vs. 6.0 days; p=0.002). A favorable tendency of clinical outcomes was observed in NTCL patients treated with IMEP plus PEG-ASP (complete remission rate, 73.7% vs. 45.5%; p=0.067). CONCLUSION: IMEP plus PEG-ASP showed similar ASP-related toxicities, shorter length of hospital stay, and a trend towards improved clinical outcomes compared with IMEP plus native E. coli L-ASP in NTCL.


Subject(s)
Ambulatory Care Facilities , Asparaginase , Escherichia coli , Escherichia , Etoposide , Humans , Ifosfamide , Length of Stay , Lymphoma , Methotrexate , Prednisolone , Seoul
3.
Article in English | WPRIM | ID: wpr-741359

ABSTRACT

PURPOSE: Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma. METHODS: We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens. RESULTS: The most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17–91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ≥3 late adverse effects. CONCLUSION: Patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.


Subject(s)
Abdomen , Bone Marrow , Carboplatin , Child , Cisplatin , Consensus , Cyclophosphamide , Doxorubicin , Drug Therapy , Etoposide , Follow-Up Studies , Humans , Ice , Ifosfamide , Infant , Isotretinoin , Liver , Lymph Nodes , Neoplasm Metastasis , Neuroblastoma , Prognosis , Radiotherapy , Recurrence , Retrospective Studies , Skin
4.
Article in English | WPRIM | ID: wpr-714708

ABSTRACT

OBJECTIVE: This retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC). METHODS: Patients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m²/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m²/day IV on days 1 to 5, every 21 days. RESULTS: From August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P < 0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI. CONCLUSION: The ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.


Subject(s)
Drug Therapy , Drug Therapy, Combination , Etoposide , Follow-Up Studies , Humans , Ifosfamide , Ovarian Neoplasms , Platinum , Recurrence , Retrospective Studies
5.
Rev. cuba. farm ; 50(1)ene.-mar. 2016. tab
Article in Spanish | LILACS, CUMED | ID: biblio-844865

ABSTRACT

Objetivo: caracterizar a los pacientes oncológicos que presenten episodios de neutropenia febril postquimioterapia ingresados en el Instituto de Oncología y Radiobiología en el periodo de enero a mayo del 2015. Métodos: se realizó un estudio descriptivo de corte transversal a una muestra de 36 pacientes. Se revisaron las historias clínicas donde se tomaron las variables analizadas. Resultados: predominaron los pacientes del sexo femenino (61,1 por ciento). Dentro de las enfermedades oncológicas predominaron los pacientes con Linfomas no Hodgkin (25,0 por ciento) y los medicamentos citostáticos vinculados a la neutropenia fueron el carboplatino, paclitaxel, ifosfamida y etopósido. La recuperación hematológica se logró en la mayoría de los casos antes de las 72 horas y el mayor número de pacientes (72,2 por ciento) fueron clasificados como una neutropenia de bajo riesgo, según los criterios de la Multinational Association for Supportive Care. Conclusiones: en la muestra estudiada la neutropenia febril presenta un incremento proporcional con la edad y las enfermedades de origen hematopoyéticos, cuyos esquemas quimioterápicos consisten en altas dosis de agentes citostáticos(AU)


Objective: to characterize the oncological patients who present with post chemotherapy febrile neutropenia and were admitted to the Institute of Oncology and Radiobiology in the period of January to May, 2015. Methods: a descriptive cross-sectional study of a sample of 36 patients. Their medical histories were checked from which the analyzed variables were taken. Results: females predominated in the study (61,1 percent). Among the oncological diseases, non-Hodgkin lymphomas (25,0 percent) prevailed whereas the cytostatic drugs found related to neutropenia were carboplatin, paclitaxel, ifosfamide and etoposide. The hematological recovery was reached in most cases before 72 hours and a lot of patients (72, 2 percent) were classified as low risk neutropenia according to the Multinational Association for Supportive Care criteria. Conclusions: in the study sample, the febrile neutropenia increases with the age and with hematopoietic diseases whereas chemotherapy schemes are based on high dose cytostatic agents(AU)


Subject(s)
Humans , Carboplatin/therapeutic use , Paclitaxel/therapeutic use , Etoposide/therapeutic use , Cytostatic Agents/adverse effects , Chemotherapy-Induced Febrile Neutropenia , Ifosfamide/therapeutic use , Epidemiology, Descriptive , Cross-Sectional Studies , Cuba
6.
Article in English | WPRIM | ID: wpr-89522

ABSTRACT

Primary malignant peripheral nerve sheath tumor (MPNST) in a young female patient, not associated with neurofibromatosis type-I is extremely rare in the liver. A 33-year-old female was admitted with a right flank pain for a weak. The CT scan showed 12.5-cm-sized mass located at the right hepatic lobe. At laparotomy, about 20.0-cm-sized mass was on the right hepatic lobe with attachment to right diaphragmatic pleura. Right hepatic lobe and adherent part of diaphragmatic pleura were resected. On histology and immunohistochemistry, it was diagnosed MPNST. Adjuvant radiotherapy for the right diaphragmatic pleura and adjuvant chemotherapy with adriamycin, ifosfamide and cisplatin were sequentially performed. The prognosis of MPNST is generally poor and it is associated with a highly aggressive course of recurrence, metastases, and death. Our case is probably a first report about combination therapy.


Subject(s)
Adult , Chemotherapy, Adjuvant , Cisplatin , Doxorubicin , Female , Flank Pain , Humans , Ifosfamide , Immunohistochemistry , Laparotomy , Liver , Neoplasm Metastasis , Neurilemmoma , Neurofibromatoses , Peripheral Nerves , Pleura , Prognosis , Radiotherapy, Adjuvant , Recurrence , Tomography, X-Ray Computed
7.
Article in English | WPRIM | ID: wpr-97100

ABSTRACT

Malignant glomus tumor is an exceedingly rare neoplasm occurring in the soft tissues. Controversy exists over whether malignant glomus tumor is a true malignancy due to the rarity of metastasis, however, this neoplasm has been known to show relatively frequent metastasis and poor outcome. To improve the outcome of systemic therapy for malignant glomus tumor might be necessary, but the appropriate chemotherapy or radiotherapy has yet to be elucidated. We report a case of malignant glomus tumor with multiple pulmonary metastases treated with total surgical resection and adjuvant chemotherapy including doxorubicin and ifosfamide; however 7 months after completion of chemotherapy primary lung nodules increased. This case suggests that these chemotherapeutic agents are not effective for the management of malignant glomus tumor with metastasis.


Subject(s)
Chemotherapy, Adjuvant , Doxorubicin , Drug Therapy , Female , Glomus Tumor , Humans , Ifosfamide , Lung , Neoplasm Metastasis , Radiotherapy , Shoulder
8.
Korean Journal of Medicine ; : 460-463, 2016.
Article in English | WPRIM | ID: wpr-101313

ABSTRACT

Here, we report on a 20-year-old patient with a primary nonseminomatous mediastinal germ cell tumor (MGCT) who developed myelodysplastic syndrome (MDS) 2 months following chemotherapy with cisplatin, etoposide, ifosfamide, and paclitaxel. Bone marrow examinations revealed that the MDS was a refractory anemia with excess type II blasts and complex chromosomal abnormalities. With the onset of MDS occurring rapidly following chemotherapy, it is unlikely to have been caused by the therapy. We discuss the association between primary nonseminomatous MGCTs and hematological malignancies, including the possibility of a common clonal origin.


Subject(s)
Anemia, Refractory , Bone Marrow Examination , Chromosome Aberrations , Cisplatin , Drug Therapy , Etoposide , Germ Cells , Hematologic Neoplasms , Humans , Ifosfamide , Myelodysplastic Syndromes , Neoplasms, Germ Cell and Embryonal , Paclitaxel , Young Adult
9.
Article in English | WPRIM | ID: wpr-788563

ABSTRACT

Malignant glomus tumor is an exceedingly rare neoplasm occurring in the soft tissues. Controversy exists over whether malignant glomus tumor is a true malignancy due to the rarity of metastasis, however, this neoplasm has been known to show relatively frequent metastasis and poor outcome. To improve the outcome of systemic therapy for malignant glomus tumor might be necessary, but the appropriate chemotherapy or radiotherapy has yet to be elucidated. We report a case of malignant glomus tumor with multiple pulmonary metastases treated with total surgical resection and adjuvant chemotherapy including doxorubicin and ifosfamide; however 7 months after completion of chemotherapy primary lung nodules increased. This case suggests that these chemotherapeutic agents are not effective for the management of malignant glomus tumor with metastasis.


Subject(s)
Chemotherapy, Adjuvant , Doxorubicin , Drug Therapy , Female , Glomus Tumor , Humans , Ifosfamide , Lung , Neoplasm Metastasis , Radiotherapy , Shoulder
10.
Article in Chinese | WPRIM | ID: wpr-360069

ABSTRACT

<p><b>OBJECTIVE</b>To investigate and compare the clinical effects and safety of DICE regimen combined with rituximab and GDP regimen combined with rituximab for the treatment of elderly patients with relapsed and refractory diffuse large B cell lymphoma.</p><p><b>METHODS</b>Ninety elderly patients with relapsed and refractory diffuse large B cell lymphoma were admitted in our hospital from January 2008 to June 2013 and randomly divided into 2 groups, including A group (45 patients) and B group (45 patients), the patients in A group were treated by DICL regimen combined with rituximab, while the patients in B group were treated by GDP regimen combined with rituximab; the clinical efficacy, disease-free survival time, the survival rate with follow-up and the incidence of toxic side-effects in 2 groups were compared.</p><p><b>RESULTS</b>The clinical efficacy of B group was significant better than that of A group (P < 0.05). The disease-free survival time of B group was significantly longer than that of A group (P < 0.05). The survival rate with follow-up of B group was significantly higher than that of A group (P < 0.05). The difference was not significant in incidence of the toxic side effects between 2 groups (P > 0.05).</p><p><b>CONCLUSION</b>Compared with DICE regimen combined with rituximab, GDP regimen combined with rituximab in treatment of elderly patients with relapsed and refractory diffuse large B cell lymphoma can efficiently reduce tumor loading, prolong the disease-free survival time, improve the long-term clinical prognosis, and not aggravate the side effects of drugs.</p>


Subject(s)
Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cisplatin , Therapeutic Uses , Deoxycytidine , Therapeutic Uses , Dexamethasone , Therapeutic Uses , Disease-Free Survival , Etoposide , Therapeutic Uses , Humans , Ifosfamide , Therapeutic Uses , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Prognosis , Remission Induction , Rituximab , Therapeutic Uses , Salvage Therapy , Survival Rate , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-360059

ABSTRACT

<p><b>OBJECTIVE</b>To explore the clinical efficacy and safety of lenalidomide plus low dose dexamethasone for treating patients with multiple myeloma (MM).</p><p><b>METHODS</b>A total of 19 MM patients were enrolled to receive the therapeutic schedule of lenalidomide plus dexamethasone in our hospital from May 2013 to June 2015. Lenalidomide 25 mg was taken orally daily for 21 days and resting for 7 days, and dexamethasone 10 mg was taken orally daily on the day 1-4, 7-10 and 13-16. The regimens were Rd (lenalidomide and dexamethasone, n = 12), and RCd (lenalidomide, ifosfamide and dexamethasone, n = 7).</p><p><b>RESULTS</b>Among 19 patients received 1 cycle of treatment 3 patients achieved complete remission (CR), 3 patients achieved very good partial remission (VGPR), 10 patients achieved partial remission (PR) and 3 patients in stable disease (SD) with an overall response rate (ORR = CR + VGPR + PR) of 84%; their ORR rate was 89% after 2 cycles of treatment. In the early stage of treatment, the renal function was improved in 4 out of 5 patients with renal dysfunction. And the common adverse reactions were hematologic toxicity in 4 patients, 1 degree rash in 5 patients, and gastrointestinal side effects in 4 patients.</p><p><b>CONCLUSION</b>The lenalidomide plus dexamethasone regimen has a good anti-multiple myeloma effect, which can control the disease rapidly and overcome the multidrug resistance in MM, improving the poor prognosis with renal dysfunction, and showing high remission rate in the patients exposed to bortezomib with low toxicity.</p>


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Dexamethasone , Therapeutic Uses , Humans , Ifosfamide , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Remission Induction , Thalidomide , Therapeutic Uses
12.
Pakistan Journal of Pharmaceutical Sciences. 2016; 29 (2): 433-437
in English | IMEMR | ID: emr-176373

ABSTRACT

Ifosfamide is an anticancer agent used largely in treatment of solid tumors. The mainstay dose-limiting toxicity of ifosfamide is nephrotoxicity. This is largely believde to be a result of ifosfamide-induced oxidative stress. In this study, we investigated the antioxidant activity of simvastatin and the possible protective role of simvastatin against ifosfamide induced nephrotoxicity. Thirty Sprague-Dawely rats were divided into five groups and given orally different drug combinations. Group I and II were regarded as control groups and received 0.1% DMSO and normal saline, respectively. Group III received ifosfamide at 50mg/kg, group IV received simvastatin at 0.3mg/kg and group V received both ifosfamide and simvastatin. All animals were decapitated 2 days after the last ifosfamide administration. Findings revealed that ifosfamide induced nephrotoxicity as indicated by a significant increase in plasma creatinine and lipid per oxidation. This increase was significantly inhibited in animals pretreated with simvastatin. Histopathological observations were in correlation with the biochemical parameters in that simvastatin minimized ifosfamide-induced renal tubular damage. The above results promote a future use of simvastatin in combination with ifosfamide in treatment of cancer patients to indicated that simvastatin protectics against ifosfamide-induced nephrotoxicity in terms of oxidative stress and might be given in combination


Subject(s)
Animals, Laboratory , Antioxidants , Ifosfamide/toxicity , Kidney/drug effects , Rats, Sprague-Dawley
13.
Fortaleza; s.n; 2016. 117 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: biblio-971954

ABSTRACT

Cistite hemorrágica (CH) induzida por ifosfamida (IFO) é uma importante complicação clínica em pacientes com câncer. Atualmente, mesna e hiper-hidratação são utilizadas como profilaxia, a despeito de ainda ser observada CH através de cistoscopia e histopatologia mesmo com essas medidas. A participação de interleucina-1 (IL-1) e fator de necrose tumoral (TNF) na patogênese da CH provê alvos para o tratamento dessa doença. Assim, esse trabalho objetivou avaliar o efeito protetor do antagonista do receptor da IL-1 (anakinra) e do anticorpo anti-TNF-alfa (infliximabe) nas respostas inflamatórias, nociceptivas e funcionais da CH experimental induzida por IFO em camundongos. Foram utilizados camundongos Swiss, C57BL6, IL-1R-/-, CASP1-/-, TNFR1-/-, TNFR1/R2-/-. Os animais WT foram submetidos ao tratamento com anakinra 100 mg/kg i.p. ou infliximabe 5 mg/kgi.p. ou salina i.p., foram tratados 1h após com IFO 400 mg/kg i.p., e 12 h após a IFO foi realizado o sacrifício, com excisão das bexigas para avaliaçãomacroscópica, histopatológica, permeabilidade vascular, mieloperoxidase, contratilidade, cistometrografia e citometria de fluxo para neutrófilos e macrófagos. Alguns animais, antes do sacrifício, foram submetidos a avaliação de nocicepção visceral. Anakinra foi capaz de atenuar hemorragia, edema, infiltrado neutrofílico, hipernocicepção visceral e disfunção vesical...


Hemorrhagic cystitis (HC) induced by ifosfamide (IFO) is an importantclinical complication in patients with cancer. Despite prophylaxis, HC isobserved. The role of interleukin-1 (IL-1) and tumor necrosis factor (TNF) in the pathogenesis of HC provides targets for treatment. Thus, this study aimed to evaluate the protective effect of the IL-1 receptor antagonist (anakinra) and anti-TNF-alpha antibody (infliximab) in experimental HC-induced by IFO in mice. Swiss , C57BL6 , IL -1R-/-, CASP1-/-, TNFR1-/-, TNFR1/R2-/-mice were used. Animals were submitted to pre-treatment with anakinra 100 mg/ kg, ip or infliximab 5 mg/ Kg, ip, or saline ip, 1h after, they were treated with IFO 400 mg/ kg ip, and 12 h after IFO injection they were killed. Then, it was performed resection of the bladder for macroscopic and histopathological evaluation, vascular permeability assay, myeloperoxidase assay, muscle contractility, cistometrogram and flow cytometry to neutrophils andmacrophages. Some animals prior to death, were subjected to evaluation of visceral nociception. Anakinra was able to attenuate hemorrhage, edema, neutrophil infiltration, visceral hypernociception and bladder dysfunction...


Subject(s)
Humans , Cystitis , Drug Therapy , Ifosfamide , Interleukin 1 Receptor Antagonist Protein , Antibodies, Monoclonal
14.
Blood Research ; : 97-102, 2015.
Article in English | WPRIM | ID: wpr-184127

ABSTRACT

BACKGROUND: Few clinical studies have clarified the prognostic factors that affect clinical outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after immunochemotherapy. METHODS: A total of 158 patients with relapsed or refractory DLBCL were enrolled. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after salvage therapy. All enrolled patients previously received the ifosfamide, carboplatin, and etoposide regimen. Clinical outcomes were compared according to several factors (age > or = 65 years, low age-adjusted International Prognostic Index [aa-IPI], maximum standardized uptake value [SUVmax] or =12 months, complete response after salvage therapy). A low aa-IPI, SUVmax or = 12 months were independent prognostic factors for survival. RESULTS: In univariate analysis and multivariate analysis, SUVmax below 6.0 (P<0.001 for progression-free survival (PFS), P<0.001 for overall survival (OS)) and low aa-IPI (P<0.001 for PFS, P<0.001 for OS) were independent prognostic factors associated with favorable outcome. CONCLUSION: The aa-IPI and initial SUVmax were powerful prognostic factors in patients with relapsed or refractory DLBCL.


Subject(s)
Carboplatin , Disease-Free Survival , Electrons , Etoposide , Humans , Ifosfamide , Lymphoma, B-Cell , Multivariate Analysis , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Recurrence , Salvage Therapy
15.
Chinese Journal of Oncology ; (12): 632-636, 2015.
Article in Chinese | WPRIM | ID: wpr-286767

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gemcitabine combined with ifosfamide (GI regimen)in patients with recurrent or metastatic nasopharyngeal carcinoma after failure of platinum-based chemotherapy.</p><p><b>METHODS</b>The clinical data of 27 nasopharyngeal carcinoma patients, who received GI regimen between April 2005 and March 2014 after failure of prior platinum-based chemotherapy, were retrospectively reviewed,and relevant prognostic factors were explored.</p><p><b>RESULTS</b>All patients were evaluable for efficacy and toxicity. No patient achieved complete response (CR). Partial response (PR) was achieved in ten patients, stable disease (SD) in thirteen patients, progressive disease (PD) in four patients, with a response rate of 37.0% and an overall disease control rate (PR+SD) of 85.2%. For ten PR patients, the median duration of response was 5.5 months. The median progression-free survival of the whole group was 6.7 months, and the Kaplan-Meier estimate of median overall survival was 17.4 months. The 1-year survival rate was 72.6%. Toxicity was mainly hematological: Grade III or IV anemia, neutropenia and thrombocytopenia were found in 3.7%, 37.0% and 18.5% of all patients, respectively. Univariate and multivariate analyses indicated that dose intensity of gemcitabine was a significant prognostic factor for PFS, whereas salvage treatment after failure of GI regimen was a significant prognostic factor for OS.</p><p><b>CONCLUSIONS</b>Gemcitabine and ifosfamide combination is effective and well tolerated by patients with advanced nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Further clinical study is warranted.</p>


Subject(s)
Anemia , Antineoplastic Agents , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinoma , Deoxycytidine , Disease-Free Survival , Humans , Ifosfamide , Induction Chemotherapy , Kaplan-Meier Estimate , Nasopharyngeal Neoplasms , Drug Therapy , Mortality , Pathology , Neutropenia , Platinum , Therapeutic Uses , Remission Induction , Salvage Therapy , Survival Rate , Thrombocytopenia , Treatment Failure
16.
Article in English | WPRIM | ID: wpr-34113

ABSTRACT

OBJECTIVE: To evaluate the efficacy and tolerability of a neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy in patients with locally advanced cervical carcinoma. METHODS: Patients with histologically confirmed locally advanced cervical carcinoma, aged > or =18 years, were treated with intravenous ifosfamide 5,000 mg/m2 and mesna 5,000 mg/m2, on day 1; intravenous paclitaxel 175 mg/m2 and cisplatin 75 mg/m2, on day 2; every 3 weeks for three cycles. Following chemotherapy, operable patients underwent radical hysterectomy and pelvic lymphadenectomy, and, if necessary, adjuvant radiotherapy. RESULTS: One hundred fifty-two patients with median age 53 years (range, 24 to 79 years), FIGO stage IIB in 126 (89%), were treated with chemotherapy for median 3 cycles (range, 1 to 3). Treatment was delayed or withdrawn in 23 patients (15%). One hundred thirty-nine patients (91%) underwent surgery. Postchemotherapy pathological complete response rate was 18% (25 patients). Postoperative radiotherapy was administered in 100 patients (72%). The 5-year overall survival and progression-free survival were 87.3% (95% confidence interval [CI], 84.5 to 90.3) and 76.4% (95% CI, 73.5 to 79.5), respectively. CONCLUSION: Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy was feasible and effective in the treatment of locally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies. Hematological and renal toxicity could be carefully prevented.


Subject(s)
Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Cisplatin/administration & dosage , Disease Progression , Feasibility Studies , Female , Humans , Ifosfamide/administration & dosage , Middle Aged , Neoadjuvant Therapy , Paclitaxel/administration & dosage , Retrospective Studies , Treatment Outcome , Uterine Cervical Neoplasms/drug therapy , Young Adult
17.
Chinese Journal of Hematology ; (12): 853-857, 2015.
Article in Chinese | WPRIM | ID: wpr-296136

ABSTRACT

<p><b>OBJECTIVE</b>To evaluateclinical features, treatment and outcomes of patients diagnosed with primary breast diffuse large B-cell lymphoma(DLBCL).</p><p><b>METHODS</b>Clinical data were analyzed for all patients diagnosed with primary breast DLBCL(n=21). Kaplan-Meier method was used to estimate 5- year overall survival(OS)rate, and the difference was compared by Log- rank test.</p><p><b>RESULTS</b>The 21 cases of patients with primary breast DLBCL were all female with median age at diagnosis as 48 years (range 21-64 years). 13 patients had International Prognostic Index(IPI)of 0, 6 IPI 1, and 2 IPI 2. The 5- year OS rates of CHOP/R- CHOP and R±DICE after R±EPOCH groups were 40.0% and 72.2% , respectively(P=0.035). The central nervous system relapse rate of CHOP/R-CHOP and R±DICE after R± EPOCH groups were 16.7% and 6.7%(P=0.500), respectively. The 5- year OS rates of patients with primary breast DLBCL staging Ⅱ E-Ⅲ E and Ⅰ E were 21.4% and 83.3% , respectively(P=0.025).</p><p><b>CONCLUSION</b>Primary breast DLBCL was rare. The patients of primary breast DLBCL with chemotherapy regimen of R±DICE after R±EPOCH might have a better prognosis and lower relapse rate of central nervous system; the primary breast DLBCL patients staging ⅡE-ⅢE might have a poor prognosis.</p>


Subject(s)
Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols , Breast Neoplasms , Diagnosis , Drug Therapy , Pathology , China , Cisplatin , Cyclophosphamide , Dexamethasone , Doxorubicin , Etoposide , Female , Humans , Ifosfamide , Lymphoma, Large B-Cell, Diffuse , Diagnosis , Drug Therapy , Pathology , Neoplasm Recurrence, Local , Prednisone , Prognosis , Retrospective Studies , Vincristine
18.
Chinese Medical Journal ; (24): 2498-2504, 2015.
Article in English | WPRIM | ID: wpr-315307

ABSTRACT

<p><b>BACKGROUND</b>High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a promising approach for lymphomas. This study aimed to evaluate the effect of ifosfamide, cisplatin or carboplatin, and etoposide (ICE)-based regimen as a mobilization regimen on relapsed, refractory, or high-risk aggressive lymphoma.</p><p><b>METHODS</b>From June 2001 to May 2013, patients with lymphomas who mobilized by ICE-based regimen for ASCT were analyzed in this retrospective study. The results of the autologous peripheral blood stem cells collection, toxicity, engraftment after ICE-based mobilization regimen were analyzed in this study. Furthermore, risk factors for overall survival (OS) and progression free survival (PFS) were evaluated by univariate analysis.</p><p><b>RESULTS</b>The stem cells were mobilized using ICE-based regimen plus rituximab or ICE-based regimen alone in 12 patients and 54 patients, respectively. The results of stem cell mobilization were excellent. Ninety-seven percentages of the patients had the stem cell collection of at least 2.0 × 10 6 CD34 + cells/kg and 68% had at least 5 × 10 6 CD34 + cells/kg. Fifty-eight percentage of the patients experienced Grade 4 neutropenia, 20% developed febrile neutropenia, and only 12% had Grade 4 thrombocytopenia. At a median follow-up of 63.8 months, the 5-year PFS and OS were 64.4% and 75.3%, respectively.</p><p><b>CONCLUSION</b>ICE is a powerful regimen for stem cell mobilization in patients with lymphomas.</p>


Subject(s)
Adolescent , Adult , Antineoplastic Agents , Therapeutic Uses , Carboplatin , Therapeutic Uses , Child , Cisplatin , Therapeutic Uses , Etoposide , Therapeutic Uses , Female , Hematopoietic Stem Cell Mobilization , Methods , Humans , Ifosfamide , Therapeutic Uses , Lymphoma , Drug Therapy , Male , Middle Aged , Retrospective Studies , Stem Cell Transplantation , Methods , Transplantation, Autologous , Young Adult
19.
Article in English | WPRIM | ID: wpr-90545

ABSTRACT

A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography. A left radical orchiectomy and an ultrasound-guided neck node biopsy were performed. A pathological examination revealed spermatocytic seminoma with extensive rhabdomyosarcomatous transformation, a condition known to be highly resistant to platinum-based chemotherapy. The patient received four cycles of etoposide, ifosfamide and cisplatin (VIP) chemotherapy. A repeat computed tomography revealed a substantial regression consistent with a partial response. Retroperitoneal lymph node dissection was attempted, which revealed rhabdomyosarcoma; however, complete microscopic resection was not achieved. After surgery, the residual abdominal lymph node progressed and salvage paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy was employed, which again achieved a partial response. Here, we present a first case report of a spermatocytic seminoma with extensive rhabdomyosarcomatous transformation and multiple metastatic lymphadenopathies that showed a favorable response to platinum-based systemic chemotherapy.


Subject(s)
Biopsy , Cisplatin , Drug Therapy , Drug Therapy, Combination , Etoposide , Humans , Ifosfamide , Lymph Node Excision , Lymph Nodes , Lymphatic Diseases , Middle Aged , Neck , Orchiectomy , Paclitaxel , Radiotherapy , Rhabdomyosarcoma , Seminoma
20.
Article in English | WPRIM | ID: wpr-13539

ABSTRACT

A nasal type extranodal NK/T-cell lymphoma (ENKL) is very rare in children. A pediatric nasal type ENKL is generally localized and is likely to have sensitivity to radiotherapy. The most common site is the upper airway tract, such as nasal region, Waldeyer's ring, paranasal sinuses and palates. It usually presents with nasal symptoms, such as obstruction or epistaxis. We describe our experience of concurrent chemoradiotherapy in a 13-year old boy having incidentally detected nasal type ENKL on laryngoscopic examination who did not have nasal symptoms. He received three cycles of dexamethasone (40 mg/day for 3 days), ifosfamide (1,000 mg/m2/day for 3 days), VP-16 (67 mg/m2/day for 3 days) and carboplatin (200 mg/m2 for 1 day) at 3-week intervals and 45 Gy intensity-modulated radiation therapy. He has been disease-free for 18 months after cessation of therapy.


Subject(s)
Carboplatin , Chemoradiotherapy , Child , Dexamethasone , Epistaxis , Etoposide , Humans , Ifosfamide , Lymphoma , Male , Palate , Paranasal Sinuses , Radiotherapy
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