RESUMEN
Doxorubicin and docetaxel as a single agent are known as active cytotoxic agents for the treatment of metastatic breast cancer (MBC). Their combination has also shown to be highly active as a second-line chemotherapy of MBC. This study was design to evaluate the efficacy and safety of docetaxel-doxorubicin combination as first line chemotherapy of MBC patients in Indonesia. Twenty-six female patients between 31-65 years old with advanced or MBC was enrolled. No prior taxane or cumulative doxorubicin of 250 mg/m2 was allowed and patients should not have a heart disease. Treatment consisted of doxorubicin 50 mg/m2 as intravenous (IV) bolus followed one hour later by docetaxel 60 mg/m2 by IV infusion over 1 hour every 3 weeks for 6 cycles. Premedication with oral corticosteroid was administered a day prior to chemotherapy until the second day of each cycle. Left ventricular ejection fraction was recorded at baseline and after the 6th cycle. At the end of study, a total of 156 cycles of chemotherapy have been delivered. Five and 11 patients had a complete response (CR) and partial response (PR), respectively, which accounted for a 61.54% best overall response. Three patients with extensive liver metastases showed complete disappearance after 6 cycles. Most frequent grade 3-4 toxicities were leukopenia (80.77%) and febrile neutropenia (5.77%). Leukopenia was usually short in duration, occurred mainly during the first and second cycle and did not require dose reduction. No patient developed heart failure. There was one death due to progressive disease after 6 cycles. Combination of doxorubicin 50 mg/m2 and docetaxel 60 mg/m2 was sufficiently active as first-line chemotherapy of MBC, especially in patients with liver metastases, with a manageable toxicity profile.
Asunto(s)
Neoplasias de la Mama , Doxorrubicina , DocetaxelRESUMEN
PURPOSE: As one of the new chemotherapeutic agents, gemcitabine is widely used as a four-week schedule in combination with cisplatin in the treatment of advanced non-small-cell lung cancer (NSCLC). In this study, we evaluated the efficacy, tolerance, and survival effect of this combination in a three-week schedule in patients with locally advanced inoperable or metastatic NSCLC. MATERIALS AND METHODS: Between January 2000 and September 2002, previously untreated 124 NSCLC patients were enrolled and 118 patients, who completed at least two cycles of chemotherapy, were evaluated. Patients received gemcitabine 1200 mg/m2 on days 1 and 8, cisplatin 75 mg/m2 on day 1 of a 21-day cycle, for a maximum of 6 cycles. RESULTS: They were 81 men and 37 women. Clinical stage IIIB was present in 56 (47.5%), and stage IV in 62 (52.4%) patients. Sixty-seven patients (56.8%) had a performance status of ECOG grade 0 or 1 and fifty-one patients (43.2%) of grade 2. During the period of chemotherapy, grade 3/4 leukopenia and neutropenia were observed in 19.5% and 31.4%, respectively and grade 3/4 thrombocytopenia in 7.6%. The overall response rate was 52.5% among the 118 patients. Overall median survival time was 12.2 months, and one-year and two-year survival rates were 50.2% and 20.4% respectively. The presence of response to chemotherapy, ECOG performance status of grade 0~1, and women showed better survival by the univariate analysis (p=0.010, 0.001 and 0.015, respectively). CONCLUSION: A three weekly gemcitabine/cisplatin doublet was relatively well tolerated, with an acceptable response rate and a reasonable median survival in locally advanced inoperable or metastatic NSCLC.