Combination chemotherapy ifosfamide and 5-fluorouracil in pancreatic cancer

Twenty-three evaluable patients with histologically proved carcinoma of the pancreas are included in this study. All patients were previously explored and found to be in-operable patients received palliative combination chemotherapy; ifosfamide and fluorouracil. Patients received 2-11 courses with a median of 5 cycles. The response rates were partial in 61% stable in 21% and increasing disease in 17%. The median survival was 9 months and the side effects were mild to moderates; anemia, GIT toxicity and alopecia. This results emphasize the role of the efficacy of ifosfamide in pancreatic tumors

Management of renal carcinoma with immuno radiotherapy

Sixty-two patients with metastatic renal cell carcinoma from January 1987 till December 1991 were collected. All patients, except six were subjected to radical nephrectomy. There were 53 cases with metastatic disease in lungs, liver, bone and brain. Patients received radiotherapy to the tumor bed, osseous and brain metastases. Concomitant with radiation, 38 patients received alpha-2 interferon [Interon A] for 12 weeks. A partial remission rate of 48%, was obtained with a median remission duration of 24 months. An overall survival of 78% at 3 years was achieved in patients who received the concomitant therapy. Survival rate was 38% in patients subjected to surgery and radiation. At 5 years the overall survival was 40% and 10% respectively. The results denote synergism between the 2 modalities immunotherapy and radiotherapy and heralds for further studies using higher doses of interferon for a longer time in metastatic renal cell carcinoma patients

Ifosphamide and carboplatin in the management of advanced stage neuroblastoma at the NCI, Egypt

Forty-two children with advanced neuroblastoma [stages 3 and 4] were treated with a combination of paraplatin and ifosphamide as front line therapy. Only 33 patients were evaluable due to early death of 9 patients. The response rate [CR+PR] was 75.8% [25/33]. Overall survival was 50% at 12 months and 23% at 24 months. The overall survival of the complete responsers was 65% and 34% at 12 and 24 months., respectively. The regimen was well tolerated by the patients following the administration of a total of 196 courses. Complications included the development of jaundice in four patients and cystitis hemorrhagica in two

Disease-free survival and long term survival in Egyptian non-Hodgkin's lymphoma patients

Non-Hodgkin's lymphoma [NHL] are not uncommon in Egypt, as they represent 9-12.2% of all the reported new cases of malignant disease. This is a retrospective study aiming to illustrate the pathological subtypes, clinical features, epidemiology, response to treatment, and survival of patients with NHL. It comprised 213 patients with NHL, diagnosed and treated at the National Cancer Institute, Cairo, since 1975 till 1988. Patients were grouped into 3 groups, each group received a different chemotherapy regime. The first was the CHOP therapy [group A], the second was the COP therapy [group B], the third was the IOP therapy [group C] patients. Responses to therapy, disease-free survival and survival were statistically compared between the three groups. The highest response rate was achieved by use of IOP therapy 55.7. The IOP therapy gave the longest median survival 26 months, versus 16 months in CHOP group, and 12 months in COP group

Chemotherapeutic management of hepatocellular carcinoma: epirubicin as a single agent and in combination

Hepatocellular carcinoma is a common cancer especially in Africa and Asia. It used to be rare in Egypt, but nowadays its relative incidence is increasing. The response to chemotherapy is so far not promising. Various chemotherapeutic agents were tried in this tumor either singly or in combinations. The present study is a randomized one comparing the results of epirubicin alone versus epirubicin with mitomycin and fluorouracil in a group of 50 patients with hepatocellular carcinoma. A partial response of 30% and 40% were achieved, respectively

pilot study of high dose epirubicin as neoadjuvant chemotherapy in the treatment of cancer of the bilharzial bladder

The study showed in the first 1-3 years, a marked reduction in the rate of relapses after radical surgery. In a historical group of 200 patients with bilharzial bladder cancer subjected to radical cystectomy with urinary diversion, 130 cases relapsed within 5 years, 118 as local relapse [90%] and 12 as distant metastases [10%], relapses were 31.4% in the first 1-3 months 46.6% in the 3-6 months, 12.7% in the 6-9 months 5.9% in the 9-12 months, and 3.4% in the 12-24 months postoperatively. The relapses were 6 out of 32 evaluable patients, 4 of them in the first year and 2 in the second year, mean 9.5 months postoperatively. This showed the beneficial effect of epirubicin in decreasing the number of relapses in comparison to the control group as well as the historical control. Most of the cases have negative lymph nodes in comparison to the group that did not receive neo-adjuvant chemotherapy. This further emphasizes the beneficial effect of epirubicin as a neo-adjuvant treatment. In conclusion, epirubicin used at a high dose of 120 mg/m2 as neo- adjuvant chemotherapy in T2-T3 resectable bilharzial bladder, cancer markedly reduced the relapse rate. A disease free survival rate of 73.5% a statistically significant result in the first postoperative 3 years. Patients of both groups were followed for relapses and survival for a total of 5 years postoperatively

Preliminary evaluation of the mitoxantrone cyclophosphamide and methotrexate combination in patients with advanced breast cancer

Fifteen patients with advanced breast cancer [mean age 43.7 years, median WHO performance status 1, nine menopaused] were treated with cyclophosphamide 500 mg/m2, methotrexate 40 mg/m2 and mitoxantrone [Novantrone] 10mg/m2 [CMN] q 21 days, for a median duration of 5 cycles [range 2-10 cycles]. Seven patients had disease free interval less than two years. Aim of this preliminary study was the evaluation of the toxicity was 53.3% [CR 2 patients 13.3% PR 6 patients 40%]. In six patients the disease was stabilized. Side effects were mild. Nausea-vomiting and alopecia were not significant. Leukopenia, mostly grade 1 and 2, occurred in 22.3 of the cycles. Grade 3 leukopenia was found in two cycles [2.6%] and grade 4 in one. Mild stomatitis was found in four patients. It is concluded that the CMN combination is as effective and generally less toxic than the currently used anthracycline containing regimens

Study of non-Hodgkin's lymphoma in Egypt: I-pediatric group

This is a retrospective study of 298 cases of pediatric non-Hodgkin's lymphoma [NHL] occurred at the Pediatric Unit, National Cancer Institute [NCI], Cairo, from January 1975 till the end of December 1984. There was a male preponderance with a male to female ratio of 2.5: 1. Median age was 7.4 years, with a range from 10 months to 16 years. Most of the cases [43%] were from the metropolitan Cairo area. Histopathology according to the working formulation showed that 7.6% were of the low grade 60% of the intermediate grade, and 32.4% of the high grade. Clinically, primary extra-nodal presentation was detected in 53.7%, mostly gastrointestinal 74.5%. Constitutional symptoms were present in 35.2% of cases. Family history of cancer was positive in 2.4% of the cases

Chemotherapeutic management of bilharzial bladder cancer: a phase II study

Advanced nonresectable bilharzial bladder cancer patients represent about one fourth of bladder cancer, reporting to the National Cancer Institute, Cairo. In these patients, a phase II trial screening various chemotherapeutic agents, one by one, was conducted since 1976. So far, published results were hexamethylmelamin 38%, methotrexate 7% and cisplatin 13%. Other drugs [adriamycin, bleomycin, and tenoposide] proved ineffective. The present study reports results achieved with five more drugs. Overall responses, complete and partial were cyclophosphamide 19%, fluorouracil 6%, pentamethylmelamine 23%, etoposide 36% and vincristine 44%. Combination chemotherapy using two or more active agents will be instituted in such patients

Serum proteins and immunoglobulins in patients with carcinoma of the bilharzial bladder

The sera of 25 patients suffering from advanced stages [T3 and T4] of carcinoma of the bilharzial urinary bladder were examined for serum proteins and immunoglobulin levels. In addition, sera of 16 bilharzial cystitis patients and of 16 normal healthy individuals were included in the study. While there was a reduction in the albumin level and an increase in alpha-1, alpha-2, and gamma globulin levels in the sera of the 25 cancer patients, the beta globulins remained apparently unchanged and the alpha-2/beta ratio had therefore inverted values [1.5] as compared to normal controls [0.9]. A definite increase in IgG, IgA, IgM and IgE fractions in bilharzial bladder cancer patients was found. The immunoglobulin levels were higher in patients with T3 than with T4 lesions. On the other hand, there was a marked decrease in the non-immunoglobulin component[s] in sera of the cancer patients. This decrease was noted more in patients with T4 than in those with T3 lesions. Serum proteins and immunoglobulins in the bilharzial cystitis patients had intermediate values more or less midway between the bladder cancer patients and the normal controls

Australia antigen and anti-australia antibody in lymphomas, leukemias and breast cancer

The sera of 90 lymphoma and 60 leukemic patients were studied for the presence of either HBsAg or anti-HBs using counter-electrophoresis. In addition, the study included 40 breast cancer patients and 20 normal healthy subjects as controls. The findings indicated a close and specific association between hepatitis B infection and leukemia. The frequency of exposure in leukemia patients was 17% compared to 5% in the other groups. Acute leukemia cases with positive HBsAg or anti-HBs reactions indicated a group with very bad prognosis. The causal relationship of hepatitis B virus to certain types of leukemias was discussed

phase II study of vindesine in patients with hodgkin's disease, lymphoma, and breast cancer

Seventy-four patients with Hodgkin's disease, lymphomas, and breast cancer were treated with vindesine 3 mg - 3.5mg/ m/[2]/week iv. Complete, partial and mixed responses were encountered in 16 of 26 patients with Hodgkins disease, in 9 of 24 lymphoma patients, and partial response in 4 of 24 breast cancer patients. Mild to moderate degree of peripheral neuropathy was encountered in 46 patients. Mild leucopenia was seen in 12 patients. It is concluded that vindesine is efficacious in Hodgkin's disease and lymphomas, and is recommended for combination chemotherapy regimes

Pathobiochemical studies on the effect of cytoxan, 5- fluorouracil and methotrexate [CMF] on mice intestine

The effect of cyclophosphamide, Methotrexate and Fluorouracil [CMF] was investigated on intestinal enzymes [5-nucleotidase, Alkaline phosphatase and Glucose-6-phosphatase] as well as on the histopathology of intestinal mucosa of mice. The drugs were given either as single agent or in combination in two dose schedule, a one day puls therapy or once every other day for 5 doses. Intestinal 5-nucleotidase is the most significantly elevated enzyme and no sign of recovery was observed 10 days after [CMF] administration. Histopathology of mice intestine showed that the initial changes that were observed by repeated small doses were more severe than those observed after single pulse administration, recovery of which needs more than ten days