Chemotherapy with or without radiotherapy in limited stage aggressive non hodgkin's Lumphoma

To compare the efficacy, toxicity and clinical out come in patients with limited-stage aggressive nondgkin's lymphoma treated with eight cycles of chemotherapy alone or four to six cycles of chemotherapy plus involved field irradiation. One hundred patients with limited aggressive non-Hodgkin's lymphoma were randomly signed to either eight cycles of CHOP alone or four to six cycles of CHOP plus involved-field radiotherapy. The end point were response rate, toxic effects, disease-free survival d overall survival Patients treated with four to six cycles of CHOP is radiotherapy had significantly better disease-free survival in patients treated with CHOP alone. The five-year estimates disease-free survival for patients receiving CHOP plus radiotherapy and for patients receiving CHOP alone were,6% and 65.1%, respectively [p=0.041]. The five-year imates of overall survival for patients receiving CHOP plus radiotherapy and for patients receiving CHOP alone were%and 70%, respectively [p=0.160]. Complete response eswere experienced in 92% in patients treated with CHOP is radiotherapy and 86% in patients treated with CHOP me [p=0.338]. Relapse in original site of disease was significantly higher in patients treated with CHOP alone 9% vs 6.5% in patients treated with CHOP plus radiotherapy =0.007. However, there was no statistically significant difference in systemic relapse between patients treated with CHOP alone [13.9%] and patients treated with CHOP plus radiotherapy [15.2%] [p=0.866]. The adverse effects included a treatment-related deaths in patients treated with eight cycles of CHOP alone versus no treatment-related deaths in ients treated with CHOP plus radiotherapy [p=0.239]. Life threatening toxic effects: grade 3,4 neutropenia were recorded 20% in patients treated with CHOP plus radiotherapy versus% in patients treated with eight cycles of CHOP alone p=0.048, symptoms and signs of congestive heart failure rerecorded in two patients treated with eight cycles of IOP alone, but in no patients treated with CHOP plus iotherapy. For subgroups identified using the Miller modification of the International prognostic Index [IP1], the 5 year disease-free survival and overall survival were signifi-Itly influenced by the number of risk factors in both treat-pt groups [CHOP alone p=0.006, p=0.043 and CHOP plus btherapy p<0.001, p=0.0/3, respectively]. Pour to six cycles of CHOP followed by involved field-radiotherapy are superior to eight cycles of CHOP alone for the treatment of localized aggressive non-Hodgkin's lymphoma. Patients who attained complete response after CHOP plus radiotherapy had more prolonged disease-free survival and higher local control than in patients treated with CHOP alone. IPI risk group was found to be the only significant predictor of overall survival and disease-free survival in both treatment groups.

Weekly irinotecan in patients with progressive or rapidly recurrent colorectal cancer pretreated with fluorouracil-based chemotherapy

To prospectively evaluate efficacy and tolerability of weekly irinotecan [CPT-11] in patients with advanced colorectal carcinoma [CRC] that had recurred or progressed following fluorouracil [5-FU]-based therapy. Forty eight patients were enrolled in this study. They were treated with irrinotecan 125 mg/m[2] intravenously [IV] every week for 4 weeks, followed by a 2- week rest. All patients were accessible for toxicity and only 44 patients completed one full course of therapy and were accessable for response. Nine patients [20.5%] attained partial response [95% CI, 10% to 27%] and no cases achieved complete response. The median duration of response was 7 months [range4to 11.5 months]. The median survival time was 10 months [95% CI 8.2 to 13.1 months] and the 1-year survival rate was 43.8% [95% CI, 33% to 53%]. Median time to progression was 4.0 months [95% CI, 2.6 to 5.1 months]. Grade 3-4 diarrhea was observed in 17 patients [35.4%], grade 3-4 nausea and vomiting in 3 patients [6.3%] and 4 patients [8.3%] respectively. Grade 3-4 neutropenia was reported in 5 patients [31.3%]. Grade 3-4 febrile neutropenia or infection affected only 2 patients [4.2%]. Weekly schedule of irinotecan has demon strated significant activity against colorectal cancer that has progressed during or shortly after treatment with 5-FU-based chemotherapy. Diarrhea is the most frequent dose limiting toxicity but can be substantially reduced through appropriate interventional management

Paclitaxel plus carboplatin versus carboplatin alone in women with platinum-sensitive recurrent ovarian carcinoma

To compare the efficacy and safety of paclitaxel plus carboplatin versus carboplatin alone in the treatment of patients with platinum-sensitive recurrent ovarian carcinoma. Forty patients with platinum-sensitive ovarian carcinoma relapsing after 6 months of being treatment-free and with no more than two previous chemo-therapy lines were enrolled in this trial. Twenty one patients were randomized to receive carboplatin [300 mg/m[2] and 19 to receive the same dose of carboplatin plus paclitaxel [175mg/m[2] The primary outcome measure was objective response. Secondary outcomes were progression-free survival [PFS], overall survival [OS] and toxicity. The response rate in the combination arm was 79% [26% complete response [CR] and 53% partial response [PR]] compared with 48% in the carboplatin arm [19% CR and 29 PRI [p=0.041]. Median PFS was higher in paclitaxel carboplatin arm [12 versus 8 months]. Median OS was also better in the combination arm [24 versus 18 months]. However, these differences were not statistically significant [p=0.23 and 0.35 respectively]. No significant differences were observed in grade 3-4 hematological toxicity. Conversely, alopecia, mucositis, myalgia/arthralgia and sensory neuropathy were more frequent in the combination arm and the differences were statistically significant [p=0.0009, 0.027, 0.001, and 0.027 respectively]. Paclitaxel plus carboplatin is a tolerable regimen. It seems to be more effective among patients with platinum-sensitive recurrent ovarian carcinoma compared with single-agent carboplatin