Docetaxel and cisplatin [DC] versus epirubicin, cisplatin and 5 fluorouracil [ECF] as systemic chemotherapy treatment for advanced gastric carcinoma [AGC]

Docetaxel and Cisplatin [DC] versus Epirubicin, Cisplatin and 5 fluorouracil [ECF] as Systemic Chemotherapy Treatment for Advanced Gastric Carcinoma [AGC]. Our study was performed to compare between DC and ECF combination chemotherapy as regard the clinical activity in terms of toxicity and response [primary objective] and the survival [secondary objective] trying to reach to a new effective and well tolerated regimen to improve the poor treatment results for palliative chemotherapy in advanced gastric cancer. Forty patients [pts] with AGC [unresectable and/or metastatic], bi-dimentionally measurable disease, performance status is >/= 70%, normal blood counts, hepatic and renal functions and no prior chemotherapy were randomized to receive DC [Docetaxel 75mg/m[2] dl and Cisplatin 75mg/m[2] dl] every 3w or ECF [Epirubicin 50mg/m[2] dl/3w and Cisplatin 60mg/m[2] dl/3w and 5 fluorouracil 200mg/m[2]/d continuous intravenous infusion for a total of 6 cycles for each regimen. The overall response was 45% for DC [n=9] [8 partial response + 1 complete response] and 30% for ECF [n=6] [all are partial responses]. Median time to progression was 7.0 months for DC and 5 months for ECF p=0.03. Median overall survival time was 10.5 months for DC and 8.5 months for ECF p=0.67. The most frequent G3 and 4 events per patient was neutropenia [DC=85%, ECF=30%]. Febrile neutropenia was recorded in 20% with DC versus 5% with ECF. Grade >/= 3 for other events with DC were anemia 15%, thrombocytopenia 10%, vomiting 10%, Diarrhea 10%, Stomatitis 0%, peripheral neuropathy 10% and lethargy 20% versus 5%, 5%, 20%, 20%, 10%, 0% and 5%, with ECF, respectively. There was no treatment related deaths. DC tends to be more effective in AGC with a higher response rate and better median time to progression and overall survival than ECF but with significantly higher neutropenia which was manageable. Use of primary prophylaxis with G-CSF is reasonably recommended

Evaluation of the efficacy and toxicity of epirubicin and cisplatin with cyclic continuous infusion of 5-fluorouracil in advanced breast cancer

Nineteen evaluable patients with advanced breast cancer were included in this study. Fourteen patients received no previous chemotherapy and five patients received previous chemotherapy [CMF] and two of them received [CAF] as well. Age of patients ranged between 25 and 55 years, the median was 38 years. There were five postmenopausal and fourteen permenopause. The most common site of metastasis was the lymph nodes [supraclavicular or contralateral axillary] which was reported in 12 patients. All patients received the cyclic continuous infusion 5- FU for seven days plus epirubicin in day one and cisplatin in day three only. There were four complete responders, partial response was recorded in eleven patients with an overall response rate 79.1%. The failure free survival for untreated patients was 71.4% after a median follow up of 19 months. In previously treated patients, the failure free survival was 20% after a median follow up period of 13 months with median response period of 9.7 months

Estudo com 4'-epirubicina em linfomas näo-Hodgkin / Study with 4'-epirubucin in non-Kodgkin's lymphomas

Com o objetivo de avaliar a eficácia e a toxicidade da 4'-epirubicina em poliquimioterapia no tratamento de linfomas näo-Hodgkin de alto grau, foram estudados 14 pacientes, sendo nove do sexo masculino e cinco do sexo feminino. A idade mediana dos homens foi de 52 anos e das mulheres, 32 anos. Linfoma histiocítico difuso foi o diagnóstico mais freqüente, representando 50 por cento dos casos. Nove oacientes haviam sido submetidos à cirurga antes do tratamento e um paciente foi submetido à radioerapia antes do início da quimioterapia. Dos 14 pacientes avaliáveis, 10 apresentaram resposta completa (91 por cento) e um apresentou resposta parcial (9 por cento). Dois pacientes faleceram durante o tratamento quimioterápico e um abandonou o tratamento por toxicidade. A duraçäo mediana da resposta foi de 17 meses após o início do tratamento. Com relaçäo à toxicidade, mucosite foi o sintoma mais freqüente, sendo observada em oito pacientes (73 por cento); náuseas e vômitos foram observados em três pacientese diarréia e alopecia, cada uma, em dois pacientes. Quatro pacientes apresentaram contagem plaquetária inferior a 150.000 plaquetas/mm3; nenhum paciente apresentou contagem leucocitária inferior a 2.000 leucócitos/mm3. Concluímos que este protocolo 4'epi é altamente eficaz no tratamento dos L.N.H. de alto grau, embora apresente expressiva toxicidade