ABSTRACT
PURPOSE: To evaluate the activity and toxicity of SarCNU, an oral chloroethylnitrosourea in patients with recurrent or metastatic colorectal cancer who have progressed after first-line chemotherapy. PATIENTS AND METHODS: Eighteen patients with recurrent or metastatic colorectal cancer following first-line chemotherapy were treated with SarCNU 860 mg/m2 orally day 1, 5 and 9 every 6 weeks. The patient's median age was 64 and the ECOG performance status was 0 in six, 1 in eleven and 2 in one patients. All patients were evaluable for toxicity and 16 were evaluable for response. RESULTS: There were no objective responses (0%). One patient had stable disease and 15 had progressive disease at their first follow-up assessment. Median survival was 7.36 months (3.75-7.49 95% C.I.). Neutropenia and thrombocytopenia were the most severe toxicities (grade 3-4 in six and nine patients respectively). Pulmonary toxicity was also seen in five patients who had a drop of DLCO grade from baseline and two patients who had a fall in FVC from baseline. CONCLUSIONS: SarCNU is inactive in recurrent or metastatic colorectal patients who have progressed after first-line chemotherapy.
Subject(s)
Antineoplastic Agents/therapeutic use , Carmustine/analogs & derivatives , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/pathology , Neoplasm Recurrence, Local/drug therapy , Adult , Aged , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Canada , Carmustine/administration & dosage , Carmustine/adverse effects , Carmustine/therapeutic use , Colorectal Neoplasms/prevention & control , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Neoplasm Metastasis/drug therapy , Survival RateABSTRACT
Two cases demonstrating unusual side effects of warfarin are described. The first case illustrates the 'purple toes' syndrome, which occurred as a complication following the use of warfarin for the treatment of atrial fibrillation and stroke. The second case is an example of warfarin-induced vasculitis in a patient with a mechanical valve prosthesis. He was unable to tolerate warfarin but was successfully managed with nicoumalone, a related compound. These complications are rare but potentially dangerous effects of a commonly used agent, warfarin.
Subject(s)
Anticoagulants/adverse effects , Toes/blood supply , Vasculitis/chemically induced , Warfarin/adverse effects , Adult , Aged , Humans , MaleABSTRACT
In order to study whether myofiber size is an important determinant of the severity of dystrophic injury, mdx and control mice were treated with an anabolic steroid, nandrolone decanoate, for 3 weeks. Treatment resulted in a population of significantly smaller fibers in both strains, and was accompanied by an increase in the proportionate area or the number of foci of dystrophic injury in mdx soleus (slow-twitch) or tibialis anterior plus extensor digitorum longus (fast-twitch) muscles, respectively. As well, serum creatine kinase activity was increased in steroid-treated mdx mice. Fiber centronucleation, an index of accumulated injury and repair, in steroid-treated mdx soleus was doubled compared to that observed in soleus muscles from untreated mdx mice. There was no change in the distribution of immunoreactive basic fibroblast growth factor, important in muscle cell proliferation, with the increased damage from treatment. However, presumptive muscle precursor cells (identified by immunoperoxidase histochemistry for neural cell adhesion molecule), appeared to be more abundant in foci of very recent fiber damage in muscles from steroid-treated than untreated mdx mice. Results show that mdx dystrophy is worsened by anabolic steroid treatment, possibly by altered influences on muscle use patterns and muscle precursor fusion, and is not accompanied by an increase in fiber size.