ABSTRACT
[This corrects the article on p. e238 in vol. 18, PMID: 21980255.].
ABSTRACT
Lung cancer is the leading cause of cancer death worldwide. Non-small-cell lung cancer (nsclc) is the most common form of lung cancer, with a median age at diagnosis of 70 years. These elderly patients are often underrepresented in the randomized clinical trials upon which chemotherapy plans are based. The objective of the present study was to determine the patterns of treatment and survival in elderly patients with advanced nsclc in Manitoba.An eligible cohort of elderly patients over 70 years of age at diagnosis (n = 497) with advanced nsclc was identified from the provincial cancer registry database for the period 2001-2004. Of the 497 patients identified, only 147 had been evaluated by a medical oncologist, and 82 of the 147 had received chemotherapy treatment, which is 16.5% of the initial cohort.Patients who received chemotherapy were younger than those who did not receive chemotherapy. Most patients receiving chemotherapy (84%) received doublet chemotherapy, with an almost equal split between cisplatin and carboplatin treatment. The median survival times for patients in this cohort were 64 weeks (stage iii nsclc) and 56 weeks (stage iv) with chemotherapy treatment, and 46 weeks (stage iii) and 26 weeks (stage iv) without chemotherapy.Although 50% of patients with advanced nsclc are more than 70 years of age, few are evaluated by a medical oncologist and even fewer are treated with chemotherapy. However, it should be noted that, in the elderly patients who were treated, survival times are comparable to those experienced by younger patients, which is indicative of a benefit of chemotherapy treatment for those elderly patients.
ABSTRACT
The pharmacokinetics and safety of rufloxacin were evaluated in a double-blind, placebo-controlled study. Two groups of 16 healthy volunteers were given a single oral loading dose of 400 or 600 mg of rufloxacin on day 1 of the study. A single daily maintenance dose of 200 or 300 mg was then administered for a further 9 days; in addition, four subjects in each group received placebos. Rufloxacin levels in plasma and urine were determined by high-performance liquid chromatography. Following the initial dose, the mean (+/- standard error of the mean) peak concentrations of rufloxacin in plasma were 3.35 +/- 0.12 micrograms/ml in the 400-mg group and 4.54 +/- 0.19 micrograms/ml in the 600-mg group. They were generally reached 2 to 3 h after dosing. At the end of treatment, maximum levels in plasma rose to 4.51 +/- 0.15 and 7.20 +/- 0.25 micrograms/ml in the 400-mg and 600-mg groups, with a mean extent of accumulation (fold) of 3.1 +/- 0.1 and 3.3 +/- 0.1. For the 400-mg and 600-mg groups, the elimination half-lives were 40.0 +/- 1.5 and 44.0 +/- 1.3 h, mean residence times were 57.8 +/- 2.2 and 63.7 +/- 1.8 h, apparent volumes of distribution were 132 +/- 4 and 139 +/- 5 liters, and apparent total body clearance were 39 +/- 1 and 44 +/- 4 ml/min, assuming complete bioavailability. Of the total dose administered, the percentages excreted in urine were 49.6 +/- 1.3 and 51.1 +/-2.1%, with renal clearances of 21 +/- 1 and 22 +/- 2 ml/min, for the 400-mg and 600-mg groups. On the whole, the treatments were well tolerated, but some minor adverse events (mainly headache, insomnia, or abdominal discomfort) were reported for 7 subjects on abnormalities were detected in the laboratory examinations or in ocular function tests. This study shows that a 200-mg daily oral dose of rufloxacin preceded by a loading dose of 400 mg are well tolerated and produce steady-state concentrations in plasma above the MIC for most susceptible pathogens.
