ABSTRACT
BACKGROUND: The aim of the study was to evaluate the response to and toxicity of pre-operative radiochemotherapy containing raltitrexed (Tomudex) for resectable rectal adenocarcinoma. PATIENTS AND METHODS: From November 2000 to June 2002, 18 consecutive patients staged T3 NO0N+ were treated with pre-operative chemotherapy (3 mg/m2 of raltitrexed on days 1, 19, 38) and concurrent radiotherapy (RT) (50.4 Gy) in 6 weeks, followed by radical surgery within 8 weeks. RESULTS: The treatment compliance was high. No major acute toxicity was reported. Concerning late toxicity, genitourinary adverse effects were prevalent. A complete response was observed in one patient (6%), partial response in eight (47%), stable disease in seven (41%) and progression in one case. Three-year actuarial disease-free and overall survival rates were 37% and 87.5%, respectively. CONCLUSION: Raltitrexed did not increase the pathological response rate compared with the rates obtained with use of preoperative RT alone and reported in the literature. Acute morbidity was low and acceptable, while late toxicity was considerable, prevalently concerning sexual dysfunction and urinary complications.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Antimetabolites, Antineoplastic/therapeutic use , Quinazolines/therapeutic use , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapy , Thiophenes/therapeutic use , Adenocarcinoma/surgery , Adult , Aged , Antimetabolites, Antineoplastic/adverse effects , Combined Modality Therapy , Disease-Free Survival , Female , Humans , Male , Middle Aged , Patient Compliance , Preoperative Care , Quinazolines/adverse effects , Rectal Neoplasms/surgery , Thiophenes/adverse effectsABSTRACT
Hypothalamic neurochemical alterations in mammals underlie disturbances of food intake. There is scarce information on these topics in elderly persons; therefore, the aims of the present study were: (i) to evaluate the orexigenic effects of a growth hormone secretagogue, administered to young and old rats and dogs, alone or in combination with molsidomine, a donor of nitric oxide and (ii) to evaluate by reverse transcription-polymerase chain reaction in the whole hypothalamus of young and old rats messenger RNA levels of a wide number of anabolic and catabolic peptides, receptors, and enzymes involved in the control of feeding behavior, relating the detected titers, whenever possible, to the feeding responses to growth hormone secretagogue. In all, the results obtained strengthen the proposition that, in the hypothalamus of old rats, anti-anorexigenic compensatory mechanisms are operative, aimed at maintaining a "normal" feeding pattern. Thus, the occurrence of a primary, age-related alteration in the feeding mechanisms is unlikely.
