Phase I study of paclitaxel, carboplatin and UFT in chemo-naive patients with advanced non-small cell lung cancer (NSCLC).

OBJECTIVE: We conducted a phase I study of paclitaxel (PTX), carboplatin (CBDCA), and UFT in chemo-naive patients with advanced non-small cell lung cancer (NSCLC). METHOD: Twenty-one chemo-naive patients with advanced NSCLC were enrolled. The study was conducted as a phase I dose-escalation study of various doses of systemic PTX followed by CBDCA on day 1 and oral UFT (400 mg/m2) on days 1-5 and 8-12, with the cycle repeated at 21-day intervals. At least three patients were enrolled in each step. RESULTS: The main toxicities were neutropenia and paresthesia, but were tolerable and reversible in all cases. Overall response rate was 57% (12 out of 21). The MTD was not reached at the highest dose level after the first cycle. Given previous recommends of PTX at 225 mg/m2 and CBDCA AUC 6 for two-drug therapy, the recommended dose for the phase II study under our regimen was set at PTX 225 mg/m2 on day 1, CBDCA AUC 6 on day 1, and UFT 400 mg/m2 on days 1-5 and 8-12. CONCLUSION: The combination of PTX, CBDCA, and UFT showed promising activity and acceptable toxicity in these chemo-naive patients, supporting the development of this combination as a feasible chemotherapeutic option for advanced NSCLC.

Correlation between bronchodilator responsiveness and quality of life in chronic obstructive pulmonary disease.

BACKGROUND: Guidelines and literature debate the importance of testing for bronchial reversibility and its total significance is unclear. Clinically, patients with greater reversibility have higher fluctuations in respiratory symptoms, and hence may have a reduced health-related quality of life (HRQoL). On the other hand, they may have a better HRQoL as medications may be more effective in this population. Presently, there are no reports concerning the relationship between HRQoL as an indicator of therapy and reversibility. We hypothesized that the reversibility of airflow limitation might be correlated with the HRQoL in COPD. METHODS: We examined 63 subjects with COPD (mean age: 71.7 years). Reversibility was measured by the change in FEV1 and FVC after the inhalation of salbutamol (300 microg), and we investigated the relationship between the reversibility and the parameters of HRQoL, which included St. George's Respiratory Questionnaire (SGRQ), Visual analogue scale-8 (VAS-8), Short-Form 36-Item Health Study, Basic activities of daily living, Instrumental activities of daily living, and the Oxygen cost diagram. RESULTS: Post-bronchodilator FEV1, % predicted was positively correlated with both the total scores of SGRQ and VAS-8 (p<0.0001 and p<0.006, respectively). Furthermore, the reversibility of FVC was positively correlated with all items of the SGRQ, except for impact (total score: p<0.02; symptoms: p<0.02; activity, p<0.05; total score of VAS-8: p<0.02). However, the reversibility of FEV1 was neither correlated with the total score nor any items in the scales. CONCLUSIONS: Those who have FVC that respond to bronchodilator at rest might result in an improvement of HRQoL after treatment.

[The frequency profiles of size of two-step tuberculin skin tests with histories of BCG vaccinations and tuberculin tests among hospital employees].

In 1998, Prevention Committee of the Japanese Society for Tuberculosis announced guidelines for dealing with nosocomial tuberculosis infections. These guidelines recommended the two-step tuberculin tests (TST) as baseline data for each medical employee when they started to work. If accurate records of previous TSTs are available in addition to baseline data, they are useful to evaluate the presence of tuberculosis infection when they started to work. We therefore studied the frequency profile of size of TST among medical employees in INBA-HITEC Medical Center and discussed methods to improve investigative measures for tuberculosis infection, and prior to skin testing we asked self-reporting questionnaires regarding history of previous BCG vaccinations and TSTs. We expected that their records of previous TSTs were accurately preserved, however, records of previous TSTs reported by medical employees were found to be inaccurate. From two-step TSTs results, the magnitude of booster phenomenon was defined by diameter of erythema and induration. Results demonstrated that the increase of induration size was larger in subjects > or = 41-years-old than in subjects < 41-years-old. Regarding booster phenomenon, no statistically significant differences were detected according to type of duty post. Many subjects with size of TST erythema > or = 30 mm on the first test showed increase erythema > or = 10 mm on the second test. We therefore suggest that the second test be made for those showing reaction size > or = 30 mm on the first test.