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1.
Mori M Tsukuda M Matsuda H Horiuchi C Taguchi T Takahashi M Nishimura G Komatsu M Niho T Sakuma N Miyakoshi A Isono Y Iwahana S 《Cancer chemotherapy and pharmacology》2011,68(4):855-862
Purpose
The aim of this study was to evaluate the feasibility and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin (CDDP) and 5-fluorouracil (5-FU) (TPF regimen) or with CDDP, 5-FU, methotrexate and leucovorin (PFML regimen) in previously untreated patients with advanced oropharyngeal squamous cell carcinoma (SCC).Methods
Fifty-six eligible patients with stage III or IV oropharyngeal SCC were treated with CCRT. Forty-four patients were men and 12 were women, and the average age of the patients was 58.8?years (range, 37?C72?years). In the TPF group, patients received CCRT with the TPF regimen [docetaxel (50?mg/m2, day 1), CDDP (60?mg/m2, day 4) and a continuous 5-FU infusion (600?mg/m2/day, days 1?C5)]. In the PFML group, patients received CCRT with the PFML regimen [CDDP (60?mg/m2, day 4), a continuous 5-FU infusion (600?mg/m2/day, days 1?C5), methotrexate (30?mg/m2, day 1) and leucovorin (10?mg/m2/day, days 1?C5)]. The total radiation dose was between 66.6 and 70.2?Gy.Results
The overall 5-year survival rate was 64.6% in all patients, 68.6% in the resectable group and 47.4% in the unresectable group. The 5-year disease-specific survival rate was 72.2% in all patients, 78.1% in the resectable group and 47.7% in the unresectable group. Regarding clinical stage, the 5-year disease-specific survival rates were 91% in stage III, 72% in stage IVa and 44% in stage IVb.Conclusion
CCRT with TPF or PFML regimen for advanced oropharyngeal SCC is tolerable and effective, especially in patients with resectable disease. 相似文献2.
Purpose
To determine the maximum-tolerated dose (MTD) of a 24-h continuous infusion of 5-fluorouracil (5-FU) when administered in combination with a fixed weekly dose of docetaxel and cisplatin in patients with advanced gastric cancer.Methods
Patients with advanced gastric adenocarcinoma (n = 21) received a weekly regimen of docetaxel, cisplatin and 5-FU (DCF) for 3 consecutive weeks every 4 weeks. The doses of docetaxel and cisplatin were fixed at 33.3 and 30 mg/m2, respectively. The dose of 5-FU was increased from a starting dose of 1,000 mg/m2 to the MTD.Results
A total of 53 cycles of chemotherapy were administered (median = 3 cycles/patient). The MTD of 5-FU was 1,750 mg/m2. All 21 patients were assessed for toxicity and 19 patients (90%) were evaluated for response. Both grade 3–4 hematologic and non-hematologic toxicities occurred in less than 10% of patients and there were no treatment-related deaths. Among the 19 patients, we observed 1 complete and 4 partial responses for an overall response rate of 26% (95% CI: 6–46%). This rate increased to 39% (95% CI: 12–66%) in 13 chemotherapy-naïve patients.Conclusions
A consecutive weekly DCF regimen at 4-week intervals appears feasible for advanced gastric cancer with a favorable toxicity profile. The recommended doses are 33.3 mg/m2 of docetaxel, 30 mg/m2 of cisplatin and 1,500 mg/m2 of a 24-h continuous intravenous infusion of 5-FU. The response of this weekly regimen in our study was favorable and deserved further investigation in a phase II trial. 相似文献3.
Tanaka Y Yoshida K Sanada Y Osada S Yamaguchi K Takahashi T 《Cancer chemotherapy and pharmacology》2010,66(6):1159-1165
Background and purpose
The optimal chemotherapeutic protocol for the treatment of esophageal cancer has not yet been established. A dose-escalation study of docetaxel combined with cisplatin and 5-fluorouracil (5-FU) was performed to determine the optimal dose in patients with advanced esophageal squamous cell carcinoma.Patients and method
We studied a total of 18 patients who had previously untreated thoracic esophageal squamous cell carcinoma with T4 tumors and/or metastasis. The patients received an infusion of docetaxel at different dose levels (levels 1, 2, 3: 30, 35, 40 mg/m2, respectively) and an infusion of cisplatin (40 mg/m2) on days 1 and 15 plus a continuous infusion of 5-FU (400 mg/m2/day) on days 1–5 and 15–19.Results
Dose-limiting toxicities (DLT) included febrile neutropenia and leukopenia. DLT occurred in 2 of 6 patients at level 1, 2 and in 3 of 6 patients at level 3. The response rate was 88.9%, including a complete response rate of 33.3%.Conclusions
To minimize toxicity and maximize dose intensity, we elected to investigate a biweekly regimen. The maximum tolerated dose was level 3, and the recommended dose was determined to be docetaxel 35 mg/m2 with cisplatin 40 mg/m2 plus 5-FU 400 mg/m2, administered biweekly. This regimen was tolerable and highly active. A phase II study has been started. 相似文献4.
Koizumi W Nakayama N Tanabe S Sasaki T Higuchi K Nishimura K Takagi S Azuma M Ae T Ishido K Nakatani K Naruke A Katada C 《Cancer chemotherapy and pharmacology》2012,69(2):407-413
Purpose
We conducted a phase II study to evaluate the efficacy and safety of a triplet regimen of docetaxel, cisplatin, and S-1 in patients with unresectable or recurrent gastric cancer.Methods
Docetaxel (40?mg/m2) and cisplatin (70 or 60?mg/m2) were given on day 1 of a 28-day cycle. S-1 (40?mg/m2) was given twice daily on days 1?C14. Treatment with this regimen was continued for a maximum of 6 cycles. Subsequently, patients with no disease progression received a combination of docetaxel and S-1.Results
Fifty-nine patients were enrolled. The median number of administered cycles was 8 (range, 1?C25). Because some patients had serious myelosuppression and renal dysfunction with 70?mg/m2 of cisplatin, dose of cisplatin was reduced to 60?mg/m2 after 19 patients had been treated. Common severe toxic effects of grade 3 or 4 were leukocytopenia (44%), neutropenia (72%), anemia (15%), and febrile neutropenia (14%). The overall response rate of this group was 81% (95% confidence interval (CI), 71?C91%). The median overall survival and progression-free survival were 18.5 (95% CI, 15.6?C21.5) and 8.7 (95% CI, 6.7?C10.7) months, respectively.Conclusions
Triplet of docetaxel, cisplatin, and S-1 is a well-tolerated and highly active regimen for advanced or recurrent gastric cancer. A 60?mg/m2 of cisplatin is as effective as 70?mg/m2 of cisplatin. 相似文献5.
Simon Pernot Emmanuel Mitry Emmanuelle Samalin Laetitia Dahan Cécile Dalban Marc Ychou Jean-François Seitz Hajer Turki Thibault Mazard Aziz Zaanan Céline Lepère Jean-Nicolas Vaillant Bruno Landi Philippe Rougier Julien Taieb 《Gastric cancer》2014,17(2):341-347
Background
Docetaxel–cisplatin-5-FU chemotherapy is superior to 5-FU-cisplatin in terms of response rate and survival in advanced gastric cancer (AGC), but is more toxic. Oxaliplatin is better tolerated than cisplatin, which it can effectively replace in this setting. We hypothesize that incorporating docetaxel into a simplified FOLFOX regimen should be a tolerable and effective option in first-line treatment of AGC.Methods
Data were collected at six French centers from patients with metastatic or local AGC who received docetaxel, fluorouracil, leucovorin, or oxaliplatin (TEF) as first-line treatment. TEF was administered as follows: docetaxel (50 mg/m2), oxaliplatin (85 mg/m2), and leucovorin (40 mg/m2) on day 1, and 5-FU continuous infusion for 48 h (2400 mg/m2) every 2 weeks.Results
Forty-one patients were enrolled. Performance status was grade 0 and 1 in respectively 27 and 58 % of patients; 17 patients had adenocarcinoma of the gastroesophageal junction; 37 patients had metastatic disease, 22 had a poorly differentiated or diffuse type. Objective response rate was 66 %, with a complete response in two patients (5 %). Median progression-free survival and overall survival were respectively 6.3 and 12.1 months. Tolerability was acceptable with no treatment-related deaths. The most frequent grade 3–4 toxicities were neutropenia (30 %) and neuropathy (12.5 %). Curative intent surgery after response to TEF was performed in seven patients (17 %).Conclusion
TEF is an effective first-line treatment with an acceptable toxicity profile for patients with AGC. It may allow curative resection in initially unresectable patients. TEF should now be evaluated in prospective randomized trials. 相似文献6.
Han Ying Bao Wei Jia Fang Xiao Chen Zhang Gen Ming Shi Sui Huang Lan Fang Yu Jin Chen Hai Bo Mou Jing Deng Peng Shen Nong Xu 《Cancer chemotherapy and pharmacology》2011,67(1):147-152
Purpose
To evaluate the efficacy and safety of FOLFIRI regimen in patients with advanced colorectal cancer refractory to fluoropyrimidine and oxaliplatin.Methods
The FOLFIRI regimen consisted of intravenous infusion of irinotecan 180?mg/m2 on day 1 plus leucovorin (LV) 400?mg/m2 on day 1 plus 5-fluorouracil (5-FU) 400?mg/m2 bolus on day 1 plus 46-hour intravenous infusion of 5-FU 2,400?mg/m2, every 2?weeks as one cycle. The main selection criterion for this study was the advanced colorectal cancer refractory to fluoropyrimidine and oxaliplatin.Results
Of the 57 evaluable patients for efficacy, 4 (7.5%) had a partial response, 36 (67.9%) had stable disease, and 13 (24.5%) had progressive disease. Median progression-free survival was 4.8?months (95% CI 3.9?C5.7?months), and median overall survival was 7.8?months (95% CI 13.1?C16.5?months). Safety analysis was based on the data of 57 evaluable patients. The most frequently observed grade 3 or 4 toxicities were neutropenia 16 (27.8%), nausea/vomiting 7 (12.3%), and diarrhea 1 (1.8%).Conclusion
FOLFIRI regimen is effective and well tolerated in patients with advanced colorectal cancer refractory to fluoropyrimidine and oxaliplatin in Chinese population. 相似文献7.
Kyong Hwa Park Jeong Sun Kim Yong Park Hee Yeon Seo Young Je Park In Keun Choi Sang Chul Oh Jae Hong Seo Chul Yong Kim Kwang Yoon Jung Sang Won Shin Yeul Hong Kim Jun Suk Kim Nam Joon Lee 《Cancer chemotherapy and pharmacology》2010,66(4):643-651
Purpose
Concomitant approach using cisplatin and 5-fluorouracil (5-FU) has shown an excellent local control rate and significantly reduced distant metastasis in patients with locally advanced nasopharyngeal carcinoma (NPC). However, optimal schedule and dosing of chemotherapy still need to be developed to reduce distant metastasis. This retrospective study was conducted to evaluate the efficacy, toxicity, and tolerability of a concurrent chemoradiation therapy (CCRT) regimen using cisplatin and 5-FU followed by adjuvant chemotherapy (AC) in patients with locoregioanlly advanced NPC.Methods
Forty-three NPC patients who had AJCC stage T3/T4 or N2/N3 and M0 disease were evaluated. The chemotherapy during CCRT consisted of cisplatin (75 mg/m2 on day 1) plus 5-FU (750 mg/m2/day on day 1–5), delivered every 4 weeks for two cycles. Three cycles of AC were given with cisplatin (75 mg/m2), epirubicin (37.5 mg/m2) on day 1, and bleomycin (7.5 mg/m2 bolus iv. on day 1 followed by 9 mg/m2 on day 1–5 by continuous infusion) every 3 weeks.Results
The overall response rate after CCRT was 95% (22 CRs and 19 PRs in 43) and 100% (16 CRs and 8 PRs in 24) after AC. Grade 3/4 neutropenia, mucositis, and weight loss were observed during CCRT phase in 18, 44, and 26% of patients, respectively. AC caused grade 3/4 neutropenia and emesis in 12.5 and 20.8% of patients, respectively.Conclusions
CCRT regimen using cisplatin and 5-FU followed by three cycles of BEC chemotherapy was effective in locally advanced NPC patients, with acceptable and reversible acute toxicities. 相似文献8.
Matteo Dalla Chiesa Gianluca Tomasello Sebastiano Buti Rodrigo Kraft Rovere Matteo Brighenti Silvia Lazzarelli Gianvito Donati Rodolfo Passalacqua 《Cancer chemotherapy and pharmacology》2011,67(1):41-48
Purpose
To evaluate a new strategy of two sequential, intensified chemotherapy regimens in metastatic gastric cancer.Patients and methods
Chemo-na?ve patients with metastatic gastric cancer were enrolled to receive 4 cycles of TCF-dd (docetaxel initially 85?mg/m2 and cisplatin initially 75?mg/m2 on day 1 [later modified due to toxicity: 70 and 60?mg/m2 respectively], l-folinic acid 100?mg/m2 on days 1 and 2, 5-fluorouracil 400?mg/m2 bolus and then 600?mg/m2 as a 22?h continuous infusion on day 1 and 2, every 14?days). Subsequently, patients with CR, PR or SD received 4 cycles of COFFI (oxaliplatin 85?mg/m2, irinotecan 140?mg/m2, l-folinic acid 200?mg/m2, 5-fluorouracil bolus 400?mg/m2 on day 1 followed by 2,400?mg/m2 as a 48?h continuous infusion, every 14?days). In both regimens pegfilgrastim 6?mg subcutaneously on day 3 was included.Results
Forty consecutive patients were enrolled. TCF-dd regimen achieved an ORR of 55% (95% CI, 40?C70). Twenty-three patients proceeded to COFFI. After this regimen the ORR was then increased to 60% (95% CI, 45?C75). Among the 21 patients treated with TCF-dd after the protocol amendments, main grade 3?C4 toxicities were: neutropenia (29%), thrombocytopenia (19%), asthenia (24%) and diarrhea (14%). COFFI caused grade 3?C4 neutropenia (all not febrile) and diarrhea in 35% and 17% of patients respectively.Conclusions
A sequential strategy with TCF-dd followed by COFFI is very active and may be of special interest in selected patients. 相似文献9.
Sun Jin Sym Min-Hee Ryu Hye Jin Kang Sung Sook Lee Heung-Moon Chang Jae Lyun Lee Tae Won Kim Jeong Hwan Yook Sung Tae Oh Byung Sik Kim Yoon-Koo Kang 《Cancer chemotherapy and pharmacology》2010,66(2):373-380
Purpose
Adding docetaxel to cisplatin and 5-fluorouracil (5-FU) (DCF) significantly improved clinical efficacy in advanced gastric cancer (AGC). To further improve the efficacy and tolerability, we substituted oxaliplatin for cisplatin and capecitabine for 5-FU in the DCF regimen and performed a phase I study to determine the recommended dose (RD) and dose-limiting toxicity (DLT) of docetaxel, capecitabine and oxaliplatin (DXO) combination in patients with AGC.Materials and methods
Previously untreated patients with histologically proven metastatic AGC and ECOG performance status 0–2 were enrolled. Docetaxel and oxaliplatin were administered i.v. on day 1. Capecitabine was administered orally bid on days 1–14. Each cycle was repeated every 3 weeks. DLTs were evaluated during the first two cycles of treatment.Results
Twenty-one patients were enrolled: 15 patients in dose-escalation phase and 6 patients in the extension at the RD. Median age was 50 years (range 21–65 years). At dose level 3 (60 mg/m2 docetaxel, 1,000 mg/m2 capecitabine, 100 mg/m2 oxaliplatin), 1 diarrhea (DLT) was found among 6 patients while at dose level 4 (60 mg/m2 docetaxel, 800 mg/m2 capecitabine, 130 mg/m2 oxaliplatin), 2 DLTs (febrile neutropenia and diarrhea) were observed among 3 patients. Therefore, the dose level 3 was determined as RD. DLTs include grade 3 diarrhea and febrile neutropenia. Cumulative (all cycles) grade 3/4 toxicity included neutropenia (75%), leucopenia (50%), febrile neutropenia (25%), diarrhea (17%), and neuropathy (17%). Of 14 patients with measurable lesions, 11 achieved partial response and 3 showed stable disease.Conclusion
The RD of the DXO regimen in patients with AGC is capecitabine 1,000 mg/m2 twice daily on days 1–14, in combination with decetaxel 60 mg/m2 (day 1) and oxaliplatin 100 mg/m2 (day 1) repeated every 3 weeks. The DXO regimen seems to have promising activity and offers an easy alternative to DCF. The toxicities appear to be still substantial, but manageable. 相似文献10.
Grossi F de Marinis F Gebbia V Riccardi F Caffo O Gamucci T Ferraù F Nardi M Moscetti L Boni L Dondi D Galligioni E 《Cancer chemotherapy and pharmacology》2012,69(2):369-375
Purpose
The aim of this study was to determine the activity and toxicity of two sequential chemotherapy regimens in the first-line treatment of advanced non-small-cell lung cancer (NSCLC).Methods
Eighty-eight chemonaive patients with stage IIIB/IV NSCLC were randomised to receive either three cycles of 75?mg/m2 cisplatin plus 75?mg/m2 docetaxel, both administered on day 1 every 21?days, followed by three cycles of 1,200?mg/m2 gemcitabine on days 1 and 8 every 3?weeks (arm A), or three cycles of 25?mg/m2 cisplatin plus 25?mg/m2 docetaxel on days 1, 8 and 15 every 28?days, followed by three cycles of 1,200?mg/m2 gemcitabine on days 1 and 8 every 3?weeks (arm B).Results
Of the evaluable patients, 61% in arm A (n?=?41) and 36% (n?=?44) in arm B completed treatment as per the protocol. The best tumour response rates were as follows (arm A and arm B): complete response: 2.4 and 2.3%; partial response: 39 and 20.4%; stable disease: 26.8 and 13.6%; and progressive disease: 31.8 and 45.4%. The median progression-free and overall survival were 3.9 and 12.3?months in arm A, respectively, 3.1 and 7.7?months in arm B. Grade 3?C4 adverse events were more common in arm A. Grade 3?C4 neutropenia was the main toxicity observed (56.1% in arm A and 11.4% in arm B).Conclusions
Our data demonstrate the feasibility of a sequential approach of cisplatin plus docetaxel followed by single-agent gemcitabine. Weekly administration of platinum-docetaxel is associated with an improved safety profile but lower efficacy than the conventional three-weekly schedule (registration ID 2004-001044-72). 相似文献11.
Eun Joo Kang Seock-Ah Im Do-Youn Oh Sae-Won Han Jin-Soo Kim In Sil Choi Jin Won Kim Yu Jung Kim Jee Hyun Kim Tae-You Kim Jong Seok Lee Yung-Jue Bang Keun-Wook Lee 《Gastric cancer》2013,16(4):581-589
Background
The aim of this study was to evaluate the activity and safety of the combination chemotherapy of 5-fluorouracil (5-FU), leucovorin, and irinotecan (FOLFIRI regimen) after failure of fluoropyrimidine, platinum, and taxane in gastric cancer (GC) and to evaluate the prognostic factors for survival.Methods
Patients received biweekly FOLFIRI chemotherapy as third-line treatment. The FOLFIRI-1 consisted of irinotecan (180 mg/m2 in a 2-h infusion) on day 1, and then leucovorin (200 mg/m2 in a 2-h infusion) and 5-FU (a 400 mg/m2 bolus, followed by 600 mg/m2 in a 22-h continuous infusion) on days 1 and 2. FOLFIRI-2 consisted of irinotecan (180 mg/m2 in a 2-h infusion) on day 1, and then leucovorin (400 mg/m2 in a 2-h infusion) and 5-FU (a 400 mg/m2 bolus, followed by 2400 mg/m2 in a 46-h continuous infusion) on day 1.Results
A total of 158 patients were included. The overall response rate was 9.6 % in patients with measurable lesions. The median progression-free survival (PFS) and overall survival (OS) were 2.1 months [95 % confidence interval (CI), 1.7–2.5] and 5.6 months (95 % CI, 4.7–6.5), respectively. The major grade 3/4 toxicity was myelosuppression (36.7 %). Good performance status (PS), fewer metastatic sites, and longer duration from the first-line to third-line chemotherapy were independent prognostic factors affecting both PFS and OS.Conclusions
The FOLFIRI regimen showed antitumor activity and tolerable toxicity profiles against advanced GC in the third-line setting. Patients with good PS, fewer metastatic sites and longer previous treatment duration might have the maximal benefit from third-line chemotherapy. 相似文献12.
Mitsugu Kochi Yuji Akiyama Tatsuya Aoki Ken Hagiwara Takao Takahashi Katsuji Hironaka Futoshi Teranishi Fumihiko Osuka Masahiro Takeuchi Masashi Fujii Toshifusa Nakajima 《Cancer chemotherapy and pharmacology》2013,72(5):1097-1102
Purpose
The purpose of this multicenter phase II study was to evaluate the efficacy and safety of a combination of irinotecan, 5-fluorouracil (5-FU), and leucovorin (FOLFIRI) plus bevacizumab as first-line chemotherapy in Japanese patients with metastatic colorectal cancer.Methods
Patients with metastatic colorectal cancer were eligible for enrollment. On day 1 of a 14-day cycle, patients received bevacizumab 5 mg/kg, irinotecan 150 mg/m2, and l-leucovorin 200 mg/m2 as an intravenous infusion, followed by 5-FU 400 mg/m2 as an intravenous bolus and then 5-FU 2,400 mg/m2 as an 46-h intravenous infusion. This treatment cycle was repeated. The primary endpoint was progression-free survival (PFS).Results
We enrolled 40 patients, but one withdrew consent before starting treatment. The remaining 39 patients received a total of 509 cycles of FOLFIRI plus bevacizumab (median 11 per patient; range 1–30). The median PFS was 11.5 months, the median overall survival (OS) was 22.0 months, and the 1-year OS rate was 81.8 %. All 39 patients had adverse events. Grade 3 or 4 neutropenia and stomatitis occurred in 21 (53.9 %) and 4 (10.3 %) patients, respectively.Conclusion
Our results suggest that FOLFIRI plus bevacizumab is a clinically effective regimen with a manageable toxicity profile as first-line chemotherapy in patients with metastatic colorectal cancer. 相似文献13.
Agustin A. Garcia MD Lawrence Leichman Joaquina Baranda Lalita Pandit Heinz-Josef Lenz Cynthia G. Leichman 《Journal of gastrointestinal cancer》2003,34(2-3):79-86
Background. Advanced pancreatic cancer has limited treatment options. 5-fluorouracil (5-FU) is frequently used in the treatment of pancreatic cancer. Preclinical studies suggest synergism between trimetrexate (TMTX), 5-FU, and leucovorin (NFL). Aim. We conducted a phase II trial to evaluate the activity and safety of NFL in pancreatic cancer. Method. Eligible patients (n=21) with untreated advanced pancreatic cancer were treated with 110 mg/m2 intravenous (IV) THTX on day 1 and 200 mg/m2 IV leucovorin prior to 500 mg/m2 IV 5-FU on day 2. Oral leucovorin (15 mg every 6 h for seven doses) started intravenous 24 h later. Results. Treatment was administered for 6 wk followed by a 2-wk rest period. Response was evaluated every 8 wk. All patients were evaluable for response and toxicity. Most patients (80%) had distant metastases. Forty-five cycles of chemotherapy were administered. The most common serious toxicities were Grade 3 diarrhea (23.8%) and nausea and vomiting (14.2%). The response rate was 4.1% (95% CI, 0–23%), median survival was 6.8 mo, and 1-yr survival was 19%. Conclusion. Treatment with NFL is well-tolerated in patients with advanced pancreatic cancer. The median survival and 1-yr survival in these patients with poor prognosis compares favorably with other treatment options. 相似文献
14.
Tatsuro Yamaguchi Hiroshi Matsumoto Michiya Yasutome Takeo Mori Keiichi Takahashi 《Cancer chemotherapy and pharmacology》2011,67(3):629-635
Purpose
To evaluate the efficacy and tolerability of systemic chemotherapy with irinotecan (CPT-11), UFT and leucovorin (LV) combined with hepatic arterial infusion (HAI) consisting of 5-fluorouracil (5-FU) in colorectal cancer patients with unresectable liver metastases.Methods
Patients were treated concurrently with escalating doses of intravenous CPT-11 (100, 120, and 140?mg/m2) on day 1 of each 14-day treatment cycle, with oral UFT (300?mg/m2 per day) and LV (75?mg/body per day) on days 1?C7 of each cycle, and with HAI 5-FU (2,000?mg/week) on days 8?C14 of each cycle.Results
Twelve patients were enrolled in the phase I study. The maximum-tolerated dose was not reached. Consequently, the recommended dose of CPT-11 for the phase II study was determined to be 140?mg/m2. Twenty-two patients were evaluated in the phase II study. Five patients experienced grade 3 neutropenia, two experienced grade 3 anorexia, two experienced nausea, and two experienced vomiting. An overall response was observed in 19 out of 22 patients (86.4%). The median progression-free survival period was 11.2?months, and the 3-year survival rate was 50.6%. Fourteen patients (63.6%) were ultimately able to undergo a complete liver resection.Conclusions
Chemotherapy with CPT-11 and UFT/LV combined with HAI yielded a high response rate and enabled a significant proportion of patients with initially unresectable liver metastases to undergo surgical resection. Further trials are warranted. 相似文献15.
Boukovinas I Androulakis N Kentepozidis N Polyzos A Papakotoulas P Ziras N Kotsakis A Vardakis N Karampeazis A Markos V Kostakopoulos A Constantinides CA Samonis G Mavroudis D Georgoulias V 《Cancer chemotherapy and pharmacology》2012,69(2):351-356
Purpose
To assess the antitumor activity and toxicity of gemcitabine, cisplatin, and docetaxel (GCD) regimen in patients with locally advanced or metastatic urothelial cancer.Patient and methods
Chemotherapy-na?ve patients, aged ??70?years with measurable or evaluable disease and a performance status (PS) of 0?C2 were treated with sequential cisplatin 80?mg/m2 (d1), gemcitabine 1,100?mg/m2 (d1 and d14), and docetaxel 80?mg/m2 (d14) every 28?days.Results
Sixty patients with an ECOG PS of 0?C2 were enroled. Most (71.7%) patients had stage IV disease. A median number of 4 chemotherapy cycles per patient (range, 1?C9) was administered. Eight (13.3%) patients achieved a CR and 16 (26.7%) a partial response (PR) (intention-to-treat: ORR 40%; 95% CI 27.6?C52.4%). Thirteen (21.7%) and 23 (38.3%) patients experienced stable and progressive disease, respectively. The median time to progression (TTP) was 7.7?months (range, 0.7?C43.4), and the median overall survival 21.4?months (range, 0.7?C68.6). Grade 3 and 4 neutropenia occurred in 27 (45%) patients and grade 3 and 4 thrombocytopenia in five (8.3%). Three (5%) patients developed febrile neutropenia. There were no treatment-related deaths. Severe non-haematological toxicity was infrequent.Conclusions
The GCD combination is an active and well-tolerated regimen in patients with chemotherapy-naive locally advanced or metastatic TCC and merits to be further investigated. 相似文献16.
Woo Kyun Bae Jun Eul Hwang Hyun Jeong Shim Sang Hee Cho Joon Kyoo Lee Sang-Chul Lim Woong-Ki Chung Ik-Joo Chung 《Cancer chemotherapy and pharmacology》2010,65(3):589-595
Purpose
This study sought to determine the feasibility and safety of induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (5-FU) triple combination chemotherapy (TPF) followed by concurrent chemoradiotherapy (CCRT) for locoregionally advanced nasopharyngeal cancer (NPC).Methods
Patients with advanced NPC were treated with three cycles of induction chemotherapy. Docetaxel (70 mg/m2) and cisplatin (75 mg/m2) were given on day 1, followed by 5-FU (1,000 mg/m2) as a continuous infusion for 4 days. After induction chemotherapy, cisplatin was given at a dose of 100 mg/m2 every 3 weeks with radiotherapy.Results
Thirty-three patients were enrolled; all patients were stage III (n = 4, 12.1%) or IV (n = 29, 87.9%). Among the patients, 32 patients completed both induction TPF therapy and CCRT, with responses as follows: five patients (15.2%) achieved a complete response (CR), and 27 patients (81.8%) a partial response (PR). At 6 weeks after CCRT, 23 patients (69.7%) had a CR and 9 patients (27.3%) a PR. The 3-year progression-free survival was 75.6% and the 3-year overall survival was 86.1%. Neutropenia (72.7%), febrile neutropenia (9.1%), and nausea (9.1%) were the most severe toxicities (grade 3–4) during induction chemotherapy, and mucositis (39.4%), fatigue (15.2%), and nausea (9.1%) were the most common toxicities (grade 3–4) during CCRT.Conclusions
Although most patients had stage IV NPC, the TPF induction chemotherapy followed by CCRT showed promising activity with manageable toxicity. These results demonstrated the possibility of effective treatment with the aim of not only a palliative, but also a curative, approach to the treatment of advanced NPC. 相似文献17.
Minghua Bai Baofeng Wang Xijing Wang Hongbing Ma Yali Wang Zhongwei Wang 《中德临床肿瘤学杂志》2013,12(8):361-364
Objective
This randomized controlled clinical study was to assess and compare the efficacy and safety of two chemoradiotherapy regimens [cisplatin + 5-fluorouracil + 3 dimensional conformal radiation therapy (3DCRT) and cisplatin + weekly docetaxel + 3DCRT] in patients with locally advanced esophageal squamous cell carcinoma.Methods
A total of seventy-four patients with clinical stages IIB to IIIB esophageal squamous cell carcinoma were enrolled. Chemotherapy for PF group comprised 5-fluorouracil at days 1–5 (250 mg/m2/d) and cisplatin (20 mg/m2) at days 1–3 of every 28-day cycle; full treatment course included 2 cycles. Chemotherapy for DP group comprised docetaxel (20 mg/m2) and cisplatin (20 mg/m2) at days 1, 8, 15, 22, 29, and 36. Both groups treated with concurrent 60 Gy 3DCRT at 200 cGy/d.Results
Seventy-four patients were enrolled and 71 completed the planned treatment, with a follow-up rate of 95.94%. Short-term curative effect was not statistically significant between the two groups (P = 0.471). The 2-year survival rates were 65.7% and 61.1%, respectively (P = 0.806), 5 years survival rates were 34.29% and 27.78%, respectively (P = 0.221), and there was no significant difference by Fisher test (P = 0.734). As common side effects, incidence rates of radioactive esophagitis and hematological toxicity were lower in DP group.Conclusion
For locally advanced esophageal cancer patients, current chemoradiotherapy with chemotherapy regimen of weekly docetaxel plus cisplatin has equal curative effect with 5-fluorouracil plus cisplatin, but well-tolerated by reducing side effects such as radioactive esophagitis and bone marrow suppression. 相似文献18.
Emi M Hihara J Hamai Y Aoki Y Okada M Kenjo M Murakami Y 《Cancer chemotherapy and pharmacology》2012,69(6):1499-1505
Purpose
We aimed to evaluate the safety, tolerability, and efficacy of combination preoperative chemoradiotherapy as first-line treatment in patients with advanced esophageal cancer.Methods
We performed a phase I dose-escalation trial of docetaxel at 25–40?mg/m2 in four planned dose levels in 3–6 patient cohorts on days 1, 15, 29, and 43 administered in combination with cisplatin (70?mg/m2 on days 1 and 29) and 5-fluorouracil (70?mg/m2/day on days 1–4 and 29–32) and concurrent radiation therapy (40?Gy). The tumors were resected during weeks 10–13.Results
This study included 7 patients with esophageal cancer. The dose-limiting toxicity was observed at a biweekly docetaxel dose of 30?mg/m2 when patients developed grade 3 febrile neutropenia, grade 4 thrombocytopenia, and grade 4 pain/esophagus, resulting in a maximum tolerated dose of 25?mg/m2. Grade 3/4 hematological toxicity was observed in 71% of the patients and grade 3/4 non-hematological toxicity in 57%. The overall tumor response rate was 86% (complete, 57% and partial, 29%). All patients underwent surgery, and there were no deaths as a result of postoperative complications.Conclusions
This preoperative chemoradiotherapy regimen using triplets is feasible but results in moderate toxicity. It is noteworthy that this regimen was associated with a high rate of pathological complete remission. 相似文献19.
Mamoru Tsukuda Junichi Ishitoya Hideki Matsuda Choichi Horiuchi Takahide Taguchi Masahiro Takahashi Goshi Nishimura Mariko Kawakami Makiko Watanabe Tatsuo Niho Toshiro Kawano Yoichi Ikeda Yasunori Sakuma Osamu Shiono Masanori Komatsu 《Cancer chemotherapy and pharmacology》2010,66(4):729-736
We compared concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin (CDDP), and 5-fluorouracil (5-FU) (TPF) with CCRT with CDDP, 5-FU, methotrexate and leucovorin (PFML) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) in terms of safety and efficacy on survival. A total of 100 patients were enrolled. The TPF group received CCRT with the TPF regimen [docetaxel (50 mg/m2: day 1), CDDP (60 mg/m2: day 4), and continuous 5-FU infusion (600 mg/m2/day: days 1–5)]. In the PFML group, patients received CCRT with the PFML regimen [CDDP (60 mg/m2: day 4)], continuous 5-FU infusion (600 mg/m2/day: days 1–5), methotrexate (30 mg/m2: day 1) and leucovorin (20 mg/m2/day: days 1–5)]. Both groups received 2 cycles of chemotherapy during definitive radiotherapy. The total radiation dose was between 66.6 and 70.2 Gray. The overall response rates after CCRT were 98 with 90% of a pathologically complete response (pCR) in the TPF group and 94 with 77% in the PFML group. For grade 3/4 adverse events, mucositis was more frequent in the PMFL group, and the TPF group showed a higher incidence of hematological toxicity. CCRT with TPF or PMFL for advanced SCCHN was tolerable and produced excellent survival rates. 相似文献
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