• Title/Summary/Keyword: chemotherapy combination

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Triplet Platinum-based Combination Sequential Chemotherapy Improves Survival Outcome and Quality of Life of Advanced Non-small Cell Lung Cancer Patients

  • Chen, Li-Kun;Liang, Ying;Yang, Qun-Ying;Xu, Fei;Zhou, Ning-Ning;Xu, Guang-Chuan;Liu, Guo-Zhen;Wei, Wei-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1863-1867
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    • 2012
  • Background: Maintenance chemotherapy is one strategy pursued in recent years with intent to break through the chemotherapy plateau for advanced non-small cell lung cancer (NSCLC). However, given the toxicity, platinum-based combinations are rarely given for this purpose. We carried out the present prospective study of triplet platinum-based combination sequential chemotherapy in advanced NSCLC to investigate if patients could tolerate and benefit from such intensive treatment. Methods: From Dec 2003 to Dec 2007, 190 stage IIIB and IV NSCLC patients in Sun yat-sen University sequentially received the 3 platinum-based combination (TP-NP-GP) treatment (T: paclitaxol175$mg/m^2$ d1; N: vinorelbine25$mg/m^2$ d1 and 8; G: gemcitabine1$g/m^2$ d1 and 8; P: cisplatin20$mg/m^2$ d1-5; repeated every 3 weeks). Patients were followed up to at least 3 years to obtain survival data. Treatment toxicities and the quality of life (QOL) were assessed during the whole treatment. Results: There were 187 patients evaluable. The TP, NP and GP response rates with sequential use were 42.8% (80/187), 41.1% (65/158) and 28.8% (21/73) respectively. Median survival time was 18.2 months and the 1, 2 and 3 year overall survival (OS) rates were 78.7%, 38.5% and 21.3%. Patients receiving > 6 cycles of chemotherapy had significantly longer OS and TTP (MST 25.3 vs. 14.5 months, TTP 15.1 vs. 9.1 months). The QOL on the whole for the patients was improved after chemotherapy. Conclusions: The sequential chemotherapy strategy with triplet platinum-based combination regimens can improve the survival outcome and the quality of life of advanced non-small cell lung cancer patients.

The Patterns of Filgrastim Uses in Breast Cancer Patients Receiving Chemotherapy (항암화학요법을 받은 유방암환자에서의 Filgrastim사용 현황)

  • Jung, Hye Jin;Shin, Wan Gyoon;Kim, Young Joo
    • Korean Journal of Clinical Pharmacy
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    • v.13 no.2
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    • pp.59-66
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    • 2003
  • Filgrastim is used as an indispensable adjuvant drug to reduce the degree and duration of chemotherapy-induced neutropenia. The purpose of this research is to study the use of filgrastim by reviewing retrospective medical records of breast cancer patients who have been treated by filgtastim in the National Cancer Center. 84 patients have received 323 cycles of chemotherapy, of which 134 cycles were treated by filgrastim $(41.5\%)$. Among those 134 cycles, 34 were for prophylaxis $(21.6\%)$, and 100 for treatment of neutropenia $(74.6\%)$. The frequence of filgrastim usage was more than $50\%$ in frequency with regimens containing docetaxel. For prophylaxis, the median of filgrastim initiation was measured on the day of chemotherapy (-3rd-13th). For the treatment, on the other hand, the median appeared on the 9th day (4th-2lst) after chemotherapy, which showed very wide distribution. Time to filgrastim initiation ranged between the 7th and the 9th day after chemotherapy in docetaxel+doxorubicin combination regimen and docetaxel single regimen, whereas it showed after the 10th day in doxorubicin+cyclophosphamide combination regimens. For the treatment, 48 out of 61 patients $(73.8\%)$ in 63 cycles have experienced fever, had to visit the emergency room, required hospitalization, caused infection, transfusion, dosage reduction and schedule changes in spite of using filgrastim with chemotherapy. For prophylaxis, 11 out of 19 patients $(17.9\%)$ in 11 cycles have experienced the same results. In conclusion, the guideline of time to the initiation and the last is required for cost-effective administration of filgrastim because of the difference occurring ANC nadir, the severity and duration of neutropenia by chemotherapy regimens.

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Combination Therapy for Advanced Maxillary Sinus Cancers (진행된 상악동암의 병용치료)

  • Cho Seung-Ho;Kim Hyung-Tae;Kim Min-Sik;Kim Hoon-Kyo;Yoon Sei-Chul;Kim In-Ah;Yoo Woo-Jeong;Kim Sung-Won
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.161-168
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    • 1997
  • Background: Cancers of the maxillary sinuses are not common and are the most difficult head and neck malignancies in which to make an early diagnosis. Objectives: This reports was conducted to evaluated the efficacy of combination therapy and the relationship between the treatment modalities and their outcome of maxillary sinus cancers. Materials and Methods: We retrospectively analyzed a clinical datas of 46 patients who were treated at the department of Otolaryngology-Head and Neck Surgery. The Catholic University of Korea over 10 years between 1987 and 1996. Results: According to AJCC TNM system, 35 patients presented with $T_4$, 10 with $T_3$, one with T1. Two patients were treated with radiotherapy alone, 4 patients with chemotherapy alone, 17 patients with radiotherapy and chemotherapy, 23 patients with combination of surgery, radiotherapy and chemotherapy. The overall 5 years survival rate for combination therapy group were 57%, but 23 patients treated with the other treatment modalities all died within 2 years except two cases with chemotherapy and radiotherapy or radiotherapy alone. There was a statistical trend for better survival and local control in those patients treated with combination therapy than others(p<0.05). Conclusion: The results of this study suggest that it may be possible to acheive better results with aggressive combination treatment including surgery in advanced cases and to avoid orbital excentration in patients with orbital invasion.

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Chemotherapy for Lung Cancer in the Era of Personalized Medicine

  • Lee, Seung Hyeun
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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    • pp.179-189
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    • 2019
  • Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

  • Cai, Yong;Wang, Ji-Ying;Liu, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5699-5703
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    • 2013
  • Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.

Haematologic Parameters in Metastatic Colorectal Cancer Patients Treated with Capecitabine Combination Therapy

  • Inanc, Mevlude;Duran, Ayse Ocak;Karaca, Halit;Berk, Veli;Bozkurt, Oktay;Ozaslan, Ersin;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.253-256
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    • 2014
  • Background: The standard treatment in the metastatic colorectal cancer consists of 5-FU based infusional regimens. However, with oral fluoropyrimidines, equal tumor responses may be obtained. Capecitabine causes macrocytosis of the cells by inhibition of DNA synthesis. In this context, a relationship was found between mean corpuscular volume (MCV) and response to therapy in breast cancer patients treated with Capecitabine, but whether this relationship also pertains in colorectal cancer has not been established. Materials and Methods: A total of 102 metastatic colorectal cancer patients treated with a oxaliplatin (XELOX)${\pm}$Bevacizumab combination were retrospectively evaluated. Patients were randomized into three groups. Hematological parameters (MCV, MPV, PCT, PLT, NLR) were recorded retrospectively, before treatment and after 3 cycles of chemotherapy. Results: After three cycles of therapy, 20 (19.6%) patients had progressive disease (PD), 41 (40.1%) had stable disease (SD), and 41 (40.1%) demonstrated a partial response (PR). In 62 (60.7%) treatment was with capesitabin plus XELOX therapy, and in 40 (39.2%) it was XELOX-Bevacizumab combination therapy. There was no difference among three groups before the treatment in terms of MCV, MPV, PCT, PLT, and NLR. MCV showed significant increase in chemotherapy response groups (PR and SD). In addition, a significant decrease was observed for platelet count in chemotherapy response groups. While NLR decrease was seen in only a PR group, PCT decrease was observed in all three groups. PCT and PLT values were higher in patients receiving Bevacizumab. Conclusions: PLT, PCT, MPV, and NLR values were decreased due to Capecitabine-based chemotherapy, however MCV was increased. PCT and PLT values were higher in patients who received Bevacizumab than those who did not. MCV, PLT, and NLR can be considered as important factors in predicting response to colorectal carcinoma treatment.

Weekly versus 3-weekly paclitaxel in combination with carboplatin in advanced ovarian cancer: which is the optimal adjuvant chemotherapy regimen?

  • Lee, Matilda X.;Tan, David SP
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.96.1-96.12
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    • 2018
  • The 3-weekly regimen of carboplatin and paclitaxel is the backbone of first line adjuvant chemotherapy for advanced ovarian cancer. The landmark Japanese Gynaecologic Oncology Group (JGOG) 3016 study demonstrated significant improvements in progression-free survival and overall survival with dose dense weekly administration of paclitaxel in combination with 3-weekly carboplatin. However, efforts to replicate these benefits have failed in subsequent phase III trials. Weekly paclitaxel is purported to have enhanced antitumor activity, with stronger anti-angiogenic effects, and yet is better tolerated. In this review, we explore the rationale for dose dense weekly paclitaxel, and compare the relevant trials as well as quality of life considerations. Possible reasons for the difference in outcomes between the JGOG 3016 and other studies are reviewed, with a focus on how the addition of bevacizumab, the variations between histological and molecular subtypes of epithelial ovarian cancers, and ethnic pharmacogenetic differences may potentially affect the efficacy of dose dense paclitaxel.

Efficacy and Safety of Docetaxel or Epirubicin, Combined with Cisplatin and Fluorouracil, (DCF and ECF) Regimens as First Line Chemotherapy for Advanced Gastric Cancer: a Retrospective Analysis from Turkey

  • Teker, Fatih;Yilmaz, Bahiddin;Kemal, Yasemin;Kut, Engin;Yucel, Idris
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6727-6732
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    • 2014
  • Objectives: Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is usually achieved by first line setting. Very few studies have compared combination regimens. This study was designed to compare two combination regimens. Methods: Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected, and divided into two groups, receiving DCF (docetaxel, cisplatin and fluorouracil) or ECF (epirubicin, cisplatin and fluorouracil) regimens. Data were collected for the retrospective analysis in a single center. Results: Eighty-six patients were eligible for analysis. Median overall survival (OS) was 10.0 months in the ECF group and 11.0 months in the DCF group (p=0.31). Median progression free survival (PFS) for ECF and DCF was equal at 6.0 months. Second line chemotherapy were administered in more than one third of patients. Both regimens had similar toxicity. Conclusions: This is the first study investigating the outcomes of gastric cancer chemotherapy in this region. ECF and DCF regimens have similar efficacy and a similar tolerability profile for first line treatment of advanced gastric cancer. The decision of the first line chemotherapy in advanced gastric cancer could be improved with patient selection according to clinical parameters and molecular markers.

A Case Report of Malignant Glomus Tumor Responding to Combination Chemotherapy (복합화학요법에 반응한 악성 사구체 종양 1예)

  • Lee Sang-Yoon;Choi In-Sil;Park Suk-Ryun;Kim Do-Yeon;Kim Kwang-Hyun;Kim Noe-Kyeong;Heo Dae-Seog
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.219-222
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    • 2002
  • Malignant glomus tumor is a very rare disease originating from the paraganglia system through the body. Glomus tumor, also known as paraganglioma, usually are considered benign, and arises in a variety of head and neck locations, most of which include the carotid body, the vagus nerve, and the jugulotympanic area. The most widely accepted management of benign glomus tumor is surgical extiration. Here, we report a case of recurrent laryngeal glomus tumor which is proven malignant and metastatic to the brain and the lungs. We have treated the patient with combination chemotherapy and radiation to the brain, the result of which is partial response in terms of decreased size of metastatic lung lesions.

Squamous cell carcinoma of the skin in an Australian shepherd dog (개에서 피부 편평상피세포암의 발생과 치료 예)

  • 권오덕
    • Korean Journal of Veterinary Service
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    • v.24 no.1
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    • pp.101-107
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    • 2001
  • Squamous cell carcinoma of the skin was diagnosed in an 11-year-old, Australian shepherd dog with a hard mass on the right rump area. On histopathological examination of the tumor showed laminated keratin "pearls" surrounded by proliferated squamous cells, and mitotic figures. The dog was treated by surgical excision and chemotherapy with vinblastine sulfate, cyclophosphamide and prednisolone for 4 weeks. The tumor was effectively treated with a combination of surgery and chemotherapy.motherapy.

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