• Title/Summary/Keyword: salvage chemotherapy

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Resistant Gestational Trophoblastic Neoplasia Patients Treated with 5-Fluouracil plus Actinomycin D

  • Manopunya, Manatsawee;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.387-390
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    • 2012
  • A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonly administered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second line of treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear. To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patients resistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen between August 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases who met the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12. The median number of cycles for each patient was two and only one case achieved remission while four of the cases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicated myelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting with manageable toxicity.

Philadelphia chromosome-positive acute lympho-blastic leukemia in childhood

  • Koo, Hong-Hoe
    • Clinical and Experimental Pediatrics
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    • v.54 no.3
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    • pp.106-110
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    • 2011
  • In pediatric patients with acute lymphoblastic leukemia (ALL), the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20-30% of Philadelphia chromosome-positive (Ph+) children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of patients in first complete remission. Recent data suggest that chemotherapy plus tyrosine kinase inhibitors (TKIs) may be the initial treatment of choice for Ph+ ALL in children. However, longer observation is required to determine whether long-term outcome with intensive imatinib and chemotherapy is indeed equivalent to that with allogeneic related or alternative donor hematopoietic stem cell transplantation (HSCT). Reports on the use of second-generation TKIs in children with Ph+ ALL are limited. A few case reports have indicated the feasibility and clinical benefit of using dasatinib as salvage therapy enabling HSCT. However, more extensive data from clinical trials are needed to determine whether the administration of second-generation TKIs in children is comparable to that in adults. Because Ph+ ALL is rare in children, the question of whether HSCT could be a dispensable part of their therapy may not be answered for some time. An international multicenter study is needed to answer the question of whether imatinib plus chemotherapy could replace sibling allogeneic HSCT in children with Ph+ ALL.

Surgical Treatment of Cancer of Tongue and Floor of Mouth (설암 및 구강저암의 수술적 치료)

  • 홍기환;양윤수
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.270-276
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    • 1997
  • The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.

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Clinical Results of Neo-Adjuvant Chemotherapy and Surgery on Osteosarcoma (Stage II B형 골육종에 대한 술전 항암화학요법 및 수술적 치료 결과)

  • Kang, Yong-Koo;Kim, Hyung-Min;Rhee, Seung-Koo;Woo, Young-Kyun;Kim, Jung-Man;Kim, Hoon-Kyo
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.27-32
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    • 1996
  • Recent advances in imaging techniques, surgery and combination anti-cancer chemotherapy have brought high survival rates in osteosarcoma. To investigate the survival rate, local recurrence and complications in treatment, we analysed 25 osteosarcoma cases who had been treated with preoperative neo-adjuvant chemotherapy, surgery and post operative chemotherapy at Department of Orthopedic Surgery, Catholic University. From May 1988 to April 1995, 42 cases of stage IIB osteosarcoma were admitted in Department of Orthopedic Surgery. Among them, 17 cases who didn't follow our treatment guidance were excluded in this study. The average age were 19 years. There were 21 males and 4 females. The involved sites were 4 humerus, 10 femur, 10 tibia and 1 talus. Eleven cases had received intraarterial cisplatin and intravenous adriamycin chemotherapy, and 7 T-10 protocol and 7 intravenous ifosfamide, ADR, methotrexate, cisplatin. Twenty-three cases were treated with limb salvage surgery, and 2 amputation. The average follow-up was 35 months(3~82). There were 14 cases of continuous disease free, 9 cases of died of disease, 1 case of alive with disease, and 1 case of no evidence of disease at final follow-up. There were three cases of local recurrence at 6,8 and 12 months after operation. The estimated Kaplan-Meier's 5 year survival rates for all, ADR-cisplatin group, T-10 protocol group, and ifosfamide regimen group were 6%, 73%, 44% and 72%, respectively.

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Ifosfamide and Doxorubicin Combination Chemotherapy for Recurrent Nasopharyngeal Carcinoma Patients

  • Dede, Didem Sener;Aksoy, Sercan;Cengiz, Mustafa;Gullu, Ibrahim;Altundag, Kadri
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2225-2228
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    • 2012
  • Background: We assessed the efficacy and toxicity of ifosfamide and doxorubicin combination chemotherapy (CT) regimen retrospectively in Turkish patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) previously treated with platinum-based chemotherapy. Methods: A total of thirty patients who had received cisplatin based chemotherapy/chemoradiotherapy as a primary treatment received ifosfamide 2500 $mg/m^2$ days 1-3, mesna 2500 $mg/m^2$ days 1-3, doxorubicin 60 mg/m2 day 1 (IMA), repeated every 21 days. Eligible patients had ECOG PS< 2, measurable recurrent or metastatic disease, with adequate renal, hepatic and hematologic functions. Results: Median age was 47 (min-max; 17-60). Twenty six (86.7 %) were male. Median cycles of chemotherapy for each patient were 2 (range:1-6). Twenty patients were evaluable for toxicity and response. No patient achieved complete response, with nine partial responses for a response rate of 30.0% in evaluable patients. Stable disease, and disease progression were observed in five (16.7%) and six (20.0%) patients, respectively. Clinical benefit was 46.7%. Median time to progression was 4.0 months. Six patients had neutropenic fever after IMA regimen and there were one treatment-related death due to tumor lysis syndrome in first cycle of the CT. No cardiotoxicity was observed after CT and treatments were generally well tolerated. Conclusion: Ifosfomide and doxorubicin combination is an effective regimen for patients with recurrent and metastatic NPC. For NPC patients demonstrating failure of cisplatin based regimens, this CT combination may be considered as salvage therapy.

Limb-Salvage Surgery using Ilizarov Technique - Report of 2 cases - (Ilizarov술식을 이용한 사지 구제술 - 2례 보고 -)

  • Cho, Duck-Yun;Koh, Eun-Sung;Lee, Ji-Sup
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.226-232
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    • 1995
  • Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

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Role of Surgery in Ewing's Sarcoma Treatment (유잉 육종의 치료에서 수술의 역할)

  • Jeon, Dae-Genn;Lee, Jong-Seok;Kim, Sug-Jun;Park, Hyun-Soo;Jang, Jin-Dae;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.38-46
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    • 1996
  • The traditional methodology in Ewing's sarcoma was chemotherapy and radiotherapy. Recently surgery is reemerging as an important therapeutic tool and some paper report increased survival with it. The purpose of this nonrandomized study is to evaluate our result of Ewing's sarcoma with surgery, retrospectively. We experienced 30 cases for seven years and among them 6 were extraskeletal. In location, axial was 10 cases and peripheral was 20. By Enneking's classification, state IIB was 26 cases and IIIB was 4. Eighteen patients took operation, chemotherapy and/or radiotherapy, and remaining twelve took chemotherapy and/or radiotherapy only. Type of operation was limb salvage in 16 cases and amputation 2. Average dosage of radiation was 45.1Gy. Six kinds of chemotherapeutic regimen were used, but among them main protocols were Ifosfamide-Adriamycin(17 cases) and IESS(Cytoxan, Adriamycin, Methotrexate, Vincristine:8 cases). Complications were as follows. In operation group, there were 3 local recurrence and one case of nonunion. In nonoperated group, one local recurrence and one pancytopenia resulting in death. Average follow up was 29.7 months. Kaplan-Meier's ten year actuarial survival rate for the whole 30 cases was 26.8%. Significant difference in survival exists between central and peripheral lesions(p=0.05, by log rank test). Types of chemotherapy and surgery itself showed no significance. But surgery is important in function and local control. More intensive chemotherapeutic regimen to prevent distant metastasis and combined surgery and radiotherapy may be needed in Ewing's sarcoma.

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Gemcitabine Plus Nedaplatin as Salvage Therapy is a Favorable Option for Patients with Progressive Metastatic Urothelial Carcinoma After Two Lines of Chemotherapy

  • Matsumoto, Kazumasa;Mochizuki, Kohei;Hirayama, Takahiro;Ikeda, Masaomi;Nishi, Morihiro;Tabata, Ken-ichi;Okazaki, Miyoko;Fujita, Tetsuo;Taoka, Yoshinori;Iwamura, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2483-2487
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    • 2015
  • This study was conducted to evaluate the effectiveness of a combination of gemcitabine and nedaplatin therapy among patients with metastatic urothelial carcinoma previously treated with two lines of chemotherapy. Between February 2009 and August 2013, 30 patients were treated with gemcitabine and paclitaxel as a second-line chemotherapy. All had received a first-line chemotherapy consisting of methotrexate, vinblastine, doxorubicin and cisplatin. Ten patients who had measurable histologically proven advanced or metastatic urothelial carcinoma of the urinary bladder and upper urinary tract received gemcitabine $1,000mg/m^2$ on days 1, 8 and 15 and nedaplatin $70mg/m^2$ on day 2 as a third-line chemotherapy. Tumors were assessed by imaging every two cycles. The median number of treatment cycles was 3.5. One patient had partial response and three had stable disease. The disease-control rate was 40%, the median overall survival was 8.8 months and the median progression-free survival was 5.0 months. The median overall survival times for the first-line and second-line therapies were 29.1 and 13.9 months, respectively. Among disease-controlled patients (n=4), median overall survival was 14.2 months. Myelosuppression was the most common toxicity. There were no therapy-related deaths. Gemcitabine and nedaplatin chemotherapy is a favorable third-line chemotherapeutic option for patients with metastatic urothelial carcinoma. Given the safety and benefit profile seen in this study, further prospective trials are warranted given the implications of our results with regard to strategic chemotherapy for patients with advanced or metastatic urothelial carcinoma.

Pemetrexed is Mildly Active with Good Tolerability for Treatment of Patients with Colorectal Cancer

  • Zhang, Hui-Qing;Lian, Chang-Hong;Ping, Yao-Dong;Song, Wen-Bin;Lu, Qing-Pu;Xie, Shu-Zhe;Lin, Tao;Cheng, Lin-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8391-8394
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    • 2014
  • Purpose: This systematic analysis was conducted to evaluate the efficacy and safety of pemetrexed based salvage chemotherapy for treatment of patients with metastatic colorectal cancer. Methods: Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for patients with colorectal cancer were identified using a predefined search strategy. Pooled response rates (RRs) were calculated. Results: For pemetrexed based regimens, 4 clinical studies including 201 patients with advanced colorectal cancer were considered eligible for inclusion. The analysis suggested that, in all patients, pooled RR was 20.4% (41/201). Major adverse effects were neutropenia, anorexia, fatigue, and anemia. No treatment related death occurred with pemetrexed based treatment. Conclusion: This systematic analysis suggests that pemetrexed based regimens are associated with mild activity with good tolerability in treating patients with metastatic colorectal cancer.