American journal of clinical oncology
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Am. J. Clin. Oncol. · Dec 1998
Case ReportsStrontium-89 (89Sr) analgesia for rare thymic carcinoid tumor with bony metastases.
The authors report the cases of two patients in whom strontium-89 (89Sr) was used to relieve diffuse metastatic bone pain. The type of cancer involved, thymic carcinoid tumor, is itself rare and the risk of its metastasizing to the bone is very low. Both patients showed a measure of response to treatment, suggesting that this analgesic method has value for some patients. The marked benefit of one patient for a total of 9 months was attributable to two 89Sr injections, whereas the other patient improved for only 5 weeks after one injection.
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Docetaxel has been shown to have significant antitumor activity. The mechanism of action is through stabilization of tubulin, arresting cells in the G2M phase of the cell cycle. The maximum tolerated dose of docetaxel is 100 mg/m2 every 21 days. ⋯ Studies of docetaxel combined with cisplatin, and docetaxel, cisplatin, and 5-fluorouracil (TPF) as induction therapy for patients with SCCHN demonstrate that these regimens are highly active. An early trial of induction TPF with leucovorin (TPFL) has yielded an overall response rate of 100% and complete response rate of 61%. In vitro studies have shown docetaxel to be a potent radiation sensitizer for squamous cell carcinoma cell lines, and phase I trials using concurrent docetaxel and radiotherapy are ongoing.
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Am. J. Clin. Oncol. · Aug 1998
Randomized Controlled Trial Multicenter Study Clinical TrialAnticachectic efficacy of megestrol acetate at different doses and versus placebo in patients with neoplastic cachexia.
Anorexia and cachexia are present in the majority of patients with advanced-stage cancer. Several agents have been tested for their ability to reverse weight loss in these patients. Megestrol acetate has been demonstrated to improve appetite and weight, independent of tumor response, when used in the treatment of metastatic breast cancer. ⋯ There were no thromboembolic events. This trial supports the efficacy of megestrol acetate at 480 mg/day in the treatment of cancer-related cachexia and anorexia, with mild toxicity. However, performance status and quality of life were not influenced by this treatment.
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Am. J. Clin. Oncol. · Jun 1998
Comparative Study Clinical TrialComparison of neutrophil and monocyte function by microbicidal cell-kill assay in patients with cancer receiving granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, or no cytokine after cytotoxic chemotherapy: a phase II trial.
Functional effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) were prospectively measured by harvesting blood samples from 51 oncology patients (21 who were receiving no cytokines, 14 receiving rhGM-CSF, and 16 who were receiving rhG-CSF) just before cytotoxic chemotherapy (baseline) immediately before the last cytokine dose (pre), 2 hours after the last cytokine dose (post), and 48 hours after the pre period (follow-up). Neutrophils and monocytes were separated and functional effects were measured by comparing cell-kill percentages, as determined by a microbial cell-kill assay against Staphylococcus aureus and Candida albicans. Optimal cell concentrations (2 x 10(6) monocytes/ml; 4 x 10(6) neutrophils/ml) and effector-to-cell ratios (1:50) were initially determined with blood samples harvested from 23 healthy volunteers. ⋯ Neutrophil activity was not altered by either cytokine. In conclusion, monocyte-induced microbial killing was enhanced in oncology patients receiving rhGM-CSF after cytotoxic chemotherapy, compared with patients receiving rhG-CSF or no cytokines. No differences in neutrophil activity were observed between patients receiving either cytokine.
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Am. J. Clin. Oncol. · Apr 1998
ReviewAnastrozole: a new addition to the armamentarium against advanced breast cancer.
Estrogen manipulation represents an effective treatment for advanced breast cancer in postmenopausal women with estrogen-receptor positive disease. The antiestrogen agent, tamoxifen, is the first choice for advanced breast cancer in postmenopausal women due to its efficacy and lack of significant side effects. As with all cancer treatments, however, cancer may recur after initial treatment with tamoxifen, and the limitations of currently available alternative hormonal therapies in terms of tolerability and convenience of administration underscore the need for new agents. ⋯ In two multicenter clinical trials, anastrozole was as effective as megestrol acetate for the treatment of advanced breast cancer in postmenopausal women who progressed after tamoxifen therapy, based on objective response rates and time to objective progression of disease. In addition, the drug did not produce the weight gain observed with megestrol acetate therapy. Anastrozole is an effective endocrine agent in the treatment of advanced breast cancer in postmenopausal women.