Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Jul 1999
Review[Combined multimodal therapy for osteosarcoma--neoadjuvant chemotherapy].
Until the 1970s, the survival rate of osteosarcoma patients was less than 20%. By the 1990s, this had improved to 60% to 70%, and limb-sparing procedures have replaced amputation in many patients thanks to effective combination therapy. Neoadjuvant chemotherapy has become an accepted practice in the majority of institutions using protocols which include MTX, ADR, BCD and CDDP as the most active agents against this disease. ⋯ Although current treatment regimens allow effective salvage therapy for the patients with pulmonary metastases, the actuarial survival rate is 30%. A more effective systemic treatment for those patients is needed. The current management of osteosarcoma is critically reviewed and a treatment strategy is proposed for discussion.
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Gan To Kagaku Ryoho · Jul 1999
[A new anti-androgen, bicalutamide (Casodex), for the treatment of prostate cancer--basic clinical aspects].
Bicalutamide (Casodex) has been approved as a new option for the treatment of prostate cancer. It is a new non-steroidal anti-androgen synthesized by the British company Zeneca. In pharmacological studies using rats and other subjects, the product showed excellent affinity with androgen receptors and was found to be anti-androgen active and effective against tumors, and so clinical trials have begun. ⋯ Moreover, it can be administered in a once-daily dose, which is expected to improve patient compliance. In a late Phase II study in Japan, a response rate as high as 64.4% was achieved when bicalutamide was administered alone. The potential for bicalutamide to be used alone is important because of the growing emphasis on patient quality of life and sexual function in prostate cancer therapy.
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Gan To Kagaku Ryoho · Jun 1999
Review[Results of questionnaire to 56 medical institutions about clinical trials of cancer chemotherapy].
From the stand point of investigators doing clinical trials of anti-cancer drugs, a questionnaire to survey of the current status of clinical trials concerning on the reactions of medical institutions to the new GCP started in April 1997, sent to 75 institutions all over the Japan. 56 institutions (75%) gave answers to the questionnaire, in August 1998. As the results, apparent decrease of Phase II & III trials were noticed compared the numbers before March 1997. IRB with one or two outside members are well functioned in these institutions. But, training related doctors, nurses (especially CRC) are nowadays most important problems, which are strongly expected to Ministry of Health and Welfare and related medical societies, for instance Japan Society of Clinical Oncology.
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Gan To Kagaku Ryoho · May 1999
Clinical Trial[Docetaxel therapy against anthracycline resistant breast cancer].
To evaluate the efficacy of docetaxel therapy against anthracycline-resistant breast cancer, twenty patients were treated with docetaxel. Of the 20 patients pretreated with anthracycline, 17 were clinically anthracycline-resistant and the remaining three were refractory to anthracycline on histoculture drug response assay. Nine patients had loco-regional recurrence and 11 had distant +/- loco-regional recurrence. ⋯ Hypersensitivity reaction was observed in one case. In addition, severe adverse effects such as grade 2 pneumonia and grade 4 diarrhea were found in one patient each. In conclusion, although the adverse effects are not negligible, docetaxel therapy is effective against anthracycline-resistant breast cancer.
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Gan To Kagaku Ryoho · May 1999
Randomized Controlled Trial Clinical Trial[Efficacy of combination with granisetron and methylprednisolone for nausea, vomiting and appetite loss in remission induction chemotherapy of acute myeloid leukemia--a randomized comparative trial between granisetron alone and granisetron plus methylprednisolone].
The prevention of nausea, vomiting and appetite loss induced by remission induction chemotherapy for acute myeloid leukemia was compared by randomization between granisetron alone and combination with granisetron plus methylprednisolone. Granisetron was administered at 40 micrograms/kg during chemotherapy, and methylprednisolone was administered concomitantly at 125 mg/body for 3 days or more in the combination group. The single and combination groups comprised 14 and 13 patients, respectively, and there was no significant difference between the background of both groups. ⋯ Appetite loss developed in 92.9% and 41.7%, respectively, and the prevention effect was clearly higher in the combination group. The prevention effects on nausea 7, 8 and 10 days after the start of chemotherapy, on appetite loss 2-10 days after it, and 2-5 days after its completion, were higher in the combination group. Granisetron revealed an excellent inhibitory effect on vomiting induced by remission induction chemotherapy for acute myeloid leukemia, but combination with granisetron and methylprednisolone was considered useful for nausea in the latter half of the treatment period and for appetite loss during the whole period.