Seminars in oncology
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Seminars in oncology · Jun 1998
ReviewDocetaxel in the management of advanced non-small cell lung cancer.
Following encouraging phase I trials in non-small cell lung cancer, the semisynthetic taxoid docetaxel has been extensively studied in the phase 11 setting, most commonly using a dose of 100 mg/m2 every 3 weeks. Major objective response rates range from 21% to 38% in previously untreated patients. ⋯ However, the median survival durations achieved do not clearly exceed those with docetaxel monotherapy. Based on preclinical evidence of synergy, docetaxel also has been combined with vinorelbine and, using prophylactic granulocyte colony-stimulating factor, it has been possible to escalate the doses of both drugs to single-agent phase II dose intensity.
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Seminars in oncology · Jun 1998
Factors influencing quality of life in cancer patients: the role of transdermal fentanyl in the management of pain.
A transdermal fentanyl patch for the treatment of chronic cancer-related pain is available in four dosages (25, 50, 75, and 100 microg/hr). Fentanyl is released from a 72-hour reservoir by diffusion through a controlled-release membrane to the skin, through which it is absorbed into the microcirculation. The pharmacokinetics of fentanyl differ markedly as a function of the route of administration. ⋯ The convenient, once-every-72 hours dosing regimen is easily adjusted to the individual's need for around-the-clock pain control, and provides stable and predictable therapeutic drug plasma concentrations. Patient acceptability is high and the cost is lower than other methods required to deliver parenteral opioids. The recent development of an oral transmucosal fentanyl citrate delivery system for the treatment of breakthrough pain will further expand the use of transdermal fentanyl patches for the treatment of chronic pain.