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Chemotherapy-related Toxicity (chemotherapy-related + toxicity)
Selected AbstractsToxicity of docetaxel plus cyclophosphamide as adjuvant therapy for breast cancer in Chinese patients , the Hong Kong experienceASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 2 2009Tsz-Kok YAU Abstract Aims: The docetaxel and cyclophosphamide (TC) regimen is increasingly popular as adjuvant chemotherapy for operable breast cancers. We conducted a retrospective study in Hong Kong to evaluate the toxicity of this regimen in Chinese patients. Methods: Between January 2007 and May 2008 76 female Chinese patients with resected stage I,III operated invasive breast cancer were treated with 4 cycles of TC (75 and 600 mg/m2, respectively, administered i.v. every 3 weeks for four cycles) in two public regional cancer centers of Hong Kong. A total of 24 (32%) patients also received primary prophylactic ciprofloxacin (500 mg twice daily, day 5,14). Chemotherapy-related toxicities were graded by the CTCAE version 3.0. Results: The median age was 50 (range 26,67). A total of 68 (89%) patients successfully completed four cycles of chemotherapy. 72 (95%) and 16 (21%) patients developed grade 3,4 neutropenia and febrile neutropenia (FN) infection, respectively, in one or more cycles. However, no grade 3,4 anemia or thrombocytopenia events were observed. Other grade 3,4 non-hematological toxicities were also uncommon, apart from allergic reactions in two (3%) patients. No viral reactivation was observed among the 8 hepatitis B carriers. Patients with prophylactic ciprofloxacin had less grade 3,4 FN infection (13% vs 25%, P = 0.214) and a higher chance of receiving the full scheduled dose (88% vs 62%, P = 0.045) than patients without. Conclusion: The myelotoxicity of TC was substantially higher in Chinese patients compared with non-Chinese patients in developed countries. Routine prophylactic measures are recommended to maintain the dose levels and reduce the risk of FN. [source] Adjuvant and neoadjuvant chemotherapy for Ewing sarcoma family tumors in patients aged between 40 and 60,CANCER, Issue 4 2007Report of 35 cases, comparison of results with 586 younger patients treated with the same protocols in the same years Abstract BACKGROUND. The clinical and pathologic features of 46 patients 40 to 60 years old with Ewing sarcoma family tumor (ESFT) diagnosed at the authors' institute between 1972 and 2000 were reviewed. METHODS. Ten patients with metastatic tumors at presentation went elsewhere for treatment; 35 of 36 remaining cases with localized disease were treated at the authors' institution according to different chemotherapy protocols activated in successive years. In patients with nonmetastatic tumors local treatment was surgery in 9 patients, radiotherapy in 16, and surgery followed by radiotherapy in 10. RESULTS. At follow-up times ranging from 6 and 34 years (mean, 17.8 years), 15 patients (42.9%) remained continuously disease-free, 19 experienced recurrence, and 1 died of chemotherapy-related toxicity. The 5- and 10-year event-free survivals were 42.9% and 35.2%, respectively, and the 5- and 10-year overall survivals were 46.1% and 42.8%, respectively. Comparing this group of patients with 586 cases of younger patients seen in the same period at Rizzoli, the only difference between the 2 groups was a significantly higher rate of tumors located in the soft tissues with a larger volume in the older group. The results achieved were comparable in the 2 groups, although the older group had a lower chemotherapy dose-intensity and a higher rate of WHO grade 4 hematologic toxicity. CONCLUSIONS. For patients with localized disease treated with adjuvant and neoadjuvant chemotherapy the results were essentially comparable in the 2 groups. It is concluded that patients 40 years or older with ESFT should be treated in the same way as younger patients and included in treatment trials for these tumors. Cancer 2007. © 2007 American Cancer Society. [source] Influence of body mass index on outcomes and treatment-related toxicity in patients with colon carcinomaCANCER, Issue 3 2003Jeffrey A. Meyerhardt M.D., M.P.H. Abstract BACKGROUND Obesity is a risk factor for the development of colon carcinoma. The influence of body mass index (BMI) on long-term outcomes and treatment-related toxicity in patients with colon carcinoma has not been well characterized. METHODS This cohort study was conducted within a large, randomized adjuvant chemotherapy trial of 3759 men and women with high-risk, Stage II and Stage III colon carcinoma who were treated between 1988 and 1992 throughout the United States. With a median follow-up of 9.4 years, the authors examined the influence of BMI on disease recurrence, overall survival, and treatment-related toxicity. RESULTS Compared with women of normal weight (BMI, 21.0,24.9 kg/m2), obese women with colon carcinoma (BMI , 30.0 kg/m2) experienced significantly worse overall mortality (hazard ratio [HR], 1.34; 95% confidence interval [95% CI], 1.07,1.67) and a nonsignificant increase in the risk of disease recurrence (HR, 1.24; 95% CI, 0.98,1.59). The influence of BMI among women was not related to any differences in chemotherapy dose-intensity across categories of BMI. In contrast, BMI was not related significantly to long-term outcomes among male patients in this cohort. Among all study participants, obese patients had significantly lower rates of Grade 3,4 leukopenia and lower rates of any Grade , 3 toxicity compared with patients of normal weight. CONCLUSIONS Among women with Stage II,III colon carcinoma, obesity was associated with a significant increase in overall mortality as well as a borderline significant increase in disease recurrence. Nonetheless, obesity was not associated with any increase in chemotherapy-related toxicity. Cancer 2003;98:484,95. © 2003 American Cancer Society. DOI 10.1002/cncr.11544 [source] Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trialCOLORECTAL DISEASE, Issue 10Online 2010T. Hasenberg Abstract Aim, Patients suffering from advanced colorectal cancer can experience unintended weight loss and/or treatment-induced gastrointestinal toxicity. Based on current evidence, the routine use of parenteral nutrition (PN) for patients with colorectal cancer is not recommended. This study evaluates the effect of PN supplementation on body composition, quality of life (QoL), chemotherapy-associated side effects and survival in patients with advanced colorectal cancer. Method, Eighty-two patients with advanced colorectal cancer receiving a palliative chemotherapy were prospectively randomized to either oral enteral nutrition supplement (PN-) or oral enteral nutrition supplement plus supplemental PN (PN+). Every 6 weeks body weight, body mass index (BMI), chemotherapy-associated side effects and caloric intake were assessed, haemoglobin and serum albumin were measured. Body composition was assessed by body impedance analysis, and QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) QLQC30 questionnaire. Results, No differences were evident at baseline between the groups for age, sex, diagnosis, weight, BMI or QoL. A difference in BMI was observed by week 36, whereas differences of the mean body cell mass could be observed from week 6, albumin dropped significantly in the PN- group in week 36 and QoL showed significant differences from week 18. Chemotherapy-associated side effects were higher in PN-. The survival rate was significantly greater in the PN+ group. Conclusion, A supplementation with PN slows weight loss, stabilizes body-composition and improves QoL in patients with advanced colorectal cancer. Furthermore, it can reduce chemotherapy-related side effects. [source] | ||||||||||