Randomized study of zorubicin versus zorubicin-cisplatin in undifferentiated carcinoma of the nasopharynx (UCNT)
| Autor: | I. Pendjer, Svetislav Jelić, V. Jovanovic, L. Mitrović, N. Milanović, Miroslav Kreačić, V. Kovčin, M. Opric, Z. Ristović |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Nausea medicine.medical_treatment Gastroenterology Evaluable Patient chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies Aged Chemotherapy Antibiotics Antineoplastic business.industry Zorubicin Daunorubicin Hematology Middle Aged medicine.disease Chemotherapy regimen Surgery Oncology chemistry Vomiting Female medicine.symptom Cisplatin business Febrile neutropenia Epirubicin medicine.drug |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 8(8) |
| ISSN: | 0923-7534 |
| Popis: | Summary Background: The most active chemotherapy regimens in UCNT were those combining anthracyclines (doxorubicin or epirubicin) and cisplatin. Our previous pilot study on 37 patients treated with the zorubicin-cisplatin combination with a RR of 67% and literature data about other anthracyclines such as epirubicin achieving a response rate of over 50% were the basis of this randomized study comparing efficacy and toxicity of the combination vs. zorubicin as monotherapy. Patients and methods: A total of 80 patients entered the study. The diagnosis of UCNT was confirmed by two independent pathologists. All patients had their primary tumors in the nasopharynx. The patients were randomized in two groups: group A (zorubicin 325 mg/m2, day 1), and group B (zorubicin 250 mg/m2, day 1 and cisplatin 30 mg/m 2, days 2-5). The inter-cycle interval was four weeks. The two groups were well balanced according to sex, age, stage Ho and TNM stage. Results: Group A: 40 patients included, 34/40 evaluable for activity. Activity on evaluable patient basis: CR 4/34 (11.75%), PR 4/34, SD 14/34, PD 12/34, response rate 8/34 (23.5%); response rate on intent to treat basis 8/40 (20%). Toxicity: granulocytopenia grade 3—4 6/40, thrombocytopenia grade 3-4 2/40, no febrile neutropenias, nausea/vomiting any grade 3/40, cardiac toxicity any grade (rhythm) 3/40 other toxicities minor or absent. Group B: 40 patients included, 36/40 evaluable for activity. Activity on evaluable patient basis: CR 10/36 (27.78%), PR 17/36, SD 3/36, PD 6/36, response rate 27/36 (75%); response rate on intent to treat basis 27/40 (67.5%). Toxicity: granulocytopenia grade 3-^4 10/40, thrombocytopenia grade 3-4 8/40, two febrile neutropenias, nausea/vomiting any grade 13/40, other toxicities mild or absent. Of the group of patients achieving a CR, four relapsed following 7,11, 22 and 23 months, one was lost to follow-up, one died after six months from fulminant hepatitis B and eight are in complete remission lasting for 30+ to 66+ months. Following CR achievement none received any consolidation radiotherapy, and the projected five years of freedom from relapse for complete responders is about 60%. Conclusion: Zorubicin is an effective drug in UCNT and its combination with cisplatin has a significant activity and an acceptable toxicity. |
| Databáze: | OpenAIRE |
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