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Neoadjuvant chemotherapy with carboplatin, ifosfamide, and peplomycin in advanced cervical squamous cell carcinoma (1999)

Nagano, T. ; Ozawa, M. ; Suzuki, A. ; [et al.]

Springer

International journal of clinical oncology 4 (1999), S. 358-363

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ISSN: 1437-7772

Keywords: Key words Uterine cervical carcinoma ; Neoadjuvant chemotherapy ; Prognosis ; Carboplatin ; Ifosfamide ; Peplomycin

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Background. To control advanced cervical squamous cell carcinoma more effectively and more easily, we used neoadjuvant chemotherapy, with three drugs carboplatin, ifosfamide, and peplomycin (PIP), in a study performed from July 1990 to October 1994 in nine Institutions. Methods. Sixty-five patients with untreated, inoperable squamous cell carcinoma of the cervix were treated with carboplatin (300 mg/m2 IV; low-dose PIP regimen, or 400 mg/m2 IV; high-dose PIP regimen) on day 1, ifosfamide (1000 mg/m2, IV) on days 1–3, and peplomycin (5 mg/body, IM) on days 1–6. The low-dose PIP was given between July 1990 and April 1992, and the high-dose PIP from May 1992 to October 1994. Results. Response rates for the low- and high-dose PIP regimens were 42.9% (12/28) and 59.5% (22/37), respectively. Measurable lesions were recognized in the cervix, pelvic lymph node (PeN), paraaortic lymph node (PAN), lung, and supraclavicular lymph node. Response rates in these individual lesions to our low- and high-dose PIP regimens were 35.7% (10/28) and 55.6% (20/36), respectively in the cervical lesion and more than 50% for both regimens in the PeN and PAN metastatic lesions, while the supraclavicular lymph node metastatic lesions responded poorly to both regimens. After low-dose PIP, surgery was performed in 2 patients (2/28; 7.1%), while after high-dose PIP, 12 patients (12/37; 32.4%) underwent surgery. The 3-year survival rate of patients with high-dose PIP was significantly higher than that of those with low-dose PIP (P 〈 0.01). Conclusions. Neoadjuvant chemotherapy with PIP appears feasible and effective. The link between dosage and treatment response and achievable surgery rate and survival rates suggests that results might be further optimized by considering patients' renal function, and utilizing the Calvert formula for dosing analysis.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s101470050085

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Detection of histamine-induced capillary protein leakage and hypovolaemia by determination of indocyanine green and glucose dilution method in dogs (1999)

Suzuki, A. ; Ishihara, H. ; Hashiba, E. ; [et al.]

Springer

Intensive care medicine 25 (1999), S. 304-310

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ISSN: 1432-1238

Keywords: Key words Histamine ; Protein permeability ; Measurements technique ; Indocyanine green ; Glucose

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Objective: The plasma volume of histamine-induced protein capillary leakage may be overestimated when this is determined using the indocyanine green (ICG) dilution method (Vd-ICG), since this dye binds to plasma proteins. The initial distribution volume of glucose (IDVG) has been shown to indicate the central extracellular fluid volume including plasma. Accordingly, the overestimation would be detected by a higher Vd-ICG/IDVG ratio. Our study was intended to examine whether the simultaneous measurement of these two variables can evaluate histamine-induced protein leakage and associated hypovolaemia. Design: Prospective animal study. Setting: Institutional animal research laboratory. Subjects: Twenty-four anaesthetized and ventilated mongrel dogs. Interventions: Anaesthetized animals were mechanically ventilated and received infusions of normal saline (n = 8), histamine 50 μg/kg per h (n = 8), or histamine 100 μg/kg per h. The Vd-ICG and IDVG were calculated using a one-compartment model by simultaneous administration of ICG 0.5 mg/kg, and glucose 100 mg/kg followed by serial arterial blood sampling. Measurements and results: In both histamine groups, a significant elevation of haematocrit and a decrease of plasma albumin concentration were found (p 〈 0.05). Although the IDVG decreased following histamine administration (p 〈 0.05), the Vd-ICG remained unchanged. The Vd-ICG/IDVG ratio increased in a dose-dependent manner after histamine administration (p 〈 0.05), but remained unchanged following normal saline administration. Conclusion: The results suggest that the Vd-ICG/IDVG ratio and the IDVG are useful in evaluating the magnitude of the leakage and hypovolaemia.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s001340050840

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Cerebral blood-flow responses to induced hypotension and to CO2 inhalation in patients with major cerebral artery occlusive disease: a positron-emission tomography study (1999)

Nishimura, S. ; Suzuki, A. ; Hatazawa, J. ; [et al.]

Springer

Neuroradiology 41 (1999), S. 73-79

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ISSN: 1432-1920

Keywords: Key words Cerebral blood flow ; Autoregulation ; Cerebrovascular disease ; Positron-emission tomography

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Our aim was to study the relationship between cerebral blood flow (CBF) responses to induced hypotension and to CO2 inhalation in patients with occlusive disease of the carotid or middle cerebral arteries. In 13 patients (8 men, 5 women) aged 31–73 years (mean ± 1 SD = 63.2 ± 10.6), regional CBF values during the resting state (CBFrest), 7 % CO2 inhalation (CBFhypercapnia), and hypotension induced by 10–20 μg/kg/min intravenous trimethaphan (CBFhypotension) were measured using positron-emission tomography (PET) with H2 15O. The % CBF change during induced hypotension (% CBFhypotension) was defined as (CBFhypotension− CBFrest)/CBFrest multiplied by 100. The % CBF change during CO2 inhalation (% CBFhypercapnia) was defined as (CBFhypercapnia− CBFrest)/CBFrest/mm Hg arterial partial pressure of CO2× 100. We defined symptomatic hemispheres as those with a stenotic or occlusive lesion with neurological symptoms or signs and asymptomatic hemispheres as those which had a similar lesion and/or were influenced by the collateral flow pattern without neurological symptoms. In the territory of the occlusive lesion, % CBFhypotension correlated significantly with % CBFhypercapnia (r = 0.793, P 〈 0.002) in the symptomatic hemispheres. In the brain regions in which trimethaphan did not induce a reduction in CBF, % CBFhypercapnia was 6.13 ± 1.79. In those in which % CBFhypotension ranged from 0 to −5, from −5 to −10, and more than −10 %, % CBFhypercapnia was 4.05 ± 1.99, 3.21 ± 1.17, and 1.73 ± 1.61, respectively, with significant differences between each pair of groups. In the asymptomatic hemispheres, % CBFhypotension also correlated with % CBFhypercapnia (r = 0.979, P 〈 0.0001). Failure to maintain CBF during induced hypotension was associated with diminished cerebrovascular vasoreactivity to hypercapnia in patients with arterial disease. This may indicate that failure of autoregulation can be assessed by the CBF response to both induced hypotension and CO2 inhalation. From the technical point of view, estimation of the CO2 response may be useful for assessing failure of autoregulation.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s002340050709

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