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  • pancreatic cancer  (2)
  • Key words 5-Fluorouracil-induced diarrhea  (1)
  • 1
    ISSN: 1569-8041
    Keywords: docetaxel ; gemcitabine ; pancreatic cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Gemcitabine and docetaxel have been claimed to be active single agents in advanced pancreatic cancer. We determined the maximum tolerable dose of docetaxel combined with a weekly fixed dose of gemcitabine and assessed the activity of this combination in advanced pancreatic cancer. Patients and methods: Phase I. Patients were treated with gemcitabine on days 1 and 8, every three weeks, at a fixed dose of 1,000 mg/m2; docetaxel was given at escalating doses starting from 70 mg/m2 on day 8. Phase II. In accord with the optimal two-stage phase II study design, 18 patients were treated with gemcitabine (1000 mg/m2) and the maximum tolerable dose of docetaxel (70 mg/m2). Results: Phase I. Dose-limiting toxicities occurred at the second dose level of docetaxel (80 mg/m2), with all three patients developing grades 3 or 4 neutropenia. Consequently, the dose tested in the phase II study was 70 mg/m2. Phase II. In the 18 patients enrolled in the study, we registered only one partial response. The time to progression was 3 months, and the median treatment survival was 5.4 months. Grade 3–4 toxicities consisted of neutropenia (three episodes) and thrombocytopenia (two episodes). Furthermore, 10 patients complained of grade 3 fatigue. Conclusions: The addition of docetaxel to gemcitabine does not appear to be useful in advanced pancreatic cancer, since gemcitabine alone achieves similar results.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-7339
    Keywords: Key words 5-Fluorouracil-induced diarrhea ; Prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Diarrhea is one of the dose-limiting toxicities for administration of fluorouracil (5FU) in patients with colorectal cancer and can result in severe morbidity and mortality. No well-defined prognostic factors influencing 5FU-associated diarrhea have been identified, which means its occurrence is unforeseeable. The aim of this study was to check whether any characteristics related to patients or chemotherapy could allow the identification of subsets of patients at higher risk of developing diarrhea while receiving a regimen containing 5FU. A logistic regression analysis was performed with age, sex, site of primary tumor, presence of primary tumor, presence of colostomy, time since surgery, number of courses of chemotherapy, diarrhea in previous courses, season of treatment, and chemotherapeutic regimens used as model parameters to predict occurrence of diarrhea in 258 colorectal cancer patients receiving a 5FU-containing regimen. Presence of primary tumor (P=0.004), previous episodes of chemotherapy-related diarrhea (P=0.00005) and summer season (P=0.014) were found to be significant risk factors for developing diarrhea. The other variables examined, such as age, sex, chemotherapeutic regimen, site of primary tumor, presence of colostomy, and time since surgery, were not significantly correlated to diarrhea. Chemotherapeutic regimen was the only parameter that allowed prediction of the severity of diarrhea : 5FU/6S-leucovorin/interferon caused more severe diarrhea, followed by 5FU/leucovorin weekly. Although the analysis of these clinical features does not seem to allow the definition of a well-defined subset of colorectal cancer patients at higher risk of 5FU-induced diarrhea, it can be recommended that patients with primary tumor, or who have experienced diarrhea in earlier courses of chemotherapy or are receiving treatment in summer should be carefully monitored, especially in the first cycles.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1569-8041
    Keywords: gemcitabine ; infusion schedule ; pancreatic cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Laboratory evidences suggest the possibility that aninfusion rate of 10 mg/m2/min may be more effective than thestandard 30-min infusion of Gemcitabine (GEM). Patients and methods:Thirty-four patients with histologicallyverified locally unresectable and/or metastatic pancreatic carcinoma receivedGEM at the dose of 1,500 mg/m2 with an infusion rate of 10mg/m2/min, associated to 5-fluorouracil (5-FU) at the dose of 600mg/m2. Both drugs were administered weekly for two consecutiveweeks out of every three weeks. Results:One complete and five partial responses have beenobserved for an overall response rate of 17% (95% CI:3%–27%). The time to progression was 3.7 months with amedian survival of 5.7 months. A clinical benefit was obtained in 5 of 29patients (17%). Grade 3–4 WHO toxicities included neutropenia(35%) and thrombocytopenia (10%). Conclusion:It is unlikely that a fixed dose rate infusion of GEM,at least with this dose, can improve palliation in comparison with thestandard 30-min infusion schedule in advanced pancreatic cancer.
    Type of Medium: Electronic Resource
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