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  • 1
    ISSN: 1569-8041
    Schlagwort(e): chemotherapy ; osteosarcoma ; relative dose intensity ; survival ; tumour response
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Despite advances in the treatment of primary limb osteosarcoma, the outcome of patients with primary metastatic and axial skeletal disease remains poor. The European Osteosarcoma Intergroup have assessed a combination chemotherapy regimen consisting of ifosfamide (IFOS) 3 g/m2/d1–2, doxorubicin (DOX) 25 mg/m2/d1–3 i.v. bolus and cisplatin (CDDP) 100 mg/m2/d1. Patients and methods: One hundred nine previously untreated patients with primary osteosarcoma were registered. Eligibility was confirmed in 103. At presentation, 45 eligible patients had metastatic disease, 15 axial skeletal primary tumours and 43 non-metastatic limb tumours. Results: The major toxicities were myelosuppression (90%, grade 3 or 4) and nausea and vomiting (74%, grade 3 or 4). Overall mean relative dose intensity (RDI) was 80% (88% CDDP, 75% IFOS, 81% DOX). Clinical response as measured by reduction in tumour volume occurred in 36% (95% confidence interval (95% CI): 27%–47%) of primary tumours. Response of pulmonary metastases to chemotherapy was seen in 33% (95% CI: 19%–49%). Good histological response (≥90% necrosis of the tumour) occurred in 33% (95% CI: 22%–45%) of resected tumours. Five-year survival was 62% in limb-non-metastatic, 41% in axial skeletal and 16% in limb metastatic patients. Conclusions: This regimen is active in osteosarcoma but does not appear to be more active than the two-drug CDDP–DOX regimen currently recommended by EOI.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1569-8041
    Schlagwort(e): germ cell tumours ; extragonadal ; mediastinum ; cisplatin-based chemotherapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Primary mediastinal non-seminomatous germ cell tumours (MNSGCT)constitute a rare malignancy. This study was performed to review ourexperience with cispatin-based chemotherapy in patients with MNSGCT. Patients and methods: Patients with MNSGCT treated with cisplatin-basedcombination chemotherapy between 1978–1995 in three university hospitalsin Spain were retrospectively studied. Results: There were 25 males and two females with a median age of 26 years(range 4–71). Fifteen patients had disease confined to the mediastinumand 12 had metastatic disease. All patients were treated with cisplatinchemotherapy regimens (PVB: 7, BEP: 6, and other regimens 12) and consideredfor residual mass surgery (RMS) when indicated. Eleven patients (40.7%)were rendered disease-free with initial treatment: four with chemotherapyalone, one with surgery plus adjuvant chemotherapy and six with chemotherapyplus RMS. Three of these patients relapsed at two, six and seven months. Theremaining 16 had unfavourable reponses (five partial response, three nochange, seven progressive disease and one toxic death) . Eleven patientsreceived salvage treatment but none of them achieved a durable response. Aftera median follow-up of 77 months (range 1–168), 10 patients remain alive.Actuarial survival at five years is 31.7%. No patients in this seriesdeveloped a haematological malignancy. Chromosomal analysis showed that 2 outof 10 patients (20%) had a 47XXY karyotype. Conclusions: Only patients who achieved disease-free status are likely tobe cured. Therefore, new up-front strategies are needed for the treatment ofMNSGCT.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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