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  • 1
    ISSN: 1569-8041
    Keywords: chemotherapy ; clinical trial ; emesis ; 5-HT3 antagonists
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: 5-HT3 antagonists are effective inreducing the acute nausea and vomiting caused by cancer chemotherapy. However,it is not clear whether continuing these agents beyond twenty four hours isuseful in controlling emesis on days two to seven after chemotherapy. Patients and methods: Four hundred seven patients receivingmoderately emetogenic chemotherapy who had been given dexamethasone 8 mg i.v.and either ondansetron 32 mg i.v. or dolasetron 2.4 mg/kg i.v. were randomizedto continue either an oral form of their 5-HT3 antagonist(ondansetron 8 mg b.i.d. or dolasetron 200 mg daily) plus dexamethasone 8 mgp.o. daily or dexamethasone alone for days two to seven. Endpoints assessedby self-report were: 1) complete control (no vomiting, no rescue medications,no missing data) of emesis; 2) nausea severity; and 3) quality-of-life asmeasured by the EORTC QLQ-C30. Results: Continuation of 5-HT3 antagonists improvedslightly, but not significantly, the complete control rate (47% vs.41%; P = 0.24 one-sided) after chemotherapy. However, mean nauseaseverity was significantly (P = 0.015 one sided) reduced (by 3 mm on a10 cm scale) on the combined arm. Minimal differences in quality of life wereobserved. Conclusion: The benefit of continuing 5-HT3antagonists beyond 24 hours is modest and the merits of routine use in thesecircumstances debatable.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: antifolate ; colorectal cancer ; phase II trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Metastatic colon cancer is difficult to treat with treatment being palliative and with little effect on survival. This trial has evaluated the effects of LY231514 (Multitargeted antifolate (MTA)) given to previously untreated patients with recurrent or metastatic colorectal carcinoma. Patients and methods: All patients were required to have a histological diagnosis of colorectal adenocarcinoma with measurable disease and no prior chemotherapy for metastatic disease. Patients had to have had performance status of 0–2, pretreatment absolute granulocyte count of ≥1.5 × 109/l and a platelet count of ≥150 × 109l. Patients received MTA at a dose of 600 mg/m2 by 10 minute infusion on day 1 repeated every 21 days. After the first 9 patients, this dose was reduced down to 500 mg/m2 every 21 days because of toxicity. Doses of MTA were modified depending on nadir counts. Results: Thirty-two eligible patients were enrolled and twenty-nine were evaluable for response. Three patients did not have repeat radiological testing to determine response because they went off study after only one cycle of treatment due to toxicity. In the 29 evaluable patients, there was 1 complete response, 4 partial responses and 14 patients with stable disease. Response rate was 17.2% (95% confidence intervals: 5.8%–35.8%). All responses occurred in the patients receiving a starting dose of MTA 500 mg/m2. Median time to progression for all eligible patients was 3.3 months. The most common toxicities experienced were mild to moderate fever, lethargy, anorexia, nausea, vomiting, stomatitis, abdominal pain, diarrhea, and skin rash. There was one death due to sepsis. Conclusion: Single-agent MTA at 500 mg/m2 given every three weeks has modest activity in metastatic colorectal carcinoma.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2649
    Keywords: Quality of life ; anti-emetic therapy ; questionnaire administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies conducted by our group suggested that the ability to demonstrate an impact of emesis control on quality of life might depend upon when an quality of life instrument was administered in relation to chemotherapy and on the time frame of the questionnaire. This study was conducted to address this issue. Six hundred and fifty patients receiving moderately emetogenic chemotherapy in a randomized trial comparing a variety of anti-emetic regimens were allocated to four different modes of administration (days 4 and 8; 3 and 7 day time frames) of the QLQ-C30. Patients who completed the questionnaire at the time of maximal impact of chemotherapy (day 3) were more likely to report deterioration in quality of life. Patients who completed questionnaires at day 8 were more likely to report deterioration in quality of life if their questionnaire had a 7 day time frame rather than a 3 day time frame. Patients receiving more effective anti-emetic therapy had better quality of life. It was concluded that better anti-emetic control improves quality of life after moderately emetogenic chemotherapy. In studying quality of life in situations where the impact of treatment waxes and wanes, careful attention needs to be paid to scheduling the administration of questionnaires and to their time frame.
    Type of Medium: Electronic Resource
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