Evaluation of adjuvant chemotherapy irinotecan + 5-fluorouracil + leucovorine in advanced colorectal cancer.

OBJECTIVE: to analyze clinical effectivity of chemotherapy based on Irinotecan, 5-Fluorouracyl and Folinic acid in patients with colorectal carcinoma. METHODS: prospective, randomized, open-label trial in group of 204 patients with advanced colorectal cancer randomized to either chemotherapy with irinotecan+5-FU+leucovorin or supportive care alone (control group) between January 1999--January 2005 was performed. Efficacy and safety of treatment was analysed. RESULTS: Administration of the irinotecan, 5FU, LV regimen to patients with stages II and III significantly improved 5-year survival (81% versus 66% and 66% versus 38%, respectively; p < 0.05). Palliative chemotherapy improved survivals also in stage IV, four patients survived 5 years. Adverse event occurred in 44 of 102 patients (43.1%). CONCLUSIONS: study confirms benefits of irinotecan chemotherapy administered to patients with advanced colorectal cancer. Preliminary data suggests that this chemotherapy regimen should be considered for first-line therapy in the adjuvant and palliative treatment of advanced colorectal cancer.

The clinical value of parenteral immunonutrition in surgical patients.

BACKGROUND & AIM: To analyze the clinical impact and cost-effectiveness of parenteral immunonutrition (PN). METHODS: Prospective clinical trial of a group of 105 patients operated on for gastric carcinoma between 2001-2003. During the postoperative period, patients were randomly allocated to one of three groups: standard PN (A), PN + glutamine (B) and PN + omega-3-FA (C). The rate and type of complications, hepatic and renal function, cost and treatment tolerance in all groups were analyzed. RESULTS: Postoperative complications were observed in 11 patients (36.6%) in group A, in 7 (23.3%) in B and in 8 (26.6%) in C. The most common complication was pneumonia. Prealbumin concentration and TLC increased faster in groups B and C. The length of hospital stay was significantly shorter in the immunonutrition groups. The cost of PN was highest in C group, while cost of hospital stay was longer in A. CONCLUSIONS: Immunostimulating parenteral nutrition helps to reduce the number of infectious complications, improves the function of the immune system, and has no influence on surgical complications, hepatic and renal function and protein synthesis. The cost of immunostimulating treatment based on omega-3-unsaturated fatty acids is higher than standard.

[Nutritional therapy and the immune system]. / Leczenie zywieniowe a uklad odpornosciowy.

Malnutrition is one of the consequences of chronic and neoplastic diseases. Therefore the attention has been paid recently to the most appropriate nutritional therapy in order to reduce the number of postoperative complications, mortality rates and the length of hospitalisation. Administered nutritional substances should cover basic and calorific demands. However it was observed that malnutrition leads to the state of immunosuppression. Several studies were carried out using potentially immunostimulating substances e.g. nucleotides, some of amino acids, vitamins and trace elements or unsaturated fatty acids, in addition to the nutritional support. The authors are presenting a review of the current state of knowledge and data from clinical trials on the immunostimulating role of the nutritional components.

Double-blind pilot-study on the efficacy of enzyme therapy in advanced colorectal cancer.

All tested variables showed a tendency in favor for Wobe-Mugos E therapy as addition to standard therapy. Enzymes improve the quality of life by reducing cancer disease typical symptoms, they reduce side effects of chemo-/radiotherapy and they have a potential of prolonging life (preliminary data only).