RESUMEN
AIMS AND BACKGROUND: MRCC responds poorly to usual treatments. Recently floxuridine (FUDR) has been administered by chronomodulated infusion, obtaining interesting results. In order to simplify the infusion, we used continuous non chronomodulated infusion. METHODS: We treated 17 patients affected by MRCC with continuous non chronomodulated infusion of FUDR. Toxicity was evaluated according to WHO criteria. Responses were recorded as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). RESULTS: Sixty-four courses of therapy were administered; 15/17 patients, treated with a median of 4 cycles, were evaluable for the response. Only 1 patient showed a grade 3 toxicity (mucositis and diarrhoea); 6 patients showed grade 1-2 diarrhoea; 2 grade 1-2 nausea and vomiting; 1 grade 2 anaemia and thrombocytopenia. No patient obtained CR; 2 PR (lasting 7 and 9 months respectively) and 4 SD (lasting 4,5,6 and 9 months) were observed. CONCLUSIONS: In our experience continuous non chronomodulated infusion of FUDR did not show important general toxicity. The observed responses were not good enough. We think that a better selection of patients (good performance status) and the use of FUDR in an earlier stage of disease, can obtain better results.
Asunto(s)
Carcinoma de Células Renales/tratamiento farmacológico , Floxuridina/administración & dosificación , Neoplasias Renales/tratamiento farmacológico , Adulto , Anciano , Antimetabolitos Antineoplásicos/administración & dosificación , Femenino , Floxuridina/efectos adversos , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Interleukin-2 therapy is known to cause many biologic effects, which are enhanced by the administration of interferon prior to or immediately after interleukin-2 infusion. Some of these effects could be related to the clinical response. METHODS: Sixteen patients with metastatic renal cell carcinoma were treated with continuous infusion of interleukin-2 plus alpha-2 interferon. Differential leukocyte count and lymphocyte subset evaluation were performed every 3 days during interleukin-2 treatment. At each cycle, the presence of the following antibodies was tested: antithyroid, antinuclear, antiplatelet and antierythrocyte. RESULTS: Fifteen patients were evaluable for response. No complete response was observed. Five patients obtained partial response (33%) and 3 stable disease (20%): 2 of them underwent surgical resection of metastases and obtained complete response. Some of our patients showed a significant increase in eosinophils, CD25+ lymphocytes and antithyroid antibodies. The association of these parameters, calculated with a "score" system, was also related to a better clinical response. CONCLUSIONS: Eosinophils, CD25+ lymphocytes and antithyroid antibodies could have a predictive value for the efficacy of interleukin-2 and alpha-2 interferon therapy in metastatic renal cell carcinoma.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Renales/sangre , Carcinoma de Células Renales/tratamiento farmacológico , Neoplasias Renales/sangre , Neoplasias Renales/tratamiento farmacológico , Adulto , Anciano , Anticuerpos Antinucleares/sangre , Anticuerpos Antineoplásicos/sangre , Autoanticuerpos/sangre , Plaquetas/inmunología , Carcinoma de Células Renales/inmunología , Carcinoma de Células Renales/secundario , Eritrocitos/inmunología , Femenino , Humanos , Interferón-alfa/administración & dosificación , Interleucina-2/administración & dosificación , Neoplasias Renales/inmunología , Neoplasias Renales/patología , Recuento de Leucocitos , Subgrupos Linfocitarios , Masculino , Persona de Mediana Edad , Glándula Tiroides/inmunologíaRESUMEN
Forty cases of cervical (excluding supraclavicular) node metastases from unknown primary tumors were observed at the medical oncology department of a large general hospital. Histologically they were epidermoid carcinoma (18 cases), undifferentiated carcinoma (16 cases) and adenocarcinoma (6 cases). In 8 patients the primary was subsequently diagnosed. Four patients were untreatable or refused treatment when diagnosed. The 3-year survival of the 36 treated patients was only 22% - indicating a poor prognosis is for this uncommon form of presentation. Patients should be treated as aggressively as possible in an attempt to eradicate the occult primary.