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1.
Nat Commun ; 14(1): 5426, 2023 09 13.
Article in English | MEDLINE | ID: mdl-37704608

ABSTRACT

Protected areas are considered fundamental to counter biodiversity loss. However, evidence for their effectiveness in averting local extinctions remains scarce and taxonomically biased. We employ a robust counterfactual multi-taxon approach to compare occupancy patterns of 638 species, including birds (150), mammals (23), plants (39) and phytoplankton (426) between protected and unprotected sites across four decades in Finland. We find mixed impacts of protected areas, with only a small proportion of species explicitly benefiting from protection-mainly through slower rates of decline inside protected areas. The benefits of protection are enhanced for larger protected areas and are traceable to when the sites were protected, but are mostly unrelated to species conservation status or traits (size, climatic niche and threat status). Our results suggest that the current protected area network can partly contribute to slow down declines in occupancy rates, but alone will not suffice to halt the biodiversity crisis. Efforts aimed at improving coverage, connectivity and management will be key to enhance the effectiveness of protected areas towards bending the curve of biodiversity loss.


Subject(s)
Biodiversity , Fresh Water , Animals , Finland , Phenotype , Phytoplankton , Mammals
2.
Environ Pollut ; 261: 114054, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32078876

ABSTRACT

Mosses take up nitrogen (N) mainly from precipitation through their surfaces, which makes them competent bioindicators of N deposition. We found positive relationships between the total N concentration (mossN%) of common terrestrial moss species (feather mosses Pleurozium schreberi and Hylocomium splendens, and a group of Dicranum species) and different forms of N deposition in 11-16 coniferous forests with low N deposition load in Finland. The mosses were collected either inside (Dicranum group) or both inside and outside (feather mosses) the forests. Deposition was monitored in situ as bulk deposition (BD) and stand throughfall (TF) and detected for ammonium (NH4+-N), nitrate (NO3--N), dissolved organic N (DON), and total N (Ntot, kg ha-1yr-1). Ntot deposition was lower in TF than BD indicating that tree canopies absorbed N from deposition in N limited boreal stands. However, mossN% was higher inside than outside the forests. In regression equations, inorganic N in BD predicted best the mossN% in openings, while DON in TF explained most variation of mossN% in forests. An asymptotic form of mossN% vs. TF Ntot curves in forests and free NH4+-N accumulation in tissues in the southern plots suggested mosses were near the N saturation state already at the Ntot deposition level of 3-5 kg ha-1yr-1. N leachate from ground litterfall apparently also contributed the N supply of mosses. Our study yielded new information on the sensitivity of boreal mosses to low N deposition and their response to different N forms in canopy TF entering moss layer. The equations predicting the Ntot deposition with mossN% showed a good fit both in forest sites and openings, especially in case of P. schreberi. However, the open site mossN% is a preferable predictor of N deposition in monitoring studies to minimize the effect of tree canopies and N leachate from litterfall on the estimates.


Subject(s)
Bryophyta , Finland , Forests , Nitrogen/analysis , Trees
3.
Glob Chang Biol ; 26(2): 392-409, 2020 02.
Article in English | MEDLINE | ID: mdl-31437331

ABSTRACT

Nutrient availability influences virtually every aspect of an ecosystem, and is a critical modifier of ecosystem responses to global change. Although this crucial role of nutrient availability in regulating ecosystem structure and functioning has been widely acknowledged, nutrients are still often neglected in observational and experimental synthesis studies due to difficulties in comparing the nutrient status across sites. In the current study, we explain different nutrient-related concepts and discuss the potential of soil-, plant- and remote sensing-based metrics to compare the nutrient status across space. Based on our review and additional analyses on a dataset of European, managed temperate and boreal forests (ICP [International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests] Forests dataset), we conclude that the use of plant- and remote sensing-based metrics that rely on tissue stoichiometry is limited due to their strong dependence on species identity. The potential use of other plant-based metrics such as Ellenberg indicator values and plant-functional traits is also discussed. We conclude from our analyses and review that soil-based metrics have the highest potential for successful intersite comparison of the nutrient status. As an example, we used and adjusted a soil-based metric, previously developed for conifer forests across Sweden, against the same ICP Forests data. We suggest that this adjusted and further adaptable metric, which included the organic carbon concentration in the upper 20 cm of the soil (including the organic fermentation-humus [FH] layer), the C:N ratio and pHCaCl2 of the FH layer, can be used as a complementary tool along with other indicators of nutrient availability, to compare the background nutrient status across temperate and boreal forests dominated by spruce, pine or beech. Future collection and provision of harmonized soil data from observational and experimental sites is crucial for further testing and adjusting the metric.


Subject(s)
Ecosystem , Soil , Benchmarking , Forests , Nitrogen , Nutrients , Sweden , Trees
4.
Sci Total Environ ; 653: 995-1004, 2019 Feb 25.
Article in English | MEDLINE | ID: mdl-30759623

ABSTRACT

Biological fixation of atmospheric nitrogen (N2) by bryophyte-associated cyanobacteria is an important source of plant-available N in the boreal biome. Information on the factors that drive biological N2 fixation (BNF) rates is needed in order to understand the N dynamics of forests under a changing climate. We assessed the potential of several cryptogam species (the feather mosses Hylocomium splendens and Pleurozium schreberi, a group of Dicranum bryophytes, two liverworts, and Cladina lichens) to serve as associates of cyanobacteria or other N2-fixing bacteria (diazotrophs) using acetylene reduction assay (ARA). We tested the hypotheses that the legacy of chronic atmospheric N deposition reduces BNF in the three bryophyte species, sampled from 12 coniferous forests located at latitudes 60-68° N in Finland. In addition, we tested the effect of moisture and temperature on BNF. All species studied showed a BNF signal in the north, with the highest rates in feather mosses. In moss samples taken along the north-south gradient with an increasing N bulk deposition from 0.8 to 4.4 kg ha-1 year-1, we found a clear decrease in BNF in both feather mosses and Dicranum group. BNF turned off at N deposition of 3-4 kg ha-1 year-1. Inorganic N (NH4-N + NO3-N) best predicted the BNF rate among regression models with different forms of N deposition as explanatory variables. However, in southern spruce stands, tree canopies modified the N in throughfall so that dissolved organic N (DON) leached from canopies compensated for inorganic N retained therein. Here, both DON and inorganic N negatively affected BNF in H. splendens. In laboratory experiments, BNF increased with increasing temperature and moisture. Our results suggest that even relatively low N deposition suppresses BNF in bryophyte-associated diazotrophs. Further, BNF could increase in northern low-deposition areas, especially if climate warming leads to moister conditions, as predicted.


Subject(s)
Bryophyta/metabolism , Forests , Nitrogen Fixation , Nitrogen/analysis , Environmental Monitoring , Finland , Humidity , Rain , Temperature
6.
Nature ; 558(7709): 243-248, 2018 06.
Article in English | MEDLINE | ID: mdl-29875410

ABSTRACT

Explaining the large-scale diversity of soil organisms that drive biogeochemical processes-and their responses to environmental change-is critical. However, identifying consistent drivers of belowground diversity and abundance for some soil organisms at large spatial scales remains problematic. Here we investigate a major guild, the ectomycorrhizal fungi, across European forests at a spatial scale and resolution that is-to our knowledge-unprecedented, to explore key biotic and abiotic predictors of ectomycorrhizal diversity and to identify dominant responses and thresholds for change across complex environmental gradients. We show the effect of 38 host, environment, climate and geographical variables on ectomycorrhizal diversity, and define thresholds of community change for key variables. We quantify host specificity and reveal plasticity in functional traits involved in soil foraging across gradients. We conclude that environmental and host factors explain most of the variation in ectomycorrhizal diversity, that the environmental thresholds used as major ecosystem assessment tools need adjustment and that the importance of belowground specificity and plasticity has previously been underappreciated.


Subject(s)
Biodiversity , Forests , Fungi/classification , Fungi/physiology , Host Microbial Interactions , Mycorrhizae/physiology , Soil Microbiology , Europe , Fungi/isolation & purification , Geographic Mapping
7.
New Phytol ; 215(3): 977-991, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28586137

ABSTRACT

The tree root-mycorhizosphere plays a key role in resource uptake, but also in the adaptation of forests to changing environments. The adaptive foraging mechanisms of ectomycorrhizal (EcM) and fine roots of Picea abies, Pinus sylvestris and Betula pendula were evaluated along a gradient from temperate to subarctic boreal forest (38 sites between latitudes 48°N and 69°N) in Europe. Variables describing tree resource uptake structures and processes (absorptive fine root biomass and morphology, nitrogen (N) concentration in absorptive roots, extramatrical mycelium (EMM) biomass, community structure of root-associated EcM fungi, soil and rhizosphere bacteria) were used to analyse relationships between root system functional traits and climate, soil and stand characteristics. Absorptive fine root biomass per stand basal area increased significantly from temperate to boreal forests, coinciding with longer and thinner root tips with higher tissue density, smaller EMM biomass per root length and a shift in soil microbial community structure. The soil carbon (C) : N ratio was found to explain most of the variability in absorptive fine root and EMM biomass, root tissue density, N concentration and rhizosphere bacterial community structure. We suggest a concept of absorptive fine root foraging strategies involving both qualitative and quantitative changes in the root-mycorrhiza-bacteria continuum along climate and soil C : N gradients.


Subject(s)
Adaptation, Physiological , Plant Roots/physiology , Taiga , Bacteria/metabolism , Betula/microbiology , Biomass , Carbon/analysis , Europe , Geography , Models, Biological , Mycelium/physiology , Mycorrhizae/physiology , Nitrogen/analysis , Plant Roots/anatomy & histology , Plant Roots/microbiology , Rhizosphere , Soil Microbiology
8.
Environ Monit Assess ; 188(4): 228, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26979172

ABSTRACT

Forest harvesting, especially when intensified harvesting method as whole-tree harvesting with stump lifting (WTHs) are used, may increase mercury (Hg) and methylmercury (MeHg) leaching to recipient water courses. The effect can be enhanced if the underlying bedrock and overburden soil contain Hg. The impact of stem-only harvesting (SOH) and WTHs on the concentrations of Hg and MeHg as well as several other variables in the ditch water was studied using a paired catchment approach in eight drained peatland-dominated catchments in Finland (2008-2012). Four of the catchments were on felsic bedrock and four on black schist bedrock containing heavy metals. Although both Hg and MeHg concentrations increased after harvesting in all treated sites according to the randomized intervention analyses (RIAs), there was only a weak indication of a harvest-induced mobilization of Hg and MeHg into the ditches. Furthermore, no clear differences between WTHs and SOH were found, although MeHg showed a nearly significant difference (p = 0.06) between the harvesting regimes. However, there was a clear bedrock effect, since the MeHg concentrations in the ditch water were higher at catchments on black schist than at those on felsic bedrock. The pH, suspended solid matter (SSM), dissolved organic carbon (DOC), and iron (Fe) concentrations increased after harvest while the sulfate (SO4-S) concentration decreased. The highest abundances of sulfate-reducing bacteria (SRB) were found on the sites with high MeHg concentrations. The biggest changes in ditch water concentrations occurred first 2 years after harvesting.


Subject(s)
Environmental Monitoring , Forestry/methods , Mercury/analysis , Methylmercury Compounds/analysis , Water Pollutants, Chemical/analysis , Finland , Forestry/statistics & numerical data , Forests , Iron , Soil/chemistry , Trees
9.
FEMS Microbiol Ecol ; 91(9): fiv094, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26220310

ABSTRACT

Vegetation and water table are important regulators of methane emission in peatlands. Microform variation encompasses these factors in small-scale topographic gradients of dry hummocks, intermediate lawns and wet hollows. We examined methane production and oxidization among microforms in four boreal bogs that showed more variation of vegetation within a bog with microform than between the bogs. Potential methane production was low and differed among bogs but not consistently with microform. Methane oxidation followed water table position with microform, showing higher rates closer to surface in lawns and hollows than in hummocks. Methanogen community, analysed by mcrA terminal restriction fragment length polymorphism and dominated by Methanoregulaceae or 'Methanoflorentaceae', varied strongly with bog. The extent of microform-related variation of methanogens depended on the bog. Methanotrophs identified as Methylocystis spp. in pmoA denaturing gradient gel electrophoresis similarly showed effect of bog, and microform patterns were stronger within individual bogs. Our results suggest that methane-cycling microbes in boreal Sphagnum bogs with seemingly uniform environmental conditions may show strong site-dependent variation. The bog-intrinsic factor may be related to carbon availability but contrary to expectations appears to be unrelated to current surface vegetation, calling attention to the origin of carbon substrates for microbes in bogs.


Subject(s)
DNA Restriction Enzymes/genetics , Euryarchaeota/isolation & purification , Methane/metabolism , Methylocystaceae/isolation & purification , Sphagnopsida/microbiology , Wetlands , Denaturing Gradient Gel Electrophoresis , Euryarchaeota/metabolism , Methylocystaceae/metabolism , Oxidation-Reduction , Polymorphism, Restriction Fragment Length , Soil Microbiology
10.
Glob Chang Biol ; 21(1): 418-30, 2015 Jan.
Article in English | MEDLINE | ID: mdl-24920268

ABSTRACT

The response of forest ecosystems to increased atmospheric CO2 is constrained by nutrient availability. It is thus crucial to account for nutrient limitation when studying the forest response to climate change. The objectives of this study were to describe the nutritional status of the main European tree species, to identify growth-limiting nutrients and to assess changes in tree nutrition during the past two decades. We analysed the foliar nutrition data collected during 1992-2009 on the intensive forest monitoring plots of the ICP Forests programme. Of the 22 significant temporal trends that were observed in foliar nutrient concentrations, 20 were decreasing and two were increasing. Some of these trends were alarming, among which the foliar P concentration in F. sylvatica, Q. Petraea and P. sylvestris that significantly deteriorated during 1992-2009. In Q. Petraea and P. sylvestris, the decrease in foliar P concentration was more pronounced on plots with low foliar P status, meaning that trees with latent P deficiency could become deficient in the near future. Increased tree productivity, possibly resulting from high N deposition and from the global increase in atmospheric CO2, has led to higher nutrient demand by trees. As the soil nutrient supply was not always sufficient to meet the demands of faster growing trees, this could partly explain the deterioration of tree mineral nutrition. The results suggest that when evaluating forest carbon storage capacity and when planning to reduce CO2 emissions by increasing use of wood biomass for bioenergy, it is crucial that nutrient limitations for forest growth are considered.


Subject(s)
Climate Change , Nutrition Assessment , Trees/chemistry , Trees/growth & development , Europe , Models, Biological , Plant Leaves/chemistry , Soil/chemistry , Species Specificity
11.
New Phytol ; 202(2): 422-430, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24387190

ABSTRACT

Understanding the relationship between nitrogen (N) availability and stand health in forest ecosystems is crucial, because a large proportion of European forests is subjected to N-deposition levels beyond their retention capacity. We used data from a long-term forest monitoring programme (ICP Forests) to test the relationship between an index of N availability, foliar nitrogen : phosphorus (N : P) ratios, tree defoliation and discoloration. We hypothesized a segmented response of stand health to N : P ratios and an improved model-fit after correcting for climatic covariates. In accordance with the hypothesis, we found a segmented response with a breakpoint for conifer defoliation at N : P ratios as low as 7.3. Inclusion of climatic variables improved the fit of the models, but there was significant collinearity with N : P. Increases in N availability appear, at least for conifers, to have a negative effect on tree health even under N-limiting conditions. Regulation of N-deposition levels is consequently as timely as ever. We propose that increases in tree defoliation, other than resulting in serious plant fitness issues, may represent early diagnostic symptoms of N-addition related imbalances.


Subject(s)
Nitrogen/metabolism , Phosphorus/metabolism , Plant Leaves/metabolism , Stress, Physiological , Tracheophyta/metabolism , Trees/metabolism , Climate , Color , Europe
12.
Proc Natl Acad Sci U S A ; 111(2): 734-9, 2014 Jan 14.
Article in English | MEDLINE | ID: mdl-24379382

ABSTRACT

Nitrogen (N) accumulation rates in peatland ecosystems indicate significant biological atmospheric N2 fixation associated with Sphagnum mosses. Here, we show that the linkage between methanotrophic carbon cycling and N2 fixation may constitute an important mechanism in the rapid accumulation of N during the primary succession of peatlands. In our experimental stable isotope enrichment study, previously overlooked methane-induced N2 fixation explained more than one-third of the new N input in the younger peatland stages, where the highest N2 fixation rates and highest methane oxidation activities co-occurred in the water-submerged moss vegetation.


Subject(s)
Alphaproteobacteria/metabolism , Carbon Cycle/physiology , Methane/metabolism , Nitrogen Cycle/physiology , Soil Microbiology , Sphagnopsida/growth & development , Sphagnopsida/microbiology , Analysis of Variance , Carbon Isotopes/metabolism , Finland , Nitrogen Isotopes/metabolism , Sphagnopsida/metabolism
13.
Tree Physiol ; 29(3): 445-56, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19203968

ABSTRACT

Variations in ectomycorrhizal (EcM) short root tips of Norway spruce (Picea abies (L.) Karst.) and Scots pine (Pinus sylvestris L.) in 16 stands throughout Finland were studied, and their relationships with latitude, organic layer C:N ratio, temperature sum and foliage biomass were determined. There were no significant differences in EcM root tip frequency (number per milligram of fine roots) or root tip mass between tree species or between northern and southern sites. The EcM root tip number per unit area of the organic layer plus the 0-30 cm mineral soil layer varied between 0.8 and 2.4 million per m(2) for Norway spruce and between 0.7 and 2.9 million per m(2) for Scots pine, and it was higher in the northern Scots pine stands than in the southern Scots pine stands. Over 80% of the EcM root tips of both species were in the organic layer and the upper 0-10 cm mineral soil layer. We related EcM root tips to foliage mass because these two components are the most important functional units in boreal tree physiology. Both species, especially the Scots pine trees, had more EcM root tips in relation to foliage mass in northern Finland than in southern Finland. Scots pine trees had more EcM root tips in relation to foliage mass than Norway spruce in the same climatic region. The EcM root tip:foliage biomass ratio of Norway spruce was positively related to the C:N ratio in the organic layer, whereas that of Scots pine was negatively related to the temperature sum. The number of EcM root tips per milligram of fine root biomass was constant, implying that trees of both species increase nutrient uptake by increasing fine root production and hence their total number of EcM tips and the area of soil occupied by mycelia. Both tree species responded to nitrogen (N) deficiency by maintaining more EcM tips per foliage unit, and this may be related to a higher proportion of N uptake in an organic form.


Subject(s)
Biomass , Mycorrhizae , Nitrogen/metabolism , Picea/microbiology , Pinus sylvestris/microbiology , Cold Climate , Finland , Mycorrhizae/metabolism , Picea/metabolism , Pinus sylvestris/metabolism , Plant Leaves/metabolism , Plant Roots/metabolism , Plant Roots/microbiology , Soil/analysis , Species Specificity
14.
Eur J Cancer ; 42(14): 2196-9, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16893642

ABSTRACT

Women with stage III ovarian cancer and with < or = 2 cm residual tumour were randomly assigned to receive either conventionally dosed chemotherapy (group A) or HDCT (group B). Patients allocated to group A received 6 cycles of paclitaxel (T) 135 mg/m2 and cisplatin (P) 75 mg/m2 every 3 weeks, and those allocated to HDCT received 3 TP cycles followed by peripheral blood stem cell mobilisation with cyclophosphamide (C) 3000 mg/m2 and T 175 mg/m2, and subsequently HDCT with carboplatin 1500 mg/m2, C 120 mg/kg, and mitoxantrone 75 mg/m2. The trial was closed early after 42 patients were entered due to slow accrual. The median follow-up time of patients who were alive was 81 months. The median progression-free survival time was 15.9 and 16.6 months (hazard ratio, HR 0.83; 95% CI 0.41-1.69, P = 0.61) and the median overall survival time was 43.7 and 64.3 months (HR, 0.74; 95% CI 0.34-1.61, P = 0.44) in groups A and B, respectively. Although one patient died of HDCT-related toxicity, the regimen was otherwise relatively well tolerated. We conclude that the HDCT regimen used was feasible, but did not result in significantly improved survival in this prematurely closed trial. A clinically important survival benefit cannot be excluded due to the small sample size.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Ovarian Neoplasms/drug therapy , Adult , Aged , Cisplatin/administration & dosage , Cisplatin/adverse effects , Female , Humans , Middle Aged , Paclitaxel/administration & dosage , Paclitaxel/adverse effects , Prospective Studies , Treatment Outcome
15.
FEMS Microbiol Ecol ; 55(2): 221-9, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16420630

ABSTRACT

Peat accumulating mires are important sources of the greenhouse gas methane. Methane emissions and methanogenic Archaea communities have been shown to differ between fens and bogs, implying that mire succession includes an ecological succession in methanogen communities. We investigated methane production and the methanogen communities along a chronosequence of mires (ca. 100-2,500 years), which consisted of five sites (1-5) located on the land-uplift coast of the Gulf of Bothnia. Methane production was measured in a laboratory incubation experiment. Methanogen communities were determined by amplification of a methyl coenzyme M-reductase (mcr) gene marker and analyzed by terminal-restriction fragment length polymorphism. The terminal-restriction fragment length polymorphism fingerprinting resulted in 15 terminal restriction fragments. The ordination configuration of the terminal restriction fragments data, using nonmetric multidimensional scaling, showed a clear gradient in the methanogen community structure along the mire chronosequence. In addition, fingerprint patterns of samples from the water table level and 40 cm below differed from one another in the bog site (site 5). Methane production was negligible in the three youngest fen sites (sites 1-3) and showed the highest rates in the oligotrophic fen site (site 4). Successful PCR amplification using mcr gene primers revealed the presence of a methanogen community in all five sites along the study transect.


Subject(s)
Ecosystem , Euryarchaeota/genetics , Euryarchaeota/isolation & purification , Methane/biosynthesis , Soil Microbiology , Biodiversity , DNA Fingerprinting , DNA, Archaeal/genetics , Euryarchaeota/metabolism , Oxidoreductases/genetics , Polymorphism, Restriction Fragment Length , Time Factors
16.
Gynecol Oncol ; 101(1): 114-9, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16266743

ABSTRACT

OBJECTIVE: To determine the feasibility and efficacy of sequential gemcitabine-carboplatin followed by paclitaxel-carboplatin in the first-line treatment of advanced epithelial ovarian cancer, with the response rate as the primary endpoint. METHODS: After primary laparotomy, 56 patients with FIGO Stages III-IV disease were given 4 cycles of gemcitabine 1000 mg/m2 d1,8 and carboplatin AUC5 (44 patients) or AUC6 (12 patients) d1 q3wk followed by 4 cycles of paclitaxel 175 mg/m2 d1 and carboplatin AUC5/6 q3wk. Of the tumors, 43 were serous, 6 clear cell, 4 endometrioid, and 3 anaplastic type. Thirty-seven (66.1%) of the patients were suboptimally debulked. RESULTS: Forty-seven patients were evaluable for response by CA-125 criteria, and 46 (98%) responded. Thirty patients (after gemcitabine-carboplatin) and 24 (after paclitaxel-carboplatin) were evaluable for response by CT (RECIST criteria), respectively. After the four gemcitabine-carboplatin cycles, the objective response rate was 83% (6 CR, 19 PR). Following completion of the whole sequential regimen, 7 patients showed a CR and 15 a PR, respectively, giving a response rate of 92%. The median progression-free survival was 12.8 months after a median follow-up of 19 months (range 7-35 months). The median overall survival has not been reached yet. The main toxicity was neutropenia as 139/221 (62.9%) of the gemcitabine-carboplatin cycles and 92/181 (50.8%) of the paclitaxel-carboplatin cycles, respectively, were associated with Grades 3-4 neutropenia. Neutropenia was reported as a serious adverse event in 5.7% of the cycles, and G-CSF support was needed in 18.4% of the cycles. Only the gemcitabine-carboplatin cycles were associated with a marked thrombocytopenia (32.1% Grades 3-4). Of the other side effects, marked allergy occurred in 14/52 (27%) exposed to paclitaxel. A total of 14 patients discontinued the treatment prematurely: 3 due to lack of efficacy, 1 due to protocol violation, and 10 due to toxicity (4 allergic reactions to paclitaxel, 3 complicated neutropenias, 1 fever, and 2 unspecified toxicities). The mean relative dose intensities were: gemcitabine 84.0%, paclitaxel 85.4%, and carboplatin 96.5%. Of the gemcitabine-carboplatin cycles and paclitaxel-carboplatin cycles, 32% and 38% were delayed, respectively. Gemcitabine d8 dose had to be omitted in 8% of the cycles. CONCLUSION: The sequential regimen of gemcitabine-carboplatin followed by paclitaxel-carboplatin is feasible in chemotherapy-naive ovarian cancer. Although its use is associated with a marked neutropenia, the neutropenia is manageable.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Ovarian Neoplasms/drug therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , CA-125 Antigen/blood , Carboplatin/administration & dosage , Carboplatin/adverse effects , Deoxycytidine/administration & dosage , Deoxycytidine/adverse effects , Deoxycytidine/analogs & derivatives , Drug Administration Schedule , Female , Humans , Middle Aged , Neoplasm Staging , Neutropenia/chemically induced , Ovarian Neoplasms/blood , Ovarian Neoplasms/pathology , Paclitaxel/administration & dosage , Paclitaxel/adverse effects , Gemcitabine
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