A prospective randomized study of Chop versus Chop plus alpha-2B interferon in patients with intermediate and high grade non-Hodgkin's lymphoma: the International Oncology Study Group NHL1 Study .

UNLABELLED: The addition of a brief alpha interferon regimen to each CHOP induction cycle, plus one year of alpha interferon thrice weekly maintenance therapy, has no early effect on response rates or survival in patients with Intermediate or High grade cell NHL. BACKGROUND: The CHOP (Cyclophosphamide, Adriamycin. Vincristine, Prednisone) regimen is the most widely used first-line therapy for patients with Intermediate or High Grade (IG/HG) non-Hodgkin's lymphoma (NHL). Alpha 2b interferon (INF) enhances response rates and improves survival in low-grade NHL. The International Oncology Study Group (IOSG) conducted a prospective randomized study comparing CHOP alone or combined with INF in patients with IG/HG-NHL. The primary study aim was to compare the objective response rates in these patient cohorts. PATIENTS AND METHODS: Patients with a confirmed diagnosis of measurable NHL of International Working Formulation (IWF) groups D to H histology were randomized to receive CHOP alone or CHOP with 5Mu INF s.c. for 5 days on days 22 to 26 of each 28 day cycle with INF 5 million units (Mu) given three times per week subcutaneously for 52 weeks in those patients who responded to CHOP plus INF. RESULTS: The overall response rates were equivalent in both groups: CHOP alone (214 patients) 81% (complete 55%, partial 26%); CHOP plus INF (221 patients) 80% (complete 54%, partial 26%). At 36 months, the actuarial survival rate was equivalent in both groups. CONCLUSIONS: There is no apparent early advantage in terms of response or survival conferred by adding the study INF regimen to CHOP therapy for patients with IG/HG-NHL.

Multiple cutaneous metastases from breast carcinoma.

A case of breast carcinoma presenting as cutaneous metastases on sites other than the anterior chest wall is reported. Multiple nodules, in numbers (reaching 900) not previously reported, were widely distributed, even to the thighs and pelvic region, which are areas not previously reported as sites of cutaneous metastases from breast carcinoma. This patient's case is further characterized by an adenocarcinoma pattern in the presenting skin lesions and a thirty-five months' survival time from the appearance of the cutaneous metastases. We emphasize the need to remove excisional biopsy specimens of unexplained skin nodules. Breast carcinoma is the most common internal malignant primary tumor in women.

Chemotherapy of advanced non-small cell lung cancer with the use of cis-platinum and VP 16-213.

Twenty eight patients (22 males, 6 females), with mean age of 55 years (range 34-71 years) were given combination chemotherapy consisting of Cis-platinum and VP 16-213 (Etoposide). The schedule was Cis-platinum, 20 mg/m2 and VP 16-213, 60 mg/m2, each given for 5 consecutive days and repeated every 4 weeks. Histological subgroups were adenocarcinoma 15, squamous cell carcinoma 9 and large cell carcinoma 4. Prior therapy was radiotherapy in 2 and no treatment in 15 patients. The ECOG performance status was 0-1 in 9 patients and 2-3 in 9 patients. Eight patients had limited disease and 20 had extensive disease. Nine of 28 patients responded, 1 CR and 8 PR's, with an overall response rate of 32%. The median duration of response was 23 weeks. Response rates according to histologic types were similar. Important prognostic factors for response were performance status, stage of the diseases and age below 55 years. Median survival was significantly longer for patients with limited disease vs extensive disease (41 vs 22.5 weeks) and in responders vs non-responders (42 vs 22 weeks). Toxicity was tolerable. This regimen is recommended for subsets of patients with the above prognostic factors.

Oral plus intramuscular medroxyprogesterone acetate (high dose Farlutal) in advanced breast cancer.

The efficacy and tolerability of the combined scheme of administering high dose medroxyprogesterone acetate in advanced breast cancer is evaluated.

Cis-platinum-adriamycin-cyclophosphamide in the treatment of advanced-recurrent cervical cancer.

Twenty-two patients with advanced or recurrent cancer of the cervix treated with cis-platinum, adriamycin and cyclophosphamide were evaluated. Nine of 22 (41% achieved objective response (2 CR + 7PR), 9/22 (41%) stable disease, 4/22 (18%) progressive disease. The mean duration of response was 24.6 weeks, with a range of 18-28 weeks. Patients with poorly differentiated histologic grade and without previous treatment had better response rates. Responders had longer survival (mean 63.5 + weeks) than nonresponders (mean 30.5 weeks). Commonly encountered toxicities were alopecia, nausea and vomiting, and leucopenia, which were all tolerable.

The use of radiotherapy for pelvic recurrence following abdominoperineal resection for carcinoma of the rectum: a 10-year experience.

Eighty-five patients who developed pelvic recurrence after abdominoperineal resection for carcinoma of the rectum have been reviewed. The average period of latency was 16 months, with increasing incidence of recurrence in the more advanced stages of the disease. Eighty per cent of recurrences occurred within two years of surgical treatment and a further 20% between two and five years after operation. The prominent manifestations were pelvic pain (100%) and mass (54%), which responded to palliative radiotherapy in 92% and 80% of the cases respectively. The mean duration of palliation was 6.5 months. Patients with pelvic recurrence secondary to rectal carcinoma benefit from palliative radiation therapy, and this should be given whenever possible.

A comparative, randomized trial of UFT and 5-fluorouracil in combination with cyclophosphamide and doxorubicin in the treatment of advanced breast cancer patients at The Philippines General Hospital.

A comparative, randomized trial was conducted to determine the efficacy of oral UFT (Tegafur and Uracil) versus 5-fluorouracil (5-FU) in combination with cyclophosphamide and doxorubicin in patients with metastatic breast cancer. Of 62 evaluable patients, 31 received UFT (350 mg/m2/day orally x 14 days), doxorubicin (50 mg/m2 intravenously [I.V.] day 1) and cyclophosphamide (500 mg/m2 I.V. day 1). The other 31 patients received 5-FU (500 mg/m2 I.V. days 1 and 8), doxorubicin (50 mg/m2 I.V. day 1), and cyclophosphamide (500 mg/m2 I.V. day 1). Regimens were repeated for a total of six cycles. The two groups were comparable in terms of age, gender, performance status, menopausal status, and number and sites of metastases. No statistical difference in overall response rates was seen (UFT arm, 48.4% vs. 5-FU arm, 35 %; p = 0.30). Median response duration was 16 weeks (range, 4-30) for both arms. The toxicity profile (alopecia, anemia, leukopenia, thrombocytopenia, diarrhea) was similar in both groups and both regimens were well tolerated. Anemia and stomatitis were significantly more common in the 5-FU arm (p = 0.02). Thus, oral UFT has response rates and duration of response that are comparable to 5-FU in a combination regimen for advanced breast cancer.