Carcinomas chemotherapy

Head and neck carcinomas Chemotherapy and surgery/radiotherapy... 

Cancer treatment is a multimodality treatment, i.e., surgery is combined with radiotherapy and antineoplastic chemotherapy. The latter treatment mode is used mainly for cancers which have disseminated. Different forms of cancer differ in their sensitivity to chemotherapy with antineoplastic agents. The most responsive include lymphomas, leukemias, choriocarcinoma and testicular carcinoma, while solid tumors such as colorectal, pancreatic and squamous cell bronchial carcinomas generally show a poor response. The clinical use of antineoplastic agents is characterized by the following principles. 

Metastatic renal cell carcinoma has a poor prognosis and resists conventional chemotherapy. Immunotherapy with IL-2 and/or IFN-a is currently regarded as the most effective therapy with, however, modest response rates of 15-20%. Similar results are also observed in patients with metastatic melanoma and the response to IFN-a and IL-2 correlates with the occurrence of tumor-infiltrating CD4+ T-lymphocytes identified in aspirates from melanoma metastases. Determination of these cells therefore seems to be a method to predict responders prior to the initiation of cytokine therapy. 

Markman, M., Cleary, S., Lucas, W. E., and Howell, S. B. (1985). Intraperitoneal chemotherapy with high-dose cisplatin and cytosine arabinoside for refractory ovarian carcinoma and other malignancies principally involving the peritoneal cavity, J. Clin. Oncol., 3, 925-931. 

Small cell lung cancer typically presents as extensive disease (approximately 60% to 70% of new cases) and progresses very quickly. Small cell carcinomas are very responsive to chemotherapy and radiation. Radiotherapy became the standard in 1969, when a randomized trial showed that it offered the potential for cure, whereas surgery did not.20 For the vast majority of patients, chemotherapy with or without radiotherapy is the treatment of choice. Even after a complete response to therapy, the cancer usually recurs within 6 to 8 months, and survival time following recurrence is typically short ( 4 months). This yields a typical survival rate of 14 to 20 months for limited disease and 8 to 13 months for extensive disease.33 Table 87-6 illustrates the general treatment path of SCLC. 

T. Konno and H. Maeda, Targeting chemotherapy of hepatocellular carcinoma Arterial administration of SMANCS/Lipiodol, in Neoplasm in the Liver (K. Okada and K. G. Ishak, eds.), Springer-Verlag, New York, 1987, p. 343. 

CA 125 is a mucin-like glycoprotein antigenic determinant expressed on the surface of coelomic epithelium and human ovarian carcinoma cells however, it does not appear to be specific for ovarian cancer because elevated levels have been reported in breast and colorectal cancers. Studies have shown increased CA 125 levels in patients with ovarian cancer, whereas decreased CA 125 levels in chemotherapy are associated with improved possibility for survival. Some studies have shown failure of CA 125 levels to return to normal after chemotherapy, indicating... 

Thus, oxygen radical production by leukocytes can be responsible for cancer development. However, the levels of leukocyte oxygen radical generation depend on the type of cancer. For example, PMNs and monocytes from peripheral blood of patients with lung cancer produced a diminished amount of superoxide [169], Timoshenko et al. [170] observed the reduction of superoxide production in bronchial carcinoma patients after the incubation of neutrophils with concanavalin A or human lectin, while neutrophils from breast cancer patients exhibited no change in their activity. Chemotherapy of lung and colorectal carcinoma patients also reduced neutrophil superoxide production. Human ALL and AML cells produced, as a rule, the diminished amounts of superoxide in response to PMA or FMLP [171], On the other hand total SOD activity was enhanced in AML cells but diminished in ALL cells, while MnSOD in AML cells was very low. It has been proposed that decreased superoxide production may be responsible for susceptibility to infections in cancer patients. 

Sugibayashi K, Akimoto M, Morimoto Y (1979a) Drug-carrier property of albumin microspheres in chemotherapy III. Effect of microsphere-entrapped 5-fluorouracil on ehrlich ascites-carcinoma in mice. J Pharmacobio-Dynam 2 350-355. 

USP received a medication error report involving the products Neumega (oprel-vekin) and Proleukin (aldesleukin). Oprelvekin, a recombinant human interleukin-11 product used to stimulate platelet production in selected patients undergoing chemotherapy, is sometimes abbreviated as IL-11. Aldesleukin, a recombinant human interleukin-2 derivative indicated in designated patient populations for the treatment of metastatic renal-cell carcinoma, is sometimes abbreviated as IL-2. 

Designation of intrathoracic or abdominal tumors as mesotheliomas is not straightforward. A mesothelial mesothelioma may be difficult to distinguish from a peripheral bronchogenic carcinoma partly because of the nature of the clinical course of the diseases as well as their similar location. Mesothelioma spreads extensively on the pleura, is usually unresectable, and responds poorly to chemotherapy or radiation. In all of these respects it is identical to peripheral carcinoma of the lung parenchyma, which may spread to the pleura. The diagnostic distinction, perhaps somewhat academic (Gaenslcr et ah, 1985), must go beyond clinical evaluation to tissue examination. 

Rivera F, Lopez-BreaM, Lopez-Vega J, PascualC, Rubio A, etal. High activity of UFT vinorelbine and cisplatin (UFTVP) as induction chemotherapy for locally advanced squamous cell head and neck carcinoma (SCHNC). ProcAm Soc Clin Oncol 1997 16 386a (abstr 1376). 

Gastrointestinal Tumor Study Group. Treatment of locally unresectable carcinoma of the pancreas comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. J Natl Cancer Inst 1988 80 751-755. 

Marcial VA, Paj ak TF, Mohuiddin M, et al. ConComitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous cell carcinoma of the head and neck. Cancer 1990 66 1861-1868. 

Cooper JS. Concurrent chemotherapy and radiation therapy for advanced stage carcinoma of the nasopharynx. Int J Radiat Oncol Biol Phys 2000 48 1277-1279. 

Robinow JS, Shaw EG, Eagan RT, etal. Results of combination chemotherapy and thoracic irradiation therapy for unresectable non-small cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 1989 17 1203-1210. 

Strauss GM, Herndon JE, Sherman DD, et al. Neoadjuvant chemotherapy and radiotherapy followed by surgery in stage Ilia non-small cell carcinoma of the lung report of a Cancer and Leukemia Group B phase II study. J Clin Oncol 1992 10 1237-1244. 

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