Chemotherapy partial response

The response to chemotherapy may be referred to as complete response, partial response, stable disease, or disease progression. 

Consolidation chemotherapy is the addition of cycles of the taxane/platinum regimen or the addition of singleagent platinum or a single taxane after completion of first-line chemotherapy.45 If the tumor has a partial response to first-line chemotherapy evident by a significant decline in CA-125 by more than 50% of the preoperative level and/or... 

FIGURE 91-3. Summary of chemotherapy treatment algorithm for epithelial ovarian cancer. CR, complete response PR, partial response PD, progressive disease. 

The current was applied in the form of electrical pulses in order to permeabilize the membranes of the tumor cells for the entry of the chemotherapeutic agent bleomycin which is a very potent cytotoxic molecule. Clinical complete responses were achieved in 56.4% of the tumors and partial responses were observed in 28.9% of the tumors. This work is thus not strictly electrochemical treatment in the sense of Nordenstrom18 and Xin32 but is rather chemotherapy aided by electrochemical-driven movement of ions, molecules and drugs etc. (e.g., by electroosmosis, electrophoresis) into the tissue regions targeted for necrosis, as in several studies28,51,93 94 described earlier within this chapter. 

E Role in therapy Rituxan is recommended for low-grade or follicular B-cell lymphoma in patients relapsing after or refractory to conventional chemotherapy. Complete responses are infrequent but partial responses appear durable. 

It was significantly effective when used in combination with fluorouracil-based chemotherapy and led to the improvement of overall response rates, time to progression, and survival of patients with metastatic colon cancer (55,57,58). Bevacizumab and irinotecan, fluorouracil, leucov-orin (IFL) chemotherapy regimen showed an increase in median survival by 4.7 months, in progression free survival by 4.36 months, and in overall response rates (complete and partial responses) by 10.2% when compared with IFL plus placebo. 

Moreover, Fiorillo et al. [393] studied the effect of a combination of liposomal daunorubicin, etoposide, and carboplatin administered to seven children with recurrent malignant supratentorial brain tumors as a second-line therapy. Chemotherapy consisted of infusion of liposomal daunorubicin on days 1 and 2 and infusion of etoposide and carboplatin on day 1 whereas courses were repeated every 3M weeks. After a total of eight courses, five of seven children evaluated were alive 12-64 months after diagnosis and 8-29 months from the start of the second-line chemotherapy. Of the seven children, three showed complete response, two partial responses, one stable disease, and one progressive disease. The time to the best response was 3-10 months, while the median time to progression was 23 months. The toxicity observed was minimum. 

A 54-year-old man with stage I folUcnlar Ijmphocytic lymphoma with cervical lymph nodes nnderwent splenectomy followed by chemotherapy with chlorambncil and had a partial response. Five months later, when he developed generalized lymphadenopathy and bone marrow involvement, he received fludarabine, cyclophosphamide, and ritnximab, with complete remission. Ten months later he developed a Merkel cell carcinoma involving the liver and lymph nodes. The disseminated tumor was chemoresistant and he died. His lymphoma remained in complete clinical remission throughout this time. 

The response to chemotherapy and other treatment modalities may be described as a cure, complete response, partial response, stable disease, or progression. These terms are used routinely in oncology to define the response to chemotherapy and other treatment modalities. A cure implies that the patient is entirely free of disease and has the same life expectancy as a cancer-free individual. Although there is no way to be absolutely certain that an individual patient is cured, a stable plateau in the survival curve after cancer treatment is taken as evidence of cure. For most cancers, the survival curves have plateaued by about 5 years. Thus 5 years of survival without... 

Restaging to determine the efficacy of induction therapy is done after two to three cycles of treatment. At this point, therapy is continued for patients with a complete or partial response or stable disease, and discontinued or changed to a non-cross-resistant regimen in patients demonstrating evidence of progressive disease. The induction chemotherapy regimen is administered for four to six cycles if the SCLC disease is responsive. In those with a complete response, PCI is offered as discussed above. After recovery from initial therapy, follow-up visits should occur every 3 months for years 1, 2, and 3, then every 6 months for years 4 and 5, then annually for patients with either a partial or complete response. ... 

A number of cytotoxic agents have demonstrated in vitro activity to melanoma only a few drugs have consistently shown a response rate greater than 10% in patients with melanoma. Since chemotherapy has rarely cured a patient with melanoma, the primary goal of chemotherapy is palliation. The results of chnical trials are generally expressed in terms of response rates. The response rate usually includes the fraction of patients who experience a partial response plus those who experience a complete response. Partial response criteria vary but may require a 50% reduction of the tumor for a minimum of 1 month. A complete response would require total regression of aU metastases for at least 1 month and is uncommon (<5%). It is essential to realize that these response rates do not reflect survival. 

Chemoembolization Chemoembolization with the combination of Ivalon and FUDR (800 mg), mitomycin C (10 mg), or cisplatin (150 mg) for colorectal hepatic metastases led to no significant improvement in response or survival. Yamashita et al. (1993), who treated 68 patients with various hepatic metastases using iodized oil and chemotherapeutic agents,noted a response rate of 22% and a median survival of 10 months. A similar result was observed by Inoue et al. (1989), i.e., a partial response rate of 16% and a median survival period of 11 months. We currently do not perform chemoembolization in patients with metastatic colorectal carcinoma because the survival rates have not improved compared to the less aggressive approach of intraarterial chemotherapy. However, Lang and Brown (1993) and Pentecost et al. (1992) are encouraged by their results for chemoembolization of hepatic metastases from colorectal cancer and they believe that the technique can be recommended as palliative treatment. More recently, Pajkos et al. (1998) treated 41 patients with metastatic colorectal carcinoma to the liver with chemoembolization consisting of Adriamycin (50 mg), mitomycin C (8 mg), cisplatin (50 mg), or carboplatin (150 mg), Lipiodol (10 ml), and starch microspheres every 6 weeks, as well as systemic 5FU (425 mg/m ) and leucovorin 20 mg/m for 5 days every 28 days. The response rate was 68% with a median survival time of 15 months. 

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