Dose-finding study of 5'-deoxy-5-fluorouridine in combination with fixed doses of cisplatin and L-folinic acid for the treatment of advanced or recurrent squamous cell carcinoma of the head and neck.

In order to assess the maximum tolerated dose of 5'-deoxy-5-fluorouridine (5dFUR) combined with a cisplatin (20 mg/m2 i.v.) and L-folinic acid (100 mg/m2 i.

Weekly 24-hour infusion with high-dose 5-Fluorouracil and 6s-leucovorin as a 2nd-line therapy in advanced colorectal-cancer resistant to a 5-fluorouracil/6s-leucovorin bolus combination.

Recently, experimental data suggested the possibility that resistance to 5FU may be overcome by administering the drug in a different schedule. To test this hypothesis we treated seventeen patients, who failed to respond to a common 5FU/leucovorin bolus regimen, with an intravenous infusion of 6S-leucovorin, at a dose of 250 mg/m(2), concurrently with 5FU at 2,600 mg/m(2) over a 24-hour period. Treatment was repeated every week.

Oral therapy with flurithromycin in ear, nose and throat infections.

In this study efficacy and tolerability of flurithromycin ethylsuccinate (FE) were evaluated in ear, nose and throat infections. One hundred and three patients were treated with FE tablets 375 mg 12-hourly for a mean duration of treatment of 8.2 days and they were divided into groups according to the pathology: pharyngitis/tonsillitis (chronic 7, acute 38), rhinosinusitis (chronic 7, acute 12), otitis (chronic 6, acute 32) and sialadenitis (acute 1).

Assisted conception and immunological infertility.

Our work with a group involved in Assisted Conception (AC) has provided us with a perfect opportunity for making an assessment of the efficiency of the techniques used for the treatment of Male Antisperm Autoimmunization (MAA) and Female Antisperm Isoimmunization (FAI). The aim of this study is to present all the most important methods of AC used by our group for the treatment of immunological infertility, such as intrauterine insemination, intraperitoneal insemination, intrafallopian gamete transfer, in-vitro insemination and intrauterine embryo transfer, intrafallopian zygote transfer, intrafallopian embryo transfer, and gamete micromanipulation. In-vitro fecundation would appear to be particularly efficient in cases of FAI, while MAA would seem to benefit more from the use of gamete micromanipulation.

A randomised trial of octreotide vs best supportive care only in advanced gastrointestinal cancer patients refractory to chemotherapy.

Octreotide, a somatostatin analogue, has been shown to inhibit the growth of gastrointestinal cancers in vitro and in vivo. To assess the anti-tumour effect of octreotide, we performed a randomised trial comparing octreotide with best supportive care in advanced gastrointestinal cancer patients refractory to chemotherapy. A total of 107 patients with advanced gastrointestinal cancer refractory to chemotherapy were randomised to receive octreotide at the dose of 200 micrograms three times a day for 5 days a week, or the best supportive care only.

Neuroprotective effect of reduced glutathione on cisplatin-based chemotherapy in advanced gastric cancer: a randomized double-blind placebo-controlled trial.

Purpose: We performed a randomized double-blind placebo-controlled trial to assess the efficacy of glutathione (GSH) in the prevention of cisplatin (CDDP)-induced neurotoxicity.

Patients And Methods: Fifty patients with advanced gastric cancer treated with a weekly CDDP-based regimen were included in this study. In patients randomized to receive GSH, GSH was given at a dose of 1.

Intensive weekly chemotherapy for elderly gastric cancer patients, using 5-fluorouracil, cisplatin, epi-doxorubicin, 6S-leucovorin and glutathione with the support of G-CSF.

Aims And Background: Elderly patients constitute the largest group of advanced gastric cancer patients. Since there is a widespread misconception that the elderly are poorly tolerant of chemotherapy, most of them are untreated or receive a less aggressive but also less efficacious chemotherapy. However, because tolerance and response to cancer seem to vary more with physiologic age than chronologic age, we evaluated the feasibility and activity of an intensive weekly chemotherapy in elderly gastric cancer patients.

Correlation among [h-3] thymidine, flow-cytometry and proliferating cell nuclear antigen indexes in colorectal tumors.

In colorectal cancer and other tumors, proliferating cell nuclear antigen (PCNA) has been found to be a useful marker in immunohistochemical studies of cell proliferation, The presence of a correlation among PCNA labeling index (PCNA LI) and values of cell proliferation expressed by [H-3]thymidine labeling index (TLI) and flow cytometry (FC), the most common techniques used in the evaluation of proliferative activity in colorectal cancer were studied. In 50 operable colorectal cancer patients, TLI, PCNA LI and determination of S-phase fraction by FC were carried out in order to evaluate the correlation among these three indices. A good correlation was obtained between PCNA LI and both TLI (r=0.

A pilot clinical trial of surgical adjuvant treatment with high-dose 6S-leucovorin/5-fluorouracil and radiation therapy for high-risk rectal carcinoma.

Aims And Background: The study was performed to evaluate the feasibility of combining leucovorin (LV) with 5-fluorouracil (5FU) and radiation therapy as adjuvant treatment for high-risk rectal carcinoma.

Methods: Twenty-five patients with histologically proven adenocarcinoma of the rectum, at high-risk of recurrence after potentially curative resection (T3 NO, T and N1-2; MO), received 5FU (370 mg/m2) and 6S-LV (100 mg/m2) on days 1-5, 4 and 8 weeks after surgery. On treatment day 64, radiotherapy on the pelvis (50 Gy) was initiated.

[Anthracycline-induced cardiotoxicity: monitoring and prevention of the lesion].

Doxorubicin is a common antitumoral agent, widely used to treat patients with a variety of neoplastic diseases: acute and severe dose-related chronic cardiotoxicity is the major limitation to optimal use of anthracycline antibiotics. Cancer patients with clinically important heart disease are thus generally not eligible for anthracycline therapy. This review discusses the clinical aspects and possible underlying pathogenetic mechanisms of cardiac damage.

Computer-assisted assessment of the variations of sperm kinetics after semen treatment with Pellet Swim-up (PSu), and with centrifugation on a discontinuous Percoll gradient at reduced volumes (mini-CDPG).

The semen of the male partners of 37 infertile couples was analyzed with the use of the HTM-S Motility Analyzer (HTM-S MA). For each sample it was thus possible to assess the Total Concentration (TC), the Motile Cell Population Concentration (MCPC), the Progressive Cell Population Concentration (PCPC), the Average Path Velocity (VAP), the Straight Line Velocity (VSL), the Curvilinear Velocity (VCL), the Straightness (STR), the Linearity (LIN), the Lateral Head Displacement (ALH) and the Head Size (HS). The same parameters were then measured on the same semen after treatment with the Pellet Swim-up (PSu) and following Centrifugation on reduced-volume Discontinuous Percoll gradient (mini-CDPG).

Bag Surgery as Part of a Protocol to Treat Ovarian Masses by Laparoscopy.

In a protocol to treat all ovarian masses endoscopically the major objection is that there are reports that even if the preoperative examinations are favorable there is still a chance as high as 2 to 6% of encountering a malignant proliferation within the cyst, necessitating a conversion to laparotomy within the same operating session. Using the following selection criteria: Premenopausal patients less than 45 years; uni-locular cysts on ultrasound or slightly septated; size of the cyst between 4 and 10 cm; benign characteristics on ultrasound; normal biochemistry, including CA 125, ESR, liver enzymes; and cysts resistant to therapy at least for 6 weeks, we have used the bags whenever the macroscopic aspect of the cyst appeared suspicious for malignancy to the surgeon. The tumor was first fully inserted in the Endo pouch (Autosuture-US Surgical) and then transected from its pedicle.

Correlation Between AFS Classification Systems of Adnexal Adhesions and Distal Tubal Occlusion, Tubal Mucosa at Salpingoscopy and Reproductive Outcome of the Patient.

From November 1988 to December 1991, 45 infertile patients underwent salpingo-ovariolysis and/or salpingoneostomy during laparotomy or laparoscopy. Findings at surgery were scored according to the AFS classification. Salpingoscopy was performed to evaluate the status of the ampullary mucosa.

Hepatocyte growth factor and macrophage inflammatory protein 1 beta: structurally distinct cytokines that induce rapid cytoskeletal changes and subset-preferential migration in T cells.

T-cell migration into tissue depends on a cascade of rapid and selective adhesive interactions with endothelium. "Triggering" is a step in that cascade required to activate T-cell integrins. Hepatocyte growth factor (HGF) may be a physiologically relevant trigger, since we demonstrate that HGF can induce both adhesion and migration of human T-cell subsets and can be detected immunohistochemically on inflamed endothelium.

Oral cooling (cryotherapy), an effective treatment for the prevention of 5-fluorouracil-induced stomatitis.

Recently, a randomised study demonstrated the utility of oral cooling (cryotherapy) in the prevention of 5-fluorouracil (5FU)-induced stomatitis. In order to verify these results a confirmatory study, using identical treatment regimen, was initiated. 84 patients treated with a 5-FU-containing regimen were randomised to a control arm or to receive oral cryotherapy.

Recombinant human erythropoietin treatment in cisplatin-associated anemia: a randomized, double-blind trial with placebo.

Purpose: To evaluate the effect of exogenous recombinant human erythropoietin (rHuEPO) on the increase of hemoglobin levels and on the transfusion requirements in patients with cisplatin (CDDP)-induced anemia, we performed a double-blind randomized trial with placebo.

Patients And Methods: One hundred patients with CDDP-associated anemia (hemoglobin level < 90 g/L) were randomized to receive either placebo (saline solution) or rHuEPO (100 U/kg body weight subcutaneously) three times per week. The end points of this study were the increase in hemoglobin levels to greater than 100 g/L after 3, 6, and 9 weeks and the effect on transfusion requirements.

Autologous bone marrow transplantation in Ki-1 lymphoma with poor prognosis. A case report.

The authors report a case of 17-years-old woman suffering from a Ki-1 lymphoma with retroperitoneal bulky disease, extranodal involvement, poor performance status and high level of LDH. Due to the unfavorable prognosis, after complete remission obtained with aggressive induction therapy, the patient received high dose of therapy based on busulfan and etoposide followed by autologous bone marrow transplantation (ABMT) as consolidation therapy. Toxicity was mild, particularly neutrophil recovery was hastened with G-CSF.

Expression cDNA cloning of a novel oncogene with sequence similarity to regulators of small GTP-binding proteins.

We generated a cDNA expression library from a human mammary epithelial cell line for detection of novel oncogenes by focus formation assay in NIH3T3 cells. A morphologically unique focus was identified and the transforming plasmid was isolated. The transforming gene, designated TIM, encoded a predicted protein species of 60 kDa containing a Dbl-Homology (DH) motif.

Cisplatin, 5-fluorouracil and interferon alpha 2b for recurrent or metastatic head and neck cancer.

On the basis of preclinical data suggesting the possibility of maximising the efficacy of 5-fluorouracil and cisplatin by interferon, a pilot clinical trial was initiated in recurrent and/or metastatic head and neck cancer. Thirty-four patients were treated with cisplatin at 100 mg m-2, followed by 5-fluorouracil at 1,000 mg m-2 by continuous infusion for 5 days. Interferon alpha 2b was administered at the dose of 3 million U i.

[Primary lymphoma of the parotid: a rare location].

Primary lymphoma of the parotid gland is uncommon: we report a case in an 82-year-old man, classified according to the Working Formulation as a low-grade lymphoma. After parotidectomy the patient was treated with radiation therapy and, subsequently, with polychemotherapy (endoxan, vincristine and prednisone) for six cycles. At follow-up examination one year after, the patient is in complete remission.

Carboplatin associated anemia treated with subcutaneous erythropoietin - a pilot-study.

In nineteen patients with carboplatin-induced anemia (hemoglobin less than 90 g/l), recombinant human erythropoietin was administered subcutaneously three times a week on an outpatient basis. The initial dose was 50 Units/kg of body weight. If response was not achieved within 3 weeks, dose was increased to 75 Units/kg.

Control of chemotherapy-induced diarrhea with octreotide. A randomized trial with placebo in patients receiving cisplatin.

Cisplatin-related diarrhea is a relatively common complication in the clinical management of cancer patients and until now no treatment for this condition has been identified. Octreotide has been reported effective in the treatment of 5-fluorouracil-related diarrhea. To assess the safety and efficacy of octreotide in controlling diarrhea caused by cisplatin, 43 patients who had already had diarrhea during the 24-hour period following a previous cisplating administration were randomized to receive either octreotide or placebo during the next cisplatin course.

Etoposide, leucovorin, 5-fluorouracil and interferon alpha-2b in elderly gastric cancer patients: a pilot study.

A total of 23 advanced gastric cancer patients older than 65 years received 500 mg/m2 5-fluorouracil i.v. on days 2-4, 120 mg/m2 vepesid i.

A pilot clinical trial of postoperative adjuvant intraperitoneal cisplatin, 5-fluorouracil, 6S-leucovorin and interferon alpha 2b in patients with resected gastric cancer.

Aims And Background: The study was performed to assess the toxicity and impact on relapse pattern of postoperative intraperitoneal cisplatin, 5-fluorouracil, leucovorin and interferon therapy as adjuvant treatment for gastric cancer patients who are at high risk for recurrence after potentially curative resection (T2 N1-2; T3-4 N any Mo).

Patients And Methods: Starting 14 to 21 days after potentially curative resection of primary gastric cancers, 22 patients were given intraperitoneal cisplatin, 60 mg/m2; 5-fluorouracil, 1000 mg/m2; 6S-leucovorin, 250 mg/m2; interferon alpha 2b, 10 MU/m2; every other week for six times.

Results: After a median follow-up of 24 months, 63% of patients were alive and free of disease.

Intensive weekly chemotherapy for advanced gastric-cancer using 5-Fluorouracil, Cisplatin, epi-Doxorubicin, 6s-leucovorin and granulocyte-colony-stimulating factor.

Thirty-four advanced gastric cancer patients received, every week for nine weeks, 5-fluorouracil 500 mg/m2 iv; epi-doxorubicin 35 Mg/M2 iv; cisplatin 40 Mg/M2 iv; 6S-leucovorin 250 mg/M2 in 4 hour infusion. Granulocyte-colony stimulating factor, at the dose of 5 mug/kg, was administered daily from the day after to the day before each chemotherapy administration. 5 patients achieved a complete response and 20 a partial response, resulting in an overall response rate of 72% (95% confidence interval, 59% to 88%).