Background. One of the most active chemotherapy combinations in advanced or recurrent cervical cancer is cis-platin-paclitaxel. However, this palliative regimen is associated with significant toxicity. Carboplatin-pac...Background. One of the most active chemotherapy combinations in advanced or recurrent cervical cancer is cis-platin-paclitaxel. However, this palliative regimen is associated with significant toxicity. Carboplatin-paclitaxel is thus an attractive option. Methods. Patients with advanced or recurrent carcinoma of the cervix treated with carboplatin-paclitaxel from April 2000 were included in the study. Starting doses of carboplatin-paclitaxel were: AUC 5-6 and 155-175 mg/m2, respectively, repeated every 28 days. Results. Twenty-five women treated with this combination were identified. Twenty-three women (92% ) had prior treatment with pelvic radiotherapy and 14 (56% ) had had concurrent radio-sensitizing cisplatin. There was a 20% PR and a 20% CR rate (10/25). The median progression-free survival for the entire group was 3 months. Responders had a median PFS of 16 months. Fourteen patients (56% ) had died of disease progression. The median overall survival (OS) was 21 months. Common toxicities included: grade 1 or 2 anemia, 68% ; grade 3 or 4 anemia, 32% ; grade 3 or 4 neutropenia, 32% ; and grade 1 or 2 peripheral neuropathy, 24% . ECOG PS did not change significantly while on treatment. Eighty-four percent of treatments were delivered on time, and 96% at full dose. Conclusions. Carboplatinpaclitaxel is an active combination in advanced and recurrent cervical cancer. In this predominantly pre-irradiated group, the combination was deliverable, well tolerated, and the most commonly observed toxicity was anemia.1078. A phase Ⅱ evaluation of flavopiridol as second-line chemotherapy of endometrial carcinoma: A Gynecologic Oncology Group study Grendys Jr. E.C./Blessing J.A./Burger R./Hoffman J. E.C. Grendys Jr., Florida Gynecologic Oncology, 2780 Cleveland Avenue, Fort Myers, FL 33901, United States -GYNECOL. ONCOL. 2005, 98/2 (249-253) Objective. A phase Ⅱ study was conducted to determine the efficacy of single agent flavopiridol therapy in patients with recurrent or persistent endometrial adenocarcinoma refractory to established treatments. Methods. Eligible patients with measurable disease who failed primary therapy including one cytotoxic regimen were eligible for the trial. They were treated with single agent flavopiridol (50 mg/m2/day, Ⅳ bolus days 1, 2, 3). Treatment was repeated every 21 days with dose adjustments made for toxicity. Patients were treated until progression of disease or adverse side effects precluded further therapy. Results. A total of 26 patients were enrolled in the study of whom, 23 patients were eligible. There were no objective responses. Five patients had stable disease (22% ), 15 (65% ) had increasing disease, and response could not be assessed in 3 (13% ). The most frequent side effects included anemia, neutropenia, and diarrhea, all of which appeared manageable. Conclusion. Flavopiridol as a single agent in the above dosing schedule appears to have minimal activity as second-line chemotherapy of endometrial adenocarcinoma.展开更多
Background. The objective of this study was to compare the clinical presentation and outcomes of women with ovarian and uterine carcinosarcoma (CS). Methods. We performed a retrospective review of patients treated for...Background. The objective of this study was to compare the clinical presentation and outcomes of women with ovarian and uterine carcinosarcoma (CS). Methods. We performed a retrospective review of patients treated for uterine or ovarian CS from 1952 to 2003. Fisher’ s Exact Test was used to compare patient characteristics. Survival curves were estimated using the Kaplan-Meier method and compared using the log rank test. Results. We identified 87 patients with uterine CS and 18 with ovarian CS. There was no difference in age, body mass index, parity, menopausal status, family history of cancer, history of pelvic radiation, diabetes or hypertension between the two groups. 43% of women with uterine CS presented at stage I/II, compared to 28% of women with ovarian tumors (P = 0.0003). 82% of patients with ovarian tumors received adjuvant chemotherapy with or without radiation; 51% of the patients in the uterine CS group received adjuvant radiation therapy. The median length of follow-up was 13 months. There was no difference in the Kaplan-Meier estimates of overall survival between the two disease sites. The median survival for uterine CS patients was 16 months, compared to 11 months in the ovarian CS group; HR = 0.991 (95% CI = 0.534, 1.839). Conclusions. We found no differences in patient demographics between the two groups. Despite differences in stage and initial treatment, there was no difference in survival between women with uterine and ovarian CS.展开更多
文摘Background. One of the most active chemotherapy combinations in advanced or recurrent cervical cancer is cis-platin-paclitaxel. However, this palliative regimen is associated with significant toxicity. Carboplatin-paclitaxel is thus an attractive option. Methods. Patients with advanced or recurrent carcinoma of the cervix treated with carboplatin-paclitaxel from April 2000 were included in the study. Starting doses of carboplatin-paclitaxel were: AUC 5-6 and 155-175 mg/m2, respectively, repeated every 28 days. Results. Twenty-five women treated with this combination were identified. Twenty-three women (92% ) had prior treatment with pelvic radiotherapy and 14 (56% ) had had concurrent radio-sensitizing cisplatin. There was a 20% PR and a 20% CR rate (10/25). The median progression-free survival for the entire group was 3 months. Responders had a median PFS of 16 months. Fourteen patients (56% ) had died of disease progression. The median overall survival (OS) was 21 months. Common toxicities included: grade 1 or 2 anemia, 68% ; grade 3 or 4 anemia, 32% ; grade 3 or 4 neutropenia, 32% ; and grade 1 or 2 peripheral neuropathy, 24% . ECOG PS did not change significantly while on treatment. Eighty-four percent of treatments were delivered on time, and 96% at full dose. Conclusions. Carboplatinpaclitaxel is an active combination in advanced and recurrent cervical cancer. In this predominantly pre-irradiated group, the combination was deliverable, well tolerated, and the most commonly observed toxicity was anemia.1078. A phase Ⅱ evaluation of flavopiridol as second-line chemotherapy of endometrial carcinoma: A Gynecologic Oncology Group study Grendys Jr. E.C./Blessing J.A./Burger R./Hoffman J. E.C. Grendys Jr., Florida Gynecologic Oncology, 2780 Cleveland Avenue, Fort Myers, FL 33901, United States -GYNECOL. ONCOL. 2005, 98/2 (249-253) Objective. A phase Ⅱ study was conducted to determine the efficacy of single agent flavopiridol therapy in patients with recurrent or persistent endometrial adenocarcinoma refractory to established treatments. Methods. Eligible patients with measurable disease who failed primary therapy including one cytotoxic regimen were eligible for the trial. They were treated with single agent flavopiridol (50 mg/m2/day, Ⅳ bolus days 1, 2, 3). Treatment was repeated every 21 days with dose adjustments made for toxicity. Patients were treated until progression of disease or adverse side effects precluded further therapy. Results. A total of 26 patients were enrolled in the study of whom, 23 patients were eligible. There were no objective responses. Five patients had stable disease (22% ), 15 (65% ) had increasing disease, and response could not be assessed in 3 (13% ). The most frequent side effects included anemia, neutropenia, and diarrhea, all of which appeared manageable. Conclusion. Flavopiridol as a single agent in the above dosing schedule appears to have minimal activity as second-line chemotherapy of endometrial adenocarcinoma.
文摘Background. The objective of this study was to compare the clinical presentation and outcomes of women with ovarian and uterine carcinosarcoma (CS). Methods. We performed a retrospective review of patients treated for uterine or ovarian CS from 1952 to 2003. Fisher’ s Exact Test was used to compare patient characteristics. Survival curves were estimated using the Kaplan-Meier method and compared using the log rank test. Results. We identified 87 patients with uterine CS and 18 with ovarian CS. There was no difference in age, body mass index, parity, menopausal status, family history of cancer, history of pelvic radiation, diabetes or hypertension between the two groups. 43% of women with uterine CS presented at stage I/II, compared to 28% of women with ovarian tumors (P = 0.0003). 82% of patients with ovarian tumors received adjuvant chemotherapy with or without radiation; 51% of the patients in the uterine CS group received adjuvant radiation therapy. The median length of follow-up was 13 months. There was no difference in the Kaplan-Meier estimates of overall survival between the two disease sites. The median survival for uterine CS patients was 16 months, compared to 11 months in the ovarian CS group; HR = 0.991 (95% CI = 0.534, 1.839). Conclusions. We found no differences in patient demographics between the two groups. Despite differences in stage and initial treatment, there was no difference in survival between women with uterine and ovarian CS.
