[Maturation therapy for advanced neuroblastoma-therapeutic effects and problems].
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Seven children with advanced neuroblastoma were treated with maturation therapy. This therapy consisted of 12 hours drip infusion of papaverine (40-45 mg/kg/day) for 2 days with or without high dose cyclophosphamide (2,000-3,600 mg/m2). During maturation therapy all patients received intravenous hyperalimentation. One patient who had received papaverine alone did not respond to the therapy. Among 6 patients treated with papaverine and high dose cyclophosphamide, 3 responded to the therapy, 2 did not and one died soon after the therapy. However, similar responses were obtained in 2 of 3 responders with high dose cyclophosphamide alone. After all, papaverine infusion was evaluated to be effective only in one patient. The clinically severe complications of papaverine infusion were somnolence in all patients and extrapyramidal symptoms in 6 patients. Because of these extremely high toxicity rates with little evidence of therapeutic effect, selection for this therapy should be carefully done and the treatment plan should be reconsidered.Keywords:
Therapeutic effect
Infusion therapy
Combination therapy
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This paper reports the toxicity of OPEC/OJEC chemotherapy in stage 4 neuroblastoma patients over 1 year of age.Ninety-five patients with stage 4 neuroblastoma received alternating courses of OPEC/OJEC--vincristine 1.5 mg/m2 (O), cisplatin 80 mg/m2 (P), etoposide 200 mg/m2 (E), cyclophosphamide 600 mg/m2 (C), and carboplatin 500 mg/m2 (J), every 21 days if there was haematological recovery.Seventy out of ninety-five (74%) patients completed seven or more courses and were evaluable for toxicity. Of these 70 patients, 33% had more than three episodes of fever and sepsis, 35% required more than five blood or platelet transfusions, 36% had grade 2 or more gastrointestinal toxicity and 9% had neurotoxicity. There was a median reduction in GFR of 32 ml/min/1.73 m2 (-46 to 134) and there was one toxic death.OPEC/OJEC is a well-tolerated therapy for stage 4 neuroblastoma over 1 year of age.
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Seven children with advanced neuroblastoma were treated with maturation therapy. This therapy consisted of 12 hours drip infusion of papaverine (40-45 mg/kg/day) for 2 days with or without high dose cyclophosphamide (2,000-3,600 mg/m2). During maturation therapy all patients received intravenous hyperalimentation. One patient who had received papaverine alone did not respond to the therapy. Among 6 patients treated with papaverine and high dose cyclophosphamide, 3 responded to the therapy, 2 did not and one died soon after the therapy. However, similar responses were obtained in 2 of 3 responders with high dose cyclophosphamide alone. After all, papaverine infusion was evaluated to be effective only in one patient. The clinically severe complications of papaverine infusion were somnolence in all patients and extrapyramidal symptoms in 6 patients. Because of these extremely high toxicity rates with little evidence of therapeutic effect, selection for this therapy should be carefully done and the treatment plan should be reconsidered.
Therapeutic effect
Infusion therapy
Combination therapy
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In developing a chemotherapeutic program for children with disseminated neuroblastoma, we established three human neuroblastoma lines in cell culture to study the effects of dibutyryl cyclic AMP, papaverine, 5-trifluoromethyl-2′-deoxyuridine, and cyclophosphamide on cell growth, biochemical behavior, and morphology. Based upon our studies, a clinical treatment program was designed. We have treated 15 patients with disseminated neuroblastoma and have established the optimum dose range and sequence of these drugs. Early results were promising; plans for continuation of clinical and experimental studies were discussed.
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Background This paper reports the toxicity of OPEC/OJEC chemotherapy in stage 4 neuroblastoma patients over 1 year of age. Procedure Ninety-five patients with stage 4 neuroblastoma received alternating courses of OPEC/OJEC—vincristine 1.5 mg/m2 (O), cisplatin 80 mg/m2 (P), etoposide 200 mg/m2 (E), cyclophosphamide 600 mg/m2 (C), and carboplatin 500 mg/m2 (J), every 21 days if there was haematological recovery. Results Seventy out of ninety-five (74%) patients completed seven or more courses and were evaluable for toxicity. Of these 70 patients, 33% had more than three episodes of fever and sepsis, 35% required more than five blood or platelet transfusions, 36% had grade 2 or more gastrointestinal toxicity and 9% had neurotoxicity. There was a median reduction in GFR of 32 ml/min/1.73 m2 (−46 to 134) and there was one toxic death. Conclusions OPEC/OJEC is a well-tolerated therapy for stage 4 neuroblastoma over 1 year of age. Med. Pediatr. Oncol. 36:239–242, 2001. © 2001 Wiley-Liss, Inc.
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Abstract The acute toxic action of a number of common chemicals was tested by their ability to cause detachment of cultured mouse neuroblastoma C1300 cells. A TD25 value was obtained by graphic estimation of the concentration needed to cause 25% of the total cell number to detach. These TD25 values were compared with LD50 values obtained from the literature, and they were found to correlate with a coefficient of 0.86. For six of the tested substances—diuron, butylated hydroxytoluene, benzidine, cyclophosphamide, Na 2 SeO 3 , and KCN‐a very poor correlation was obtained. These diverging results could be ascribed to deficiencies in the neuroblastoma cell detachment test and emphasize the necessity for combined in vitro test procedures.
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TO ADDRESS THE PROBLEM OF DRUG DOSAGE as a limiting factor for successful chemotherapy, seven patients with Stage IV neuroblastoma were treated with very high dose cyclophosphamide with imidazole carbox-imide (DTIC) and vincristine sulfate in conjunction with intensive supportive care. None of the patients experienced a complete response. The major toxicity was myelosuppression, complicated by significant infections. Toxicity was significantly more severe in this study than in similar regimens using these three drugs at conventional doses. Although the number of patients in this study was small and most had received prior therapy, our data do not support the efficacy of very high dose cyclophosphamide in the treatment of Stage IV neuroblastoma.
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Objective To investigate the clinical effect of small incision operation in treating children hernia.Methods Retrospective review of clinical data of 40 cases of children with indirect inguinal hernia in children in recent years,generally comparable,20 patients were treated with small incision operation treatment as the observation group,the remaining 20 patients using ordinary incision operation treatment as control group.The incision size,operative time,blood loss and length of hospital stay and postoperative complications were analyzed.Results 40 patients were successfully completed the operation,no postoperative complications.Operative time and length of stay in observation group were significantly less than the control group(P 0.01).Conclusion Compared with the traditional surgical treatment,minimally invasive surgical treatment of children hernia with a small incision,quick recovery,with the desired therapeutic effect.
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Objective: To observe the clinical efficacy of the conservative treatment for early postoperative inflammatory after ileus traumatic intestinal rupture. Method: In our hospital from May 2008 to December 2012,82 patients treated traumatic intestinal rupture the postoperative the EPISBO patients,The clinical data were analyzed retrospectively,the clinical features and outcome of conservative treatment were reviened.Result: The group of 82 patients after the conservative treatment,53 cases were cured,effective in 25 cases,total effective rate was 95. 1%,transit operation of one case,with out deaths. After cure gastrointestinal symptoms such as bloating,abdominal pain,were clinically cured,were followed up for 6 to 18 months,no recurrence. Conclusion: Conservative treatment is the preferred method of treatment of early postoperative inflammatory after ileus traumatic intestinal rupture,but should discover surgical indications given surgery to improve the therapeutic effect.
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Metronomic chemotherapy (MCT), the chronic administration, at regular intervals, of low doses of chemotherapeutic drugs without extended rest periods, allows chronic treatment with therapeutic efficacy and low toxicity. Our preclinical results suggested that combined MCT with cyclophosphamide and celecoxib could inhibit breast cancer growth. The aim of this study was to determine the toxicity, safety and efficacy of oral MCT with cyclophosphamide 50 mg per orem daily and celecoxib 400 mg (200 mg per orem two-times a day) in advanced breast cancer patients. During the first stage of the study, the therapeutic response consisted of prolonged stable disease for ≥24 weeks in six out of 15 (40%) patients with a median duration of 37.5 weeks and a partial response in one out of 15 (response rate: 6.7%) patients lasting 6 weeks. The overall clinical benefit rate was 46.7%. The median time to progression was 14 weeks. Progression-free survival at 24 weeks was 40% and the 1-year overall survival rate was 46.7%. The adverse events were mild (gastric, grade 1; and hematologic, grade 1 or 2). No grade 3 or 4 toxicities were associated with the treatment. Evaluation of patients' quality of life showed no changes during the response period. MCT with cyclophosphamide plus celecoxib is safe and shows a therapeutic effect in advanced breast cancer patients.
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