levoleucovorin and Cystadenocarcinoma

This report compares long-term survival rates for patients treated with four different chemotherapeutic regimens for Stages III and IV ovarian adenocarcinoma. The patients were entered into consecutive, prospective, randomized studies with an essentially common chemotherapeutic arm. The first study compared the single agent melphalan with actinomycin D, 5-fluorouracil, and Cytoxan. The second study compared 5-fluorouracil plus Cytoxan and methotrexate-leucovorin rescue plus Cytoxan. The patient characteristics in the two studies were very similar except for more aggressive tumor-reductive operations in the second study. Observed survival rates for the first 2 years in the second study were very much higher than in the first study. However, by the third, fourth, and fifth years, the survival rates of the 5-fluorouracil-Cytoxan-treated individuals had reached the same low levels seen in the first study. It appears that an optimum surgical procedure by itself may enhance survival during the first 2 years. Survival with methotrexate-leucovorin rescue plus Cytoxan was statistically significantly better than with melphalan or actinomycin D-5-fluorouracil-Cytoxan. Third-, fourth-, and fifth-year survival rates with methotrexate-leucovorin rescue plus Cytoxan were substantially higher than with 5-fluorouracil-Cytoxan; however, the survival distributions for these two treatments were not statistically significantly different. Long-term survival rate data for patients with Stages III and IV ovarian adenocarcinomas treated with chemotherapy are rare. The 19% 5-year survival rate with methotrexate-leucovorin rescue plus Cytoxan in the present study is considerably higher than other reported survival rates.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Child; Cyclophosphamide; Cystadenocarcinoma; Dactinomycin; Female; Fluorouracil; Humans; Leucovorin; Methotrexate; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Ovary; Prognosis; Prospective Studies; Random Allocation; Time Factors

A group of 60 patients with advanced head/neck cancer were treated with high-dose folinic acid (500 mg/m-2/week-1) plus 5-fluorouracil (400 mg/m-2/week-1 on day 1, and cisplatin (20 mg/m-2/week-1) 24 h after folinic acid infusion was completed. Out of 55 evaluable patients, 10 patients (18%) experienced a complete response with a mean duration of 11.4+ months, 25 patients had a partial response (45%) of 6.7+ months, 6 patients (11%) showed a stabilization of 4.8+ months, and 14 (25%) progressed. The overall response rate was 63.6% (95% confidence limits 56.5%-69.5%). Patients pretreated with radiotherapy had a 67% overall response rate, while those pretreated with chemotherapy showed a 54% overall response rate. All patients with cancer of the oropharynx had a major response, while patients with cancer of the oral cavity had the lowest response rate. The mean survival of patients who attained a complete response was 14.5+ months. Partial responders had a mean survival of 10.6+ months, while patients who progresses survived a mean of 3.6+ months. The treatment has been very well tolerated with few cases of grade 3 gastrointestinal toxicity. Grade 1-2 leukopenia was recorded in 64% of cases, grade 1-2 nausea/vomiting in 85%. In one case therapy was stopped because of persistent diarrhoea.

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinoma, Squamous Cell; Cisplatin; Cystadenocarcinoma; Drug Administration Schedule; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Leucovorin; Male; Middle Aged; Neoplasm Metastasis