levoleucovorin and Hydronephrosis

To evaluate the feasibility of concurrent chemoradiotherapy (CCRT) in very advanced bladder cancer (stage IV) and further analyze the prognostic factors in these patients.. We retrospectively reviewed the clinicopathological features and outcomes of patients with muscle-invasive bladder cancer after CCRT. Sixty-one patients with muscle-invasive bladder cancer who underwent CCRT between January 1996 and March 2011 were eligible for evaluation. Chemotherapy consisted of cisplatin (50 mg/m(2)) at day one, and 5-fluorouracil (500 mg/m(2)/day) and leucovorin (50 mg/m(2)/day) at days 1, 2, and 3, every three weeks, for a maximum of six cycles. The radiation dose was 44-45 Gy to the entire pelvis and 60-66 Gy to the entire bladder, with a daily fraction of 1.8-2 Gy.. By August 2012, the estimated median progression-free survival (PFS), cancer-specific survival, and overall survival (OS) were 25.7, 64.3 and 35.8 months, respectively; the complete response (CR) rate was 68.8%. Both clinical stage and CR following CCRT, were independent prognostic factors for PFS, cancer-specific survival, and OS. Patients with stage IV disease who achieved CR had significantly better PFS (log-rank p=0.01), cancer-specific survival (log-rank p=0.01), and OS (log-rank p=0.01) than those with stage II/III disease but no CR. The absence of hydronephrosis was the only factor predictive of CR after CCRT (odd ratio, 4.21; p=0.04).. CR was the most important prognostic factor in muscle-invasive bladder cancer. Selected patients with stage IV bladder cancer could benefit from CCRT if a CR is achieved.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Chemoradiotherapy; Cisplatin; Disease-Free Survival; Female; Fluorouracil; Humans; Hydronephrosis; Leucovorin; Male; Middle Aged; Muscle Neoplasms; Neoplasm Invasiveness; Neoplasm Staging; Radiotherapy Dosage; Remission Induction; Retrospective Studies; Survival Rate; Treatment Outcome; Urinary Bladder Neoplasms

A 61-year-old complaining of anorexia and general fatigue was admitted to our hospital for further examination. She was diagnosed as advanced sigmoid colon cancer with multiple metastases of lung, liver, and left hydronephrosis. Since curative surgery was not deemed possible, we started chemotherapy with bevacizumab/FOLFOX6 (bi-weekly drip infusion). After the 6th course, colonoscopy revealed a significant tumor reduction and changes to the scar tissues. CT did not reveal a complete disappearance, but found some reductions in metastases of lung and liver. Sigmoidectomy and lymph node resection (D1) were performed. We did not disappeared any dissemination and the histological diagnosis revealed a complete disappearance of cancer cells in the main tumor. She was discharged 13 days after surgery, following chemotherapy which included bevacizumab and XELOX. The chemotherapy using bevacizumab/FOLFOX6 is a candidate for the standard treatment strategy for inoperable advanced colon cancer. Herein we report this rare case with a review of the literature.

Topics: Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Female; Fluorouracil; Humans; Hydronephrosis; Leucovorin; Liver Neoplasms; Lung Neoplasms; Middle Aged; Organoplatinum Compounds; Sigmoid Neoplasms; Tomography, X-Ray Computed

The patient was a 64-year-old male diagnosed as advanced sigmoid colon cancer accompanied with hydronephrosis caused by peritoneal dissemination and para-aortic lymph node metastases. We performed transverse colostomy in the end of June 2008. Though he got renal failure, he was recovered by dialysis and diuretic. He received chemotherapy with LV+5-FU in the middle of August, continuously with bevacizumab (BV)+mFOLFOX6 in the end of October. In December, an elevated CEA marker was decreased after these treatments. Sigmoidectomy was done in the beginning of February 2009, dissemination disappeared completely. Histologically, most mucinous carcinoma cells disappeared or denatured, with viable tumor cells slightly remained.

Topics: Angiogenesis Inhibitors; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Aorta, Abdominal; Bevacizumab; Colostomy; Fluorouracil; Humans; Hydronephrosis; Leucovorin; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Seeding; Organoplatinum Compounds; Peritoneal Cavity; Sigmoid Neoplasms