Intraarterial infusion chemotherapy for metastatic liver tumors using multiple anti-cancer agents suspended in a lipid contrast medium

Article Abstract:

It is difficult to treat patients with metastatic liver tumors. When ethiodized oil (Lipiodol) is injected into the main artery leading to the liver, it is retained only by cancerous tissue. The intraarterial infusion of anti-cancer drugs combined with Lipiodol has been recently used as a therapeutic system for metastatic liver cancer. The drugs are released slowly and continuously. To enhance the sensitivity of the chemotherapy, more than one drug can be used. A clinical trial was conducted comparing the effectiveness of multiple drugs and single drugs, which were both combined with the oil, in 42 patients with metastatic liver cancer that could not be surgically removed. The multiple drug suspension consisted of 5-fluorouracil, doxorubicin, and mitomycin C, which were previously shown to be released from the oil independently of one another and at a constant rate. The single drugs used were doxorubicin or stylene mareic acid neocarzinostatin. Of the 25 patients who were treated with multiple anti-cancer drugs suspended in Lipiodol, 73.3 percent responded to the drugs which was demonstrated by a decrease in tumor size that was detected by a computed tomography scan. The mean survival time after treatment was 12.5 months. Of the 17 patients given the single drug suspension, 40 percent responded to the drug which was demonstrated by a decrease in tumor size, and the mean survival rate was 3.5 months. Therefore, the treatment with multiple drugs suspended in oil was a more effective therapy for metastatic liver cancer than the single drug suspension treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Antineoplastic agents, Metastasis, Cancer metastasis, Liver cancer

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A phase II trial of 5-fluorouracil, doxorubicin, mitomycin C, and leucovorin in advanced gastric carcinoma

Article Abstract:

Out of about 20,000 diagnosed cases of stomach cancer in 1989, only one quarter are candidates for curative surgery, and only a quarter of these are likely to survive more than five years. A currently accepted chemotherapeutic protocol for gastric cancer consists of 5-fluorouracil, doxorubicin, and mitomycin C, called the FAM regimen. However, the average survival time is still short, and stomach cancer remains the sixth largest cause of cancer deaths in the United States. In preparation for a randomized trial, which could definitively assess the contribution of leucovorin when added to the accepted FAM protocol, the safety and effectiveness of FAM-leucovorin treatment was evaluated in a total of 32 patients with stomach cancer. The estimated average survival time was 11.5 months for all patients, and a response rate of 38 percent was obtained among patients in whom the disease was measurable. These results are not outside the range of what might be expected with FAM alone. Cumulative bone marrow suppression required the limitation of FAM dosage to the point where the 5-fluorouracil component was no longer being administered at the optimum dose. Since the theoretical justification for leucovorin administration is as a possible synergistic boost for 5-fluorouracil, the addition of leucovorin to the FAM protocol is not an effective means of demonstrating whether any such synergism actually takes place. (Consumer Summary produced by Reliance Medical Information, Inc.)

Leucovorin, Folinic acid

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Urinary pepsinogen I as a tumor marker of stomach cancer after total gastrectomy

Article Abstract:

Pepsinogen is a protein made by stomach cells which is converted into the powerful digestive enzyme pepsin. Pepsinogen is actually a class of closely related proteins which have been labeled 1 through 7. Stomach cancer cells also make pepsinogen. The presence of pepsinogen in the blood or the urine is not a useful marker for the presence of stomach cancer in general, since so much pepsinogen is present from the normal stomach cells that the contribution of the tumor cells is negligible. However, patients with stomach cancer often must have their entire stomachs surgically removed. Since these patients should have little pepsinogen in their blood, an increase in pepsinogen should be a good indicator of the recurrence of stomach cancer. The amount of pepsinogen I was measured in the blood of 15 patients who have had their stomachs removed. After a normal range of pepsinogen I values was established, the same test was performed on 74 more stomach cancer patients who had their stomachs removed. The test indicated 22 patients as positive. In 20 of these cases, clinical symptoms were present that indicated the recurrence of stomach cancer. Therefore, the false-positive rate could be at most two out of 22. It is not yet known, however, whether these two patients may actually have recurrent stomach cancer which has not yet begun to produce symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Tumor markers, Pepsinogen

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