Anemia significantly affects quality of life of cancer patients, but the impact of hemoglobin levels on survival is still unclear. The aim of this retrospective study was to assess the prognostic ...role of pre-chemotherapy hemoglobin levels in patients with ovarian cancer. Two hundred twenty-two patients were divided in 3 groups based on baseline hemoglobin levels (< 10 gr/dl (54 pts., 24%); 10-11.9 gr/dl (87 pts., 39%), > or = 12 gr/dl (82 pts., 37%)). Correlations among baseline characteristics (age, ECOG performance status, stage, grading, histology, residual disease after primary surgery) and baseline hemoglobin level were analyzed. Poor performance status (p = 0.03), more advanced stage (p = 0.01), and sub-optimal residual disease (p = 0.002) were more frequent in patients with lower hemoglobin values. There was no significant correlation between baseline hemoglobin level and response rate to subsequent chemotherapy. Based on univariate analysis, hemoglobin categories were statistically significant predictors for time to progression (p = 0.0002) and overall survival (p < 0.0001). Based on multivariate analysis, patients with hemoglobin between 10 and 12 g/dl had a 1.45 hazard ratio (HR) for recurrence and a 1.35 HR of death compared with patients with normal hemoglobin. Patients with hemoglobin < 10 g/dl had a 2.02 HR of recurrence and a 2.49 HR of death compared with patients with normal hemoglobin. These findings show that hemoglobin level prior to chemotherapy is an independent predictor of progression-free survival and overall survival in patients treated for ovarian carcinoma.
The present study was conducted to evaluate activity and toxicity of the FLEC (folinic acid 100 mg/m2; 5-fluorouracil 1000 mg/m2; carboplatin 300 mg/m2; epirubicin 60 mg/m2) schedule as second-line ...treatment for progressive locally advanced or metastatic pancreatic cancer (LAMPC). FLEC was administered every 3 weeks with an angiographic catheter introduced into the tumor vascular bed. Thirty-two patients were enrolled. Twenty patients had a PS of 2. Twenty-five patients had metastatic disease to liver. Seven (21.9%) partial responses were observed (WHO criteria). Fifteen patients (46.9%) had stable disease and ten patients (31.2%) had progressive disease. The median OS from the diagnosis was 11.8 months. PS (p=0.0308) and pain (WHO scale, p=0.0222; analogic scale, p=0.0446) significantly improved after therapy. No patient discontinued treatment because of toxicity (NCI-CTC criteria). The current study shows that intraarterial chemotherapy is a good therapeutic option in second-line treatment of LAMPC.
C-erbB2 is over-expressed or amplified in many carcinomas. We assessed the relationship between erb-B2 immunoreactivity, and its predictive role in progression-free survival and treatment outcome in ...patients with cervical carcinoma. Sections from 65 cervical carcinoma were immunostained with antibody to p185 erbB2. Immunoreactive ErbB2 was found in 25 patients (38%) + 15 pts. (23%); ++ 10 pts. (15%). There were no correlation with age, performance status, grading and histology. Erb-B2 immunoreactivity significantly correlated with stage of the disease. Positive immunoreactivity was found in 63%, 44%, 14% and 0% of stage I, II, III and IV carcinomas, (p = 0.0045). Progression-free survival was longer in erb-B2 positive patients without reaching significance. No correlation was found between erbB2 and response to radiotherapy or chemotherapy. In conclusion, a significant proportion of stage I and II cervical cancer express erb-B2 compared to more advanced stages. Expression of the oncogene does not appear to be related to prognosis or treatment outcome.
After intravenous (i.v.) administration (10 mg/kg), the biodisposition of phenytoin (PHT) in serum (total and free concentration), cerebrospinal fluid (CSF), brain, and the interstitial fluid (IF) of ...the normal brain were determined in dogs. A sufficient volume of IF was obtained through a multiperforated polypropylene ball implanted into the left parietotemporal region for 4-5 weeks. PHT brain distribution coefficient values ranged between 1.9 and 3.75, while the ratios of IF to free serum PHT concentrations ranged between 0.19 and 1.04; thus, our data indicate that most of the free unbound PHT which enters the brain parenchyma accumulates in the cellular compartment. Furthermore, at 60 and 90 min the peak CSF and IF concentrations are delayed; thus, for PHT, an apparent diffusion front from the CSF into the extracellular space of the brain seems to occur.
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