A Danikiewicz | PubMed Health

PubMed2001

[Evaluation of quality of life in patients with advanced colorectal cancer treated with topotecan].

UNLABELLED: During last years a few new directions appeared in therapy of advanced colorectal cancer. Topotecan, a camptothecin analog, seems to be one of the promising novel drug in these cases. Its unique mechanism of action is connected with inhibition of the nuclear enzyme topoizomerase I. Assessing therapeutic effects of new cytotoxic drugs we should consider their impact on survival time and quality of life as well. The aim of our study was the attempt to assess the quality of life of patients with advanced colorectal cancer (IV stage in TNM scale), treated by topotecan. Clinical trial was performed in the group of 10 patients. Topotecan was administered intravenously at 1.5 mg/m2/day for 5 days and repeated every 21 days. Quality of life assessment was performed at special time points using Rotterdam Symptom Checklist. We observed improvement in quality of life in six out ten patients having advanced colorectal cancer. Two patients did not show any change in quality of life and two patients with progression of disease demonstrated lower quality of life during topotecan treatment. CONCLUSION: Topotecan has a positive influence on quality of life of patients with advanced colorectal cancer. Further study are needed to confirm this observation.

Aged↗

PubMedDate not supplied

Decrease of erythropoietin level by human recombinant tumour necrosis factor alpha (hrec TNFalpha) in patients with advanced cancer.

UNLABELLED: Anaemia is a frequent complication of chronic inflammation, infectious diseases and cancer. Inappropriate erythropoietin production is regarded as one of the main causative factors responsible for the occurrence of anaemia. The pathogenesis of TNFalpha induced-anaemia has not been fully clarified yet and its influence on hematopoiesis has been suggested. We performed a clinical study to access the influence of hrec TNFalpha administration on plasma EPO concentration and the degree of anaemia in patients with advanced solid tumours for whom no other kind of therapy but palliative treatment was available. All these patients exposed mild anaemia (HT 36.1 +/- 1.0%). Plasma EPO was estimated at 8 a.m. before and after 5 days of TNFalpha therapy with a dose of 75 pg/day iv (cycle I). Two weeks later plasma EPO was estimated again before and after 5 days of TNFalpha administration of a double dose (150 microg/day) (cycle II). The control group comprised 8 non-cancer patients (5M/3F, age 48.5 +/- 6yr) with the same degree of anaemia (HT 36 +/- 1.1%) due to haemorrhage. In the control group the plasma EPO level was significantly higher (54.2 +/- 8 mU/ml) than in cancer patients before cycle I (17.1 +/- 2.5 mU/ml) and II (14.6 +/- 3.8 mU/ml) respectively.TNF administration was followed by a significant decline of plasma EPO both after the first (17.1 +/- 2.5 vs 9.0 +/- 1.5 mU/ml) and second cycle (14.6 +/- 3.8 vs 8.4 +/- 2.0 mU/ml) of TNF treatment. CONCLUSIONS: Patients with solid cancer and mild anaemia are characterised by inappropriate low plasma EPO concentration. Therapy with TNFalpha exerts a suppressive effect on EPO secretion in these patients.

Adult↗