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J Izsó

Publications and source records attributed to J Izsó.

4 recordsLinked to original sources

[Irinotecan--experience with second-line treatment in advanced colorectal cancer] .

The prognosis for patients with advanced colorectal cancer who fail to respond to a 5-FU based therapy is poor. About 7% response rate can be achieved with second line therapeutic regiments, the overall survival is about 6-7 months. The aim of authors was to assess the efficacy and toxicity profile of irinotecan (CAMPTO) in patients with advanced colorectal cancer, resistant to 5-FU based chemotherapy. From October 1996 to November 1998 19 previously treated metastatic colorectal cancer patients with documented progression were recruited. Irinotecan was given at a dose of 350 mg/m2 i.v. over 90 min. every 3 week. Tumor response and toxicity were assessed using WHO criteria. Median age: 59.7 years (42-72). Tumor sites: 12/19 colon, 7/19 rectum. 11/19 patients had 1 metastatic site, 8/19 had 2 or more metastatic sites. CR: 0/19, PR: 3/19, MR: 2/19, SD: 10/19, PD: 4/19. Median time to progression was 9.1 months (range 1.5-22). The overall median survival was 15.5 months (range 2.5-37). Grade 3-4 delayed diarrhoea occurred in 26.3% of patients. Grade 3 neutropenia occurred in 15.7% of patients. Preliminary results confirm the clinical value of irinotecan in 5-FU resistant metastatic colorectal cancer with tolerable toxicity profile. Irinotecan should be considered as the basic chemotherapeutic agent for second line treatment of metastatic colorectal cancer.

Adult↗

[Low-dose leucovorin and interferon-alpha as modulators of 5-fluorouracil for adjuvant chemotherapy of colorectal cancer].

It has recently been published the results of a prospective, comparative study for adjuvant chemotherapy of 164 colorectal cancer patients. Pathological stages were Dukes B 79, C 85 of the cases. The site of primary tumour was colon 108, rectum 56 of the patients. The treatment protocols were as follows: 425 mg/m2 5-fluorouracil plus 20 mg/m2 leucovorin on days 1-5 at 28 days cycles six times (LV group). The IFN group received the same chemotherapy completed with weekly 3 x 3 MIU interferon alpha. Both treatment groups were well balanced. The mean follow up time was 38.1 months. There were 91 patients of relapse and 65 deaths this time. The time to progression was 15 months in the LV group and 12.7 months in the IFN group (p < 0.05). The mean survival time was 24 months in the LV group compared to 22.3 of the IFN group. The frequency and sites of relapses did not differ statistically between the both groups. The preoperative CEA-level was elevated in 42 cases. The mean survival time was 26.4 months in the cases having normal CEA-level compared to 16.1 months of the cases with high-level (p < 0.001). The side-effects were transient and mild, while in the group treated with interferon were more instances of fever, fatigue, flu-like syndrome, psychic disorders, depression and agitation. The administration of interferon had to be interrupted in 4 cases. The results of interim analysis suggest choosing the so-called Mayo protocol for the standard adjuvant treatment of colorectal cancer.

Adjuvants, Pharmaceutic↗

[Combined therapy of metastatic liver neoplasms: intrahepatic chemoembolization and systemic chemotherapy].

Chemoembolisation has been an effective treatment-option for unresectable colorectal liver metastases, however it frequently fails because of tumour progression outside the liver. We conducted a pilot study to assess the toxicity and efficacy of combined regional and systemic chemotherapy for patients having liver dominant disease. Three cycles of chemoembolisation using 50 mg adriamycin, 8 mg mitomycin C, 50 mg cisplatinum admixed with 10 ml of lipiodol were given at 6 weeks intervals. The systemic therapy consisted of 425 mg/m2 5-fluorouracil and 20 mg/m2 leucovorin by intravenous infusion 1-5 days repeated every 28 days. 41 patients were treated for the period 1st January 1994-31st December 1996. Out of these 27 were male, 14 female with a medium age of 62 years (40-78). Primary site of tumour was colon in 30 cases and rectum in 11 cases. 14 patients received prior chemotherapy (5 adjuvant, 9 palliative). Mean follow up time is 18 months (4-36) in this study. 27 partial and 1 complete remissions were achieved at the average response rate of 68%. Mean time of progression was 10.7 months (4-18), overall survival time was 15 months (4-36). Common toxicity was the postembolisation syndrome consisting of abdominal pain, fever, chills, reversible elevated liver enzymes. Four patients had drug-induced cholangiohepatitis. At 15 patients we experienced grade 3, toxicity (5 diarrhoea, 3 mucositis, 2 vomiting, 2 leukopenia, 2 thrombocytopenia, one skin rush). No treatment related death or catheter complications were observed. Although these treatment results are superior to our historical experience, a controlled clinical trial will be acquired to establish this approach.

Antimetabolites, Antineoplastic↗