A combination of cisplatin (60 mg/m2 i.v. on day 1), etoposide (100 mg/m2 i.v. on days 1-3) and bleomycin (15 mg i.v. on days 1 and 8) (PEB regimen) was given every 4 weeks as salvage therapy in 10 refractory and 13 relapsing patients with poor-prognosis non-Hodgkin's lymphomas. All but one of these patients had previously been treated with anthracycline-containing combination chemotherapy. We observed 4 complete remissions (CRs) and 4 partial responses (PRs), whereas 3 patients showed only a minor response (MR) and 12 were considered to be induction failures. Therefore, the objective (CR + PR) response rate was 35%. The most frequent side effect was vomiting, registered in all patients despite antiemetic treatment. Hematologic toxicity was of moderate degree, and bone marrow recovery was observed after almost all cycles after a 3-week rest period. Since objective responses were achieved only in relapsing patients, the PEB regimen seemed to be effective in these cases, whereas it was useless in early refractory non-Hodgkin's lymphomas.
A new combination chemotherapy including mitoxantrone 10 mg/m2 i.v. on day 1 and 5-fluorouracil 400 mg/m2 i.v. plus folinic acid 200 mg/m2 i.v. on days 1-5 was administered every 28 days to 13 patients with locally advanced or metastatic colon (1 case), ractosigmoid colon (4 cases), or rectum (8 cases) carcinoma. The median number of cycles performed was 3 (range, 1-9). No patient achieved complete or partial remission with this regimen, whereas 5 showed a stable disease lasting 3-8 months. Acute toxicity was mild/moderate in intensity and comparable to that reported with the standard 5-fluorouracil + folinic acid combination. Since we observed no major responses in our 13 consecutive patients, we consider that the overall activity of our regimen, at the doses and schedule utilized, was only moderately effective in advanced colorectal carcinoma.
26 patients with astrocytoma grade II-III, and 36 with malignant glioma (astrocytoma grade IV or glioblastoma) were submitted three days after surgery to a cycle of combination chemotherapy, including BCNU, VCR, PCZ (BVP). Eighteen days after surgery, patients received 40 Gy (astrocytoma grade II-III) or 45 Gy (malignant glioma) of megavoltage whole-brain irradiation, with an additional boost to the 'tumor' bed of 20 Gy, delivered in 6 weeks. Vincristine was injected weekly during radiotherapy. At the end of radiotherapy, patients received BVP every 6 weeks for at least 8 cycles or until a recurrence or progressive disease. Performance status of grade 1 or 2 was achieved in 15 (60%) and in 5 (20%), respectively, of patients with astrocytoma grade II-III after 6 months, and in 6 ps. (29%) and in 9 ps. (42%) after 12 months of follow-up. Only 2 (5.5%) and 18 (64%) patients with malignant glioma achieved a performance status of grade 1 or 2 after 6 months, and these proportions are 6% and 35%, respectively, after 12 months. After a 5-year follow-up, 59% of patients with astrocytoma are still alive, with a median survival time of 60+ months, whereas only 4% of patients with malignant glioma are alive, with a median of 11.2 months.
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