A 19‐year‐old man with a germ cell tumor who experienced hypertension, acute myocardial infarction, and cerebrovascular accident (CVA) associated with hypomag‐nesemia as late complications of cisplatin‐based chemotherapy is presented, and previously reported cases in the literature are reviewed. Different physiopathologic mechanisms are hypothesized for early and late vascular complications of cisplatin.

1) Small intestinal lymphoma occurs more frequently than gastric lymphoma in our study. 2) The median age of the Turkish patients with primary GIL is approximately 10 years less than those in the Western countries. 3) The therapeutic results of S+CT are superior to those of CT in the early stages of the disease.

Twenty-nine patients with advanced refractory breast cancer were treated with cisplatin 20 mg/m2/d and VP-16 100 mg/d for 5 days every 3-4 weeks. Ten patients received mitomycin C 10 mg/m2 every 6 weeks additionally. Partial response was obtained in 10 of 26 evaluable patients (38%). The response rates for the group treated with and without mitomycin C were 40% and 37.5%, respectively. Median response duration was 5.5 months in partial responders. Median survival was 9.5 months for partial responders and 2 months for the rest of the patients. Cisplatin and VP-16 combination can be considered as a salvage treatment in heavily pretreated patients with advanced breast cancer.

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Prognostic factors and the results of the cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) ± bleomycin treatment in 93 consecutive evaluable patients with aggressive lymphomas are presented. The overall response rate, excluding 7 patients with primary extranodal lymphoma who were in complete remission after surgery, was 83% with a complete response (CR) rate of 69%. Overall survival (OS) rates of all patients and disease-free survival (DFS) rates of complete responders at 4 years were 52 and 66%, respectively. Almost two thirds of the patients could be given at least 75% of the planned chemotherapy doses. Treatment toxicities were in acceptable limits, only 10% of the patients had grade 3-4 hematological toxicity. Age, performance status (PS), stage, number of extranodal sites (ENS) (≤ 1 vs. > 1), B symptoms, serum LDH levels were evaluated as prognostic factors. Univariate survival analysis yielded stage, ENS and PS as significant prognostic factors for OS (p = 0.0009, p = 0.0028 and p = 0.0155, respectively). Only involvement of more than 1 ENS was strongly associated with low CR (p = 0.0479) and high relapse rates (p = 0.0118), and it was also determined as the only independent prognostic factor for OS in patients younger than 60 (p = 0.0015). A modified age-adjusted prognostic index, including ENS in addition to stage, LDH and PS, was found to be more significant than the original age-adjusted International Prognostic Index (IPI) for both DFS (p = 0.0030) and OS (p < 0.00001). In conclusion, modified age-adjusted index may be a convenient alternative to the original age-adjusted IPI to identify high-risk patients with aggressive lymphomas in Turkey and probably also in other developing countries for experimental intensive regimens.

Twenty-six patients with metastatic colorectal cancer were given cisplatin (CDDP) and dacarbazine (DTIC). Patients who relapsed while receiving adjuvant 5-fluorouracil (FU) or had 5-FU-resistant metastatic disease were included. Median age was 52 years and the male-to-female ratio was 1. Performance status (ECOG) was 3 in 5 patients and 0–2 in the remainder. CDDP (20 mg/m²/day i.v.) and DTIC were given (250 mg/m²/day i.v.) on days 1–5. The treatment was repeated every 3 weeks until disease progression. Total response rate was 19.2% (95% confidence interval: 4.5–34.3%) with one clinical complete response (3.8%) and 4 partial responses (15.4%). Median response duration was 5 months. Median survival for the whole group and for responders was 6 and 8 months, respectively. In conclusion, CDDP + DTIC combination has modest activity in patients with colorectal cancer resistant to 5-FU treatment.

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