Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double blind study has been lead on 75 patients affected by head and neck cancer treated with CDDP, to verify the alizapride's antiemetic efficacy versus placebo and metoclopramide. On 76 patients examined, 28 has been treated with CDDP 50 mg/mq + alizapride; 28 with CDDP 50 mg/mq + metoclopramide and finally 19 with CDDP 50 mg/mq + placebo. Both alizapride and metoclopramide administered have resulted effective on the control of the emesis induced with CDDP without side effects.
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PMID:[Control of the emesis induced by cisplatin in patients with head and neck neoplasms. Randomized study of metoclopramide alizapride and placebo]. 219 85

Neutropenic enterocolitis is a recognized complication of immunosuppression or chemotherapy for leukemia. It presents as severe abdominal pain and tenderness, fever, and diarrhea associated with granulocytopenia. Gastrointestinal symptoms associated with chemotherapy for head and neck neoplasms include nausea and emesis, but not acute abdominal distress. We present, to our knowledge, the first case of neutropenic enterocolitis in a patient receiving cisplatin and fluorouracil chemotherapy for metastatic head and neck cancer.
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PMID:Neutropenic enterocolitis. A new complication of head and neck cancer chemotherapy. 229 18

Twenty-three patients with advanced untreated head and neck cancer, nine patients with recurrent cancer, and six patients with recurrent cancer who underwent surgery and had postoperative persistence of tumor were treated with three 2-week courses of irradiation (1,500 cGy in 10 fractions each) concurrently with cisplatin and a 5-day infusion of 5-fluorouracil. A fourth 2-week course of irradiation (2,000 cGy in 10 fractions) brought the final tumor dose to 6,500 cGy. Twenty patients in the untreated group and three patients in the recurrent group (33%) had a complete response. There were 10 local recurrences in the untreated group (43%), seven in the recurrent group (78%), and three in the persistent group (50%). At 17 months after the start of treatment, the survival rate for the untreated patients was 51%, for the patients in the recurrent group it was 11%, and for the patients in the persistent group it was 20% (P = .03). Most patients experienced toxicity, including nausea, vomiting, weight loss, and mucositis. Clinical trials are necessary to determine whether simultaneous chemotherapy and radiation therapy is an improved method of treatment for advanced head and neck cancer.
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PMID:Advanced head and neck cancer: low-dose, split-course radiation therapy and simultaneous infusion of 5-fluorouracil and cisplatin. 236 76

The disposition of unchanged cisplatin was compared after two- and 24-hour intravenous (IV) infusion to eight patients with germ cell cancer (dose, 100 mg/m2), 14 patients with head and neck cancer (dose, seven patients 50 mg/m2; seven patients, 100 mg/m2). Patients were randomized to receive either a two- or 24-hour infusion in the first course of treatment and the reverse in the second course. Cisplatin renal clearance, total clearance, and the percentage of the dose excreted unchanged in urine were significantly lower with the longer infusion. Total clearance was 345 +/- 97.0 mL/min/m2 after the two-hour infusion and 268 +/- 70.7 mL/min/m2 after the 24-hour infusion (P less than .0001). Renal clearance was 79.1 +/- 35.3 mL/min/m2 and 34.1 +/- 14.9 mL/min/m2 (P less than .0001). The percentage of the dose excreted unchanged in urine was 22.9 +/- 6.5% and 12.8 +/- 4.0%, respectively (P less than .0001). The ratio of cisplatin renal clearance to creatinine clearance was 1.95 +/- .96 after the two-hour infusion and .90 +/- .40 after the 24-hour infusion (P less than .001). There was only a poor relationship between cisplatin renal clearance and creatinine clearance after a two-hour infusion (r2 = .05, P greater than .1) or 24-hour infusion (r2 = .18, P greater than .05). The severity of emesis was graded on a four-point scale and was significantly less with the 24-hour infusion than with the two-hour infusion (P less than .05). Twenty-four-hour infusion of cisplatin resulted in greater drug retention in patients due to reduced renal clearance, but was also associated with reduced emetic toxicity, probably as a result of lower peak plasma levels.
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PMID:Two- versus 24-hour infusion of cisplatin: pharmacokinetic considerations. 253 3

Chemotherapeutic regimens containing cisplatin are the most effective ones in the treatment of squamous cell carcinoma of the head and neck. Because of the high rate of dose-limiting side effects of cisplatin, carboplatin, a second-generation cisplatin analogue, was tested in a phase II trial with fluorouracil in 55 previously untreated patients with advanced carcinoma of the head and neck. Among the 52 patients who completed the study, there were 17 complete responses (33%), 28 partial responses (54%), five patients with no change (10%), and two with progressive disease (4%). Toxic side effects of all courses summed together included leukopenia in 65% of courses, thrombocytopenia in 45% of courses, nausea or vomiting in 29% of courses, and change in serum creatinine level in 3% of courses. These data were compared with the results of our study with cisplatin and fluorouracil in comparable patients and indicated that carboplatin and fluorouracil is better for induction chemotherapy in the treatment of head and neck cancer than cisplatin and fluorouracil due to similar effectiveness but less toxic effect.
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PMID:Carboplatin. The better platinum in head and neck cancer? 265 67

A cooperative phase II study of cisplatin in head and neck cancer was conducted in 23 institutions. Eighty-nine patients were entered into this trial, of which 73 were evaluable. Two different regimens were employed in this study. Regimen A: cisplatin 10 mg/m2 intravenous (i.v.) infusion daily, days 1-5, q 3 wk. Regimen B: cisplatin 50 mg/m2 i.v. infusion, day 1, q 3 wk. Two patients achieved complete response and 17 achieved partial response with an overall response rate of 26.0%. By histological types, the response rate was 26.3% in the case of squamous cell carcinoma. Partial response were observed in 2 cases of adenocarcinoma and in one case each of adenoid cystic carcinoma and transitional cell carcinoma. The response rate was 19.4% for previously treated patients, as compared to 63.6% for the previously untreated group. Toxic effects were observed in 94.7% of 76 evaluable cases. From 50 to 68% of patients experienced nausea, vomiting and anorexia. No patient exhibited a serum creatinine level exceeding 2 mg/dl. Anemia and leukopenia were observed in 58.9% and 32.9% respectively. It is therefore concluded that cisplatin is markedly useful for the treatment of head and neck cancer.
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PMID:[A cooperative phase II study of cisplatin in patients with head and neck cancer]. 300 63

Combination chemotherapy with CDDP and 5-FU was performed in 19 patients with evaluable head and neck cancer and 2 CR patients and 7 PR patients were obtained; thus the response rate was 47.4%. Histologically, the present therapy is considered to be especially effective against well differentiated squamous cell carcinoma (83.3%). The present therapy is considered to be useful as a neo-adjuvant chemotherapy (75.0%), but it is desirable to perform at least 2 courses of treatment. The side effects observed were nausea, vomiting, anemia, leukocytopenia and alopecia, etc., and most of them were reversible. However, there were 2 patients in which the continuation of chemotherapy was impossible due to renal disorders.
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PMID:Combination chemotherapy with CDDP and 5-FU in head and neck cancer. 302 Oct 95

Twenty-seven patients with assessable, regionally advanced, or metastatic upper aerodigestive cancer of diverse histology received a combination of mitomycin C, adriamycin, and cis-diamminedichloroplatinum. All patients had previously received extensive surgery and/or radiation therapy. We observed an overall 46% partial response rate (12/26). This included seven of 15 (47%) responders with squamous cell carcinoma. Six of those seven patients responded within the initial month of treatment. For all study participants, the median time to progression and survival was 3.8 months and 7.3 months, respectively. Moderate-to-severe nausea, vomiting, anorexia, and alopecia were the most common toxicities. Myelosuppression (WBC less than 4,100 cells/mm3) and thrombocytopenia (PLTS less than 130,000 cells/mm3) occurred in 100% and 71% of the 21 patients with nadir data recorded, respectively. There were no episodes of sepsis nor did we detect any meaningful impairment in renal function. This regimen is active in the previously treated head and neck cancer patient and can be conveniently administered on an outpatient basis with acceptable and manageable side effects.
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PMID:A phase II clinical trial of the combination mitomycin C, adriamycin, and cis-diamminedichloroplatinum in patients with advanced upper aerodigestive cancer. 309 35

Cisplatin combinations are active in patients with epidermoid cancer of the head and neck. Because of the incidence of dose-limiting toxicity and the need for hospitalization for iv hydration and mannitol diuresis, the search for active analog(s) with less of such toxicity has been intensive. In a limited institution study of Wayne State University and the Southwest Oncology Group, a clinical trial of carboplatin (CBDCA) and iproplatin (CHIP) in patients with recurrent head and neck cancer was carried out. Sixty-four patients were entered and 63 were evaluated, 29 receiving CBDCA and 34 receiving CHIP therapy. These patients were stratified according to important prognostic factors. The response rate to CBDCA was 24% (seven responses among 29 patients; three complete responses and four partial responses), and to CHIP was 12% (four responses among 34 patients; one complete response and three partial responses). Both drugs were administered without prior hydration or mannitol diuresis on an outpatient basis. The major side effect was myelosuppression, which was reversible but cumulative and dose-limiting. Less severe vomiting occurred as compared to the incidence of this toxicity with cisplatin and no significant renal or hearing loss occurred. It was concluded that further evaluation of these agents with other active drug(s) in patients with head and neck cancer is warranted.
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PMID:Platinum analogs in recurrent and advanced head and neck cancer: a Southwest Oncology Group and Wayne State University Study. 330 Sep 67

Because of the clinical activity of carboplatin in several types of tumors, this drug was studied in a phase II trial of 25 patients with advanced head and neck cancer [stage IV (M0)] without prior treatment. Six patients (24%) achieved objective response, including two patients with complete response. Carboplatin toxicity was mild in most patients, with nausea, vomiting, and myelosuppression being the most frequent side effects. No renal or neurologic toxicity was observed. Further trials of carboplatin in advanced head and neck cancer are warranted.
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PMID:Carboplatin, an active drug in advanced head and neck cancer. 353 Apr 43


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