Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two patients with metastatic colorectal cancer were treated with a regimen of 5-fluorouracil 600 mg/m2 (maximum, 1.0 g) i.v./week and folic acid 140 mg/m2 i.v. given 1 h prior to the 5-FU. This study was undertaken in an attempt to confirm the in vitro finding that inhibition of thymidylate synthetase by 5-fluorouracil is prolonged by the presence of folates. There were four partial responses (18%) with mean duration 4 months. Dose-limiting toxicity was enteritis, seen in 12 patients (58%), and causing hospitalization in seven patients. Enteritis was shown to be due to the folic acid in most patients. Two patients died from leukopenia, enteritis, and sepsis. Mean serum folate levels at the time of 5-FU injection were 36 microM. This regimen is no more effective than 5-FU alone and has significantly more serious toxicity. Further investigation of this regimen is not recommended.
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PMID:5-Fluorouracil and high-dose folic acid treatment for metastatic colon cancer. 382 92

Three patients with primary carcinoma of the liver and 11 patients with metastatic carcinoma of the liver were treated by hepatic arterial infusion of 5-FU and Mitomycin C (MMC), using a totally-implantable, percutaneously-refillable infusion pump: INFUSAID 210, 400. The infusion cannulae were placed into the hepatic arteries under direct vision on laparotomy, and the pumps were placed in subcutaneous pockets. The implanted pumps were well tolerated in these patients, who received chemotherapy as outpatients; the only adverse effects noted were related to 5-FU and MMC toxicity. The cumulative duration of successful infusion exceeded 104 months (for individual patients: range 2 to 20 months; average 7.4 months). Complications associated with conventional intraarterial chemotherapy (artery thrombosis, catheter sepsis and dislodgement, pump infusion variation and pump failure) were not seen with the INFUSAID delivery system. The pump is refilled every two weeks via percutaneous puncture. All therapy was given on an outpatient basis. Pump acceptance and tolerance was 100%. Our study using this infusion pump to deliver 5-FU and MMC has shown response rates of 66% (2/3) for primary carcinoma of the liver with cirrhosis and 82% (9/11) for metastatic carcinoma of the liver. The average survival for the primary and metastatic carcinomas of the liver were 6.0 months and 8.4 months respectively. Utilization of the totally-implantable INFUSAID pump provides a convenient, cost-effective, and safe administration technique for patients with primary and metastatic carcinomas of the liver.
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PMID:[Intra-arterial infusion chemotherapy of hepatic carcinoma using a totally-implantable Infusaid pump]. 393 60

The effects of combination chemotherapy including mitoxantrone (MXN) "M-VEMFH" for advanced breast cancer were studied. The M-VEMFH regimen consisted of MXN 7 mg/m2, VCR 0.7 mg/m2, EX 333 mg/m2, MTX 13.3 mg/m2 i.v. on day 1, 5-FU 333 mg/m2 i.v. from day 1 to day 5 and pred. (H) 60 mg/m2 p.o. with tapering off in 2 weeks. In 7 cases heavily pretreated with combination chemotherapy including ADR, CR 2, PR 2, NC 2 and PD 1 were observed (response rate 57.1%). In 5 cases without prior ADR, PR 1, NC 2 and PD 2 were obtained. One case given 586 mg/m2 of prior ADR died of congestive heart failure after administration of 47 mg/m2 of NXN. One case died of sepsis. The other side effects were stomatitis, vulvitis, abnormal gustation, nausea, vomiting and alopecia. M-VEMFH is effective combination chemotherapy for advanced breast cancer resistant to ADR, but care must be exerted due to the accompanying cardiotoxicity and leukopenia.
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PMID:[Effects of combination chemotherapy M-VEMFH including mitoxantrone in advanced breast cancer]. 405 16

Cisplatin plus 5-FU appears to have significant additive activity in various tumors, such as head and neck carcinoma and esophageal cancer. A partial explanation for this may be drug synergism, which has been noted in the L1210 leukemia model. Based on these data, a prospective trial of weekly bolus 5-FU (15 mg/kg) and cisplatin (60 mg/m2) given every 3 weeks was initiated at Indiana University. Forty-one patients, of whom 38 are fully evaluable for response, were treated with these two drugs. Ten partial and one complete response (complete + partial response rate = 29%) were observed in the 38 evaluable patients. Thirteen additional patients had stable disease for greater than or equal to 3 months. The median durations of remission and survival time were 6 and 10.3 months, respectively. Myelosuppression was unusually severe, with granulocyte counts less than 1000/mm3 in 65% of patients, including four patients with granulocyte count nadirs less than 100/mm3. Three patients developed granulocytopenic fever, with two drug-related deaths (sepsis, hyperosmolar coma). Nearly all patients had nausea and vomiting, but this was not a treatment-limiting toxic effect in any patient. Although this combination suggests a higher response rate than usually seen with bolus iv 5-FU in colon cancer, a trial comparing 5-FU alone or with cisplatin to determine whether true synergy exists is currently underway.
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PMID:Cisplatin plus 5-FU for the treatment of adenocarcinoma of the colon. 407 11

A 17-year-old male with previously undiagnosed congenital Factor IX deficiency (13%) presented with gastrointestinal bleeding and a hepatic mass. Prolonged thrombin and Reptilase times, which partially corrected with CaCl2 and a discrepancy between thrombin-clottable and immunoreactive plasma fibrinogen, suggested a dysfibrinogenemia. Laparotomy disclosed metastatic hepatoma. Adequate hemostasis was obtained with clotting factor replacement, but wound healing was delayed. Patient fibrinogen purified with 2.1 M glycine migrated normally on immunoelectrophoresis and 7.5% polyacrylamide-SDS gel electrophoresis. However, fibrin monomers prepared from purified patient fibrinogen displayed impaired aggregation at high and low ionic strengths when compared with fibrin monomers from normal and control Factor IX deficient subjects. Aggregation of normal monomers was delayed when mixed 1:1 with patient monomers. Fibrinopeptide release was normal, and total sialic acid content was similar to that of normal and control fibrinogens. Chemotherapy, consisting of 5-FU given via intra-arterial hepatic infusion, was accompanied by significant transient clinical improvement which coincided with correction of thrombin clotting times and fibrin monomer aggregation. Reappearance of fibrinogen dysfunction occurred with clinical deterioration prior to death from metastatic hepatoma and sepsis. This case is the first to corroborate the postulated tumor marker role of dysfibrinogenemia in a patient with hepatoma by documenting a direct relationship with response to chemotherapy.
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PMID:Acquired dysfibrinogenemia in a hemophiliac with hepatoma: resolution of fibrinogen dysfunction following chemotherapy. 626 56

Seventy-nine patients with metastatic breast cancer underwent examination of their bone marrow as part of their staging workup. Thirty-one (39%) showed no evidence of bone marrow involvement (BM-); 48 (61%) were found to have bone marrow metastases (BM+). Both groups of patients were treated with intensive chemotherapy with 5-FU, Adriamycin, cyclophosphamide, methotrexate, and nonspecific immunotherapy with BCG, methanol extraction residue, or Levamisole. The groups were comparable in age, race, menopausal status, and disease-free interval; however, the BM+ group had a higher proportion of patients with dominant osseous disease and a somewhat lower overall tumor burden. Ten of 21 patients in the BM+ group treated with 100% of the calculated dose of chemotherapy are still alive, compared with only three of 27 patients treated with lower doses. A similar dose response was observed in the BM- group. Myelosuppression was more common and more severe in the BM+ group. Hematologic support, i.e., packed erythrocytes and platelet transfusions, was required in 60% of BM+ patients, as opposed to 26% of BM-. Infectious complications were also higher in the BM+ group, in which five episodes of sepsis and two infectious deaths were observed. These results suggest that metastatic breast cancer patients with bone marrow invasion achieve excellent palliation with aggressive high-dose chemotherapy. Higher morbidity requiring aggressive supportive care suggests that these patients should be treated by physicians and centers experienced in their management.
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PMID:Combination chemotherapy for breast cancer metastatic to bone marrow. 723 95

A phase III randomised study, comparing treatment with fluorouracil, epidoxorubicin and methotrexate (FEMTX) with the best supportive care, was conducted in patients with unresectable or metastatic gastric cancer. During the period from July 1986 to June 1992, 41 patients were randomised to receive FEMTX or best supportive care. MTX was given in a dose of 1500 mg m-2 intravenously (i.v.) followed after 1 h by 5-FU 1500 mg m-2 i.v. on day 1; leucovorin rescue was started after 24 h (30 mg orally every 6 h for 48 h) and epidoxorubicin 60 mg m-2 i.v. was administered on day 15. In addition both groups received tablets containing vitamins A and E. Response rates for FEMTX were as follows: complete response (CR), 19% (4/21); partial response (PR), 10% (2/21); no change (NC), 33% (7/21); and progressive disease (PD), 24% (5/21). Response rates in the control group were: NC, 20% (4/20); and PD, 80% (16/20). Increased pain was observed in one patient in the treated group and in 11 patients in the control group within the first 2 months. WHO grade III/IV toxicity in the chemotherapy group was as follows: nausea/vomiting 40%, diarrhoea 10%, stomatitis 15%, leucopenia 50% and thrombocytopenia 10%. One possible treatment-related death was due to sepsis. The median time to progression in the FEMTX group was 5.4 months [95% confidence interval (CI) 3.1-11.7 months], but only 1.7 months in the control group (95% CI 1.2-2.7 months) (P = 0.0013). Similarly, the FEMTX group displayed significantly (P = 0.0006) prolonged survival compared with the control group, i.e. median survival 12.3 months (95% CI 7.1-15.6 months) vs 3.1 months (95% CI 1.6-4.6 months). In conclusion, FEMTX combined with vitamin A and E is a fairly well-tolerated treatment, giving a response rate of 29% in patients with advanced gastric cancer, and also prolonging patients' survival. It can be used as a reference treatment in testing new investigational combinations.
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PMID:Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. 753 17

We designed our study to evaluate the safety and efficacy of simultaneous chemoradiation therapy in an accelerated, twice-a-day schedule to improve local control and survival in advanced lung cancer patients. Forty-one patients were entered into the study. Twenty-three had stage IIIB and 18 had stage IIIA disease. They received cisplatin 30 mg/m2, VP-16 80 mg/m2, and 5-Fluorouracil (5-FU) 900 mg/m2 in iv infusion. Radiation therapy consisted of 2G twice a day for 5 days, followed by a 2-week rest. This cycle was repeated 3 times. Patients were evaluated for surgical resection after the second cycle. Acute toxicity was acceptable: 3 patients expired (1 congestive heart failure, 1 sepsis, 1 pulmonary embolism). The 1-year actuarial survival was 60.3%; the 2-year actuarial survival was 55.3%. Our results show that this regimen is well tolerated and that the 2-year actuarial survival appears to be comparable to that reported in the literature.
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PMID:Simultaneous chemoradiation in advanced non-small cell lung cancer. 838 89

We have performed combined chemotherapy with 5-FU, a biochemical modulator, and low dose CDDP for advanced or recurrent cancer of the digestive system. The therapy was effective in 37% of all cases and in 45.5% and 41.6% of esophageal and gastric cancer cases, respectively. In addition, few patients developed adverse side effects including renal disorders, one of the major side effects of CDDP. Therefore, we considered home anti-cancer chemotherapy feasible. For 27 outpatients with advanced cancer of the digestive system including 15 cases of esophageal cancer, 4 cases of gastric cancer, 3 cases of colon cancer, 4 cases of pancreatic cancer and 1 case of gall bladder cancer, 4 to 6 week home adjuvant chemotherapy was performed. The regimen comprised 1 week of oral administration of 300 mg/body/day of UFT-E granules and 5 days of continuous intravenous infusion of 25 mg/body/day of CDDP using an infusor pump. During the follow-up, 3 cases of catheter obstruction, 3 cases of catheter sepsis and 1 case of pneumothorax appeared. These complications all resulted from the catheter, and safe home anti-cancer chemotherapy could be continued because 5-FU and CDDP did not cause severe side effects.
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PMID:[Combined chemotherapy with 5-FU and low dose CDDP for advanced or recurrent cancer of the digestive system and home anti-cancer chemotherapy]. 884 89

Gastric cancer is the most chemosensitive adenocarcinoma among digestive neoplasms. A few years ago, we performed a phase II trial with the FLEP regimen, in which fluorouracil (5-FU) and leucovorin are combined with etoposide and cisplatin (Platinol). This regimen resulted in a 39% response rate and high toxicity. Then we used the combination UFT (tegafur and uracil)/leucovorin/etoposide: UFT 390 mg/m2/day orally on days 1 to 14; leucovorin 500 mg/m2 i.v. day 1, and 15 mg/12 h orally on days 2 to 14; and etoposide 100 mg/m2 i.v. on day 1 and then 200 mg/m2/day orally on days 2 and 3. Forty-six patients received a median of five courses. Five patients (11%) achieved a complete response and 12 (26%) a partial response, for an overall response rate of 37%. The response rate was 50% in patients with an Eastern Cooperative Oncology Group performance status of 0 to 1. Grades 3 to 4 toxicities appeared as follow: 17% of patients had diarrhea, 11% had nausea/vomiting, and 13% of patients had anemia. One patient died of neutropenia and sepsis. The median survival time was 9 months. In summary, UFT/leucovorin/etoposide is effective and moderately toxic in patients with advanced gastric cancer. A new trial with UFT/leucovorin/epirubicin is ongoing.
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PMID:The UFT/leucovorin/etoposide regimen for the treatment of advanced gastric cancer. Oncopaz Cooperative Group. 934 81


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