Short Chemotherapy Regimen Research Articles

Algorithm for the use of 12-month linezolid treatments in patients with pre-XDR tuberculosis

The research was aimed to formulate a clear algorithm for the use of short, 12-month, regimens, which consist mainly of linezolid, in patients with pre-XDR, and to develop clear inclusion/exclusion criteria and indications for the use of such on / off algorithms and indications for the use in patients with extensively drug-resistant tuberculosis (pre-XDR TB), based on the study of immediate and remote treatment results. Materials and methods. The “case-control” study included 90 patients with pre- MDR. For the treatment of patients in the main group (35 patients), 6 anti-TB drugs were administered before receiving the result of the TMC: linezolide (Lzd), levofloxacine (Lfx), caproemycine (Cm), protionamide (Pt), cycloserine (Cs), pyrazinamide (Z). In cases of resistance to Ofloxacine (Ofx) or Km/Cm, Lfx was replaced with moxifloxacine (Mfx), with the addition of high dose of isoniazide (H). Such an intensive methodology lasted for a period of 6 months, transitioning to the up-keep phase after a period of 6 months without Cm. Patients in the control group (55 patients) received individual chemotherapy of standard duration - 8 months IF AMBT and 12 months PF AMBT, without linezolid. Results. In patients with pre-MDR, who were administered 12-month shorter regimens, an increase in effective treatment by 41,6 % was found due to a reduction in the «lost of follow-up», «treatment failure» and «die» category. Relapse occurred only in 1,8 % of patients treated with the standard regimen without linzolid. Conclusions. The use of algorithms for the appointment and selection of short, 12-month, regimens of linezolide treatment can improve the outcome of «effective treatment» in patients with pre-MDR by 41,6 % compared to patients, who received standard treatment without linzolid. Key words: pre-XDR, short chemotherapy regimen, effective treatment. For citation: Feshchenko YI, Lytvynenko NA, Pohrebna MV, Senko YO, Protsyk LM, Bororova OL, Chobotar OP, Patiuk YO. algorithm for the use of 12-month linezolid treatments in patients with pre-XDR tuberculosis. Journal of the National Academy of Medical Sciences of Ukraine. 2019;25(3):278–84 The article was received on May 25, 2019 | For review, September 3, 2019 |

Delay in adjuvant radiation treatment and outcomes of breast cancer--a review.

Recent meta-analyses have shown the importance of locoregional control as a long-term determinant of breast cancer survival. Whether factors related to the delivery of radiotherapy, such as delay, dose, fractionation or irradiated volume, are associated with outcome remains unclear. We performed a critical review of the literature on delay to radiation using a computerized search of papers published between 1985 and 2000. Periods of accrual, details of radiotherapy, surgical and systemic treatment, and information on prognostic factors were noted. Studies on sequencing of adjuvant therapy were compared to studies on delay to radiation, classified according to whether or not patients also received chemotherapy. Comparisons of patients receiving systemic therapy to individuals spared this option were considered uninformative since the impact of delaying radiation is then highly confounded by systemic treatment received. The single published experimental study on sequencing suggests that delay to radiation may compromise local control, and this is consistent with a few retrospective reports on delay to radiotherapy among patients receiving chemotherapy. However, indirect evidence from two randomized clinical trials of chemotherapy, and the majority of observational studies on delay to radiotherapy, suggest that it has no impact on either local, distant control or survival. Factors, methodological, and others, that could explain these inconsistencies are discussed. No study restricted to patients at low risk of recurrence suggested an impact of delaying radiation. Short chemotherapy regimens are likely to represent a safe option with respect to outcome of radiation treatment.

Análisis comparativo de 3 regímenes de tratamiento en niños con linfoma de Burkitt

Between January 1980 and June 1996, a total of 86 patients with Burkitt’s lymphoma were treated at our institution. The current study is a retrospective review of how these patients evolved comparing the complications, overall and disease-free survival rates using 3 different treatment regimens.Forty-six patients were treated with regimen 1, 26 with regimen 2 and 14 with regimen 3. The following variables were analyzed: age and sex of the population, laboratory and X-ray results (blood chemistry, lactic dehydrogenase, bone marrow aspirate, cerebral spinal fluid, cytology, imaging studies of the primary tumor), the stage of the disease, the chemotherapeutic regimen received, the complications experienced, overall and disease-free survival rates, causes of death and prognostic factors.The patients median age was of 72 months. A total of 63 patients (73%) had advanced stage (III–IV) and the remaining 23 early stages (I–II). There was and overall survival rate of 63.9% for all stages and a overall disease-free survival rate of 54.5%. No statistical difference when overall survival comparison was made between regimens 1 (51%) and 2 (72%) (p=0.13). A difference was observed when regimen 1 was compared to regimen 3 (86%) (p=0.025). The overall survival comparison among the three treatment regimens had a p value of 0.06. All of the patients that remained in full remission beyond 18 months are alive and without evidence of disease regardless of the stage and treatment regimen.Intensive, short chemotherapy regimen appears to be a superior regimen when compared to other regimens. Regimen 3 offers a relatively low morbidity and the highest disease free survival of the three regimens studied.

Experience of a 2-day BEP regimen in postsurgical adjuvant chemotherapy of ovarian germ cell tumors.

The outcome of 31 patients with malignant ovarian germ cell tumors treated by surgery and a medium dose etoposide containing short chemotherapy regimen between 1988 and 1997 is reported. Of the 31 patients, 16 (51.6%) had malignant teratomas, 8 (25.8%) had dysgerminomas, 6 (19%) endodermal sinus tumors and one (3.2%) mixed germ cell tumor. Twenty-four (77.4%) patients were at FIGO stage I (of which 18 were stage IA), 2 (6.5%) at stage II, 4 (12.9%) at stage III and 1 (3.2%) at stage IV. Twenty-five (80.6%) patients underwent conservative surgery, 1 (3.2%) underwent bilateral salpingo-oophorectomy and 4 (12.9%) had total hysterectomy with bilateral salpingo-oophorectomy and omentectomy. One (3.2%) patient refused definitive treatment. Three patients with stage IA grade 1 immature teratomas were not treated with adjuvant chemotherapy and one patient with a stage IA dysgerminoma refused chemotherapy. Two patients with endodermal sinus tumor returned to their countries of origin after surgery. Twenty-five patients received bleomycin, etoposide, and cisplatin (BEP) regimen with etoposide dosage fixed at 120 mg/m2 on day 1 and day 2, bleomycin 15 mg intravenous bolus on days 1 and 2 and cisplatin 100 mg/m2 on day 1. Chemotherapy was administered at four weekly intervals for 4 cycles or until complete response was achieved. The median number of cycles of chemotherapy was four (range 3-6) for stage I, 6 (range 4-7) for stage II and 5 (range 5-6) for stage III tumors. Of the entire cohort of 29 patients analyzed, the median follow up period was 5 years. One patient died from stage IIIC endodermal sinus tumor and one patient had persistent teratoma in the lungs. The overall disease free survival control rate was 93.1%. There were three cases of the growing teratoma syndrome involving the liver, abdominal peritoneum, and the pelvis, respectively. No mortality resulted from the growing teratomas. No pulmonary complications, secondary primary tumor or leukemia was detected. Menstrual function returned in all patients with fertility-preserving surgery and one pregnancy occurred. This interesting data suggest that a medium dose 2-day BEP postsurgical adjuvant chemotherapy regimen is effective and superior to expectant treatment of malignant ovarian germ cell tumors. This report, however, should be viewed as a pilot study. The result indicates that a prospective randomised controlled trial to demonstrate equivalence of this regimen with the standard BEP regimen is warranted.