Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study

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dc.contributor.authorPentheroudakis, G.en
dc.contributor.authorBriasoulis, E.en
dc.contributor.authorKalofonos, H. P.en
dc.contributor.authorFountzilas, G.en
dc.contributor.authorEconomopoulos, T.en
dc.contributor.authorSamelis, G.en
dc.contributor.authorKoutras, A.en
dc.contributor.authorKarina, M.en
dc.contributor.authorXiros, N.en
dc.contributor.authorSamantas, E.en
dc.contributor.authorBamias, A.en
dc.contributor.authorPavlidis, N.en
dc.date.accessioned2015-11-24T19:23:55Z
dc.date.available2015-11-24T19:23:55Z
dc.identifier.issn1651-226X-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/22385
dc.rightsDefault Licence-
dc.subjectAdenocarcinoma/*drug therapyen
dc.subjectAdulten
dc.subjectAgeden
dc.subject*Ambulatory Care/methodsen
dc.subjectAntineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic useen
dc.subjectArea Under Curveen
dc.subjectCarboplatin/administration & dosageen
dc.subjectCarcinoma/*drug therapyen
dc.subjectDisease Progressionen
dc.subjectDisease-Free Survivalen
dc.subjectDrug Administration Scheduleen
dc.subjectFemaleen
dc.subjectGreeceen
dc.subjectHumansen
dc.subjectInfusions, Intravenousen
dc.subjectKaplan-Meier Estimateen
dc.subjectLymphatic Metastasisen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectNeoplasms, Unknown Primary/*drug therapy/pathologyen
dc.subject*Outpatientsen
dc.subjectPalliative Care/*methodsen
dc.subjectPeritoneal Neoplasms/drug therapy/secondaryen
dc.subjectPredictive Value of Testsen
dc.subjectPrognosisen
dc.subjectRisk Factorsen
dc.subjectTaxoids/administration & dosageen
dc.subjectTreatment Outcomeen
dc.titleDocetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II studyen
heal.abstractINTRODUCTION: Taxane/platinum combinations exhibit synergistic cytotoxicity and activity against a broad range of solid tumours. We sought to optimise the regimen as a suitable outpatient palliative treatment for cancer of unknown primary (CUP). PATIENTS AND METHODS: Eligible CUP patients with adenocarcinoma or poorly differentiated carcinoma, performance status of 0-2, adequate organ function and assessable disease were treated with docetaxel 75 mg/m(2) and carboplatin at an area under the concentration time-curve (AUC) of 5, both as 30-minute intravenous infusions, every three weeks. Patients with isolated axillary adenopathy, squamous cell cervical or inguinal adenopathy and PSA or germ-cell serum tumour markers were excluded. RESULTS: Forty-seven patients entered the trial, 24 with predominantly nodal disease or non-mucinous peritoneal carcinomatosis (favourable risk) and 23 with visceral metastases (unfavourable risk). A median of 6 cycles of chemotherapy were administered, with relative dose intensities of both drugs >90%. Response rates were 32% (46% in favourable risk, 17% in unfavourable), comparable to the activity of paclitaxel/platinum regimes, though complete remissions were seen only in favourable risk patients. Granulocyte-colony stimulating factor support was used in a third of treatment cycles. Toxicity was mild and manageable, with grade 3-4 neutropenia in 26% of patients, febrile neutropenia in 7% and severe non-hematologic side-effects in less than 8% of patients. No toxic deaths or severe neurotoxicity were seen. Median time to progression (TTP) and overall survival (OS) were 5.5 and 16.2 months respectively. Survival was driven mainly by favourable-risk patients (22.6 months), as those with visceral metastases had a poor median survival of only 5.3 months. Good performance status and low-volume disease predicted for superior outcome, while docetaxel relative dose-intensity was a positive prognosticator only in favourable-risk patients. CONCLUSIONS: One-hour docetaxel/carboplatin is a convenient, safe and effective outpatient palliative treatment for CUP patients, providing meaningful survival prolongation only in favourable-risk patients. Insights in the molecular biology of CUP are needed for the development of targeted therapeutic manipulations of malignant resistance and progression.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1080/02841860701843043-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/18607872-
heal.identifier.secondaryhttp://informahealthcare.com/doi/pdfplus/10.1080/02841860701843043-
heal.journalNameActa Oncolen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2008-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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