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Cancer Chemotherapy Regimen for Thyroid Cancer
Adriamycin-Cisplatin (AC)
Abstract: A randomized evaluation of the effectiveness
and toxicity of the combination of doxorubicin and cisplatin and of
doxorubicin alone in patients with advanced thyroid carcinoma was
carried out.
Ninety-two patients
were entered and 84 were evaluable. They were stratified according
to histological classification, Eastern Cooperative Oncology Group (ECOG)
performance status, and metastatic sites. Forty-one patients
received doxorubicin as a single agent and seven had partial
response (17%). Forty-three
patients received the combination, and there were five complete and
six partial responses (combined response rate of
26%). This difference for
overall response rate is not significant (P greater than 0.1).
However, five complete responses
were seen in the combination-treatment group, whereas none were
observed in the single-agent treatment group; a significant
difference was obtained (P = 0.03). Four of these five complete
responders survived for more than 2 years, and two patients remained
in a complete response after the discontinuation of therapy and are
still alive. None of the partial responses exceeded 2 years in
duration. The life-threatening toxicities from chemotherapy occurred
in five patients treated with the combination of drugs and two
treated with doxorubicin alone. However, none of the toxicities were
fatal. The study has shown clearly that the
quality of response achieved by the combination of drugs
is far superior to that achieved by single-agent chemotherapy.
References
Shimaoka K. Schoenfeld DA. DeWys WD. Creech RH. DeConti R. A
randomized trial of doxorubicin versus doxorubicin plus cisplatin in
patients with advanced thyroid carcinoma. Cancer. 56(9):2155-60,
1985 Nov 1.
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| Regimen |
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Adriamycin...... 60 mg/sqm IV day 1.
Cisplatin....... 40 mg/sqm IV day 1.
FREQUENCY....... Repeat cycle every 3 weeks. |
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Summary |
Small phase
III study is one of the few available clinical trials examining the role of
chemotherapy in metastatic thyroid cancer (AC vs. Adriamycin single agent) |
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Overall Response
Rate |
26% vs. 17% (NO STAT.
SIGNIFICANT) |
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Complete Response
Rate |
5 in the combination arm |
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Toxicity |
More in the combination arm |
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| Article reviewed by: |
Peter S. Kennedy, M.S., M.D.
President, Metropolitan Hematology Oncology Medical Group. |
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