Results of a prospective clinical study of the efficiency and safety of intensive-dose chemotherapy programs for malignancies
https://doi.org/10.17650/1818-8346-2008-0-3-63-68
Abstract
The theoretical rationale for intensification of chemotherapy (CT) has become a basis for using of high-dose chemotherapy and for reducing of intervals between courses. At the same time, the toxic effect of cytostatics on bone marrow is one of the most critical deferent to the intensification of CT. The use of dose-intensive regimens, without supporting granulocyte colony-stimulating factor (G-CSF) preparations, inevitably results in the occurrence of severe neuropenia in most patients and the development of serious infectious complications.
This paper presents the results of the prospective clinical study of the safety and efficiency of intensive-dose CT programs for breast cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, conducted at Moscow City Cancer Hospital Sixty-Two in the period of April to November 2007. The study included 56 patients aged 18 to 72 years who received different intensive-dose CT, including 21 patients with breast cancer, 30 with Hodgkin’s lymphoma, and 5 with non-Hodgkin’s lymphoma. For hemopoietic stimulation, the Russian recombinant G-CSF preparation Leukostim® was subcutaneously injected for all the patients. According to results of this study, intensive-dose CT regimens are effective in treating a number of malignancies and the administration of Leukostim® substantially enhances the accessibility of current treatment for malignancies in a wide circle of Russian patients. The capacities of intensedose CT require meticulous investigation and the method itself deserves further development and Russian oncologists’ scrupulous attention.
About the Authors
D. L. StroyakovskyRussian Federation
I. V. Profatilo
Russian Federation
G. B. Strelnikova
Russian Federation
R. G. Kuliyev
Russian Federation
E. M. Livantsova
Russian Federation
References
1. Skipper H.E. Kinetics of mammary tumor cell growth and implications for therapy. Cancer 1971;28:1479—99.
2. Norton L., Simon R. The Norton- Simon hypothesis revisited. Cancer Treat Rep 1986;70:163—9.
3. Frei E., Canellos G.P. Dose, a critical factor in cancer chemotherapy. Am J Med 1986;69:585—94.
4. Каледин В.И., Николин В.П., Тимофеева О.А. и др. Апоптозопосредованная регрессия перевиваемой лимфосаркомы LS мышей линии СВА при монои полихимиотерапии. Экспер онкол 2002;24(1):55—8.
5. Blume K.G., Thomas E.D. A review of autologous hematopoeitic cell transplantation. Biol Blood Marrow Transplant 2000;6:1—12.
6. Gutierrez-Delgado F., Maloney D.G., Press O.W. et al. Autologous stem cell transplantation for non-Hodgkin lymphoma: comparison of radiation-based and chemotherapy-only preparative regimens. Bone Marrow Transplant 2001;28:455—61.
7. Gutierrez-Delgado F., Maloney D.G., Holmberg L.A. et al. Autologous stem cell transplantation for patients with Hodgkin’s disease, a comparison of two high-dose chemotherapy regimens. Bone Marrow Transplant 2003;32:279—85.
8. Bodey G.P., Buckley Y., Sathe Y.S. et al. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 1966;64:328—40.
9. Crawford J., Ozer H., Stoller R. et al. Reduction in the incidence of chemotherapy-induced febrile neutropenia in patients with small cell lung cancer by granulocyte colony-stimulating factor (R-met G-CSF). N Engl J Med 1991;325:164—71.
10. Welte К., Reiter A., Mempel К. et al. A randomized phase-III study of the efficacy of granulocyte-colony stimulating factor in children with high-risk acute lymphoblastic leukemia. Blood 1996;87(8):3143—50.
11. Trillet-Lenoir V., Green J., Manegold С. et al. Recombinant granulocyte colony-stimulating factor reduces the infectious complications of cytotoxic chemotherapy. Eur J Cancer 1993;29A:319—24.
12. Duhrsen U., Villeval J.L., Boyd J. et al. Effects of recombinant human granulocyte colony-stimulating factor on hematopoietic progenitor cells in cancer patients. Blood 1988;72:2074—81.
13. Citron M.L., Berry D.A., Cirrincione C. et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer. First report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 2003;21(8):1431—9.
14. Sieber M., Bredenfeld H., Josting A. et al. 14-day variant of the bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone regimen in advanced-stage Hodgkin's lymphoma: results of a pilot study of the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2003;21(9):1734—9.
15. Engert A., Bredenfeld H., Döhner H. et al. Pegfilgrastim support for full delivery of BEACOPP-14 chemotherapy for patients with high-risk Hodgkin's lymphoma: results of a phase II study. J Haematologica 2006;91(4):546—9.
16. Balzarotti M., Spina M., Sarina B. et al. Intensified CHOP regimen in aggressive lymphomas: maximal dose intensity and dose density of doxorubicin and cyclophosphamide. J Ann Oncol 2002;13(9):1341—6.
17. Толкушин А.Г., Куликов А.Ю., Ягудина Р.И., Моисеева Т.Н. Сравнение оригинального препарата филграстим (Нейпоген) с российским воспроизведенным препаратом (Лейкостим) для профилактики и лечения нейтропении на фоне цитостатической полихимиотерапии больных с продвинутыми стадиями лимфогранулематоза: анализ «затраты-эффективность» и «минимизация затрат». М.: ММА им. И.М. Сеченова, ГНЦ РАМН, 2008.
Review
For citations:
Stroyakovsky D.L., Profatilo I.V., Strelnikova G.B., Kuliyev R.G., Livantsova E.M. Results of a prospective clinical study of the efficiency and safety of intensive-dose chemotherapy programs for malignancies. Oncohematology. 2008;(3):63-68. (In Russ.) https://doi.org/10.17650/1818-8346-2008-0-3-63-68