https://scholars.lib.ntu.edu.tw/handle/123456789/580466
標題: | Biochemical modulation of doxorubicin by high-dose tamoxifen in the treatment of advanced hepatocellular carcinoma | 作者: | ANN-LII CHENG KUN-HUEI YEH Fine R.L. Chuang S.-E. Yang C.-H. Wang L.-H. DING-SHINN CHEN |
公開日期: | 1998 | 出版社: | H.G.E. Update Medical Publishing Ltd. | 卷: | 45 | 期: | 24 | 起(迄)頁: | 1955-1960 | 來源出版物: | Hepato-Gastroenterology | 摘要: | BACKGROUND/AIMS: In vitro data have indicated that tamoxifen (> 2.5 uM) significantly enhances the cytotoxic effect of doxorubicin in hepatocellular carcinoma (HCC) cells. This clinical study was conducted to examine whether tamoxifen, at a dose sufficient to result in a plasma concentration of more than 2.5 uM, may improve the therapeutic efficacy of doxorubicin in patients with advanced HCC. METHODOLOGY: A prospective phase II study was conducted. Eligible patients had unresectable and non-embolizable HCC, objectively measurable tumors, adequate neogram with absolute granulocyte count > 2000/mm3 and platelet count > 1 x 10/mm3, total serum bilirubin < 3.0 mg/dl, age ? 75 year, and a Karnofsky performance status ? 50%. The treatment included oral tamoxifen 40 mg/m2, q.i.d, Day 1 to 7, and intravenous doxorubicin 60 mg/m2, Day 4, repeated every 3 weeks. RESULTS: Between May 1994 and December 1996, a total of 38 patients were enrolled in the study. Thirty-six patients were evaluable for tumor response and treatment-related toxicities. There were 32 men and 4 women, with a median age of 49 years. They received an average of 3.8 (range: 1-12) courses of chemotherapy. ECOG (Eastern Cooperative Oncology Group) Grade 304 leucopenia and Grade 3=4 thrombocytopenia developed in 27.2% and 12.5% courses given, respectively. Gastrointestinal toxicity was generally mild. Three patients developed symptomatic cardiac toxicity. Twelve patients (33.3%, 95% confidence interval 17-51%) had achieved a partial remission (PR), with a median progression-free survival of 7 months. Median survivals of the responders and non-responders were 10 and 3 months, respectively (p < 0.05). The median Karnofsky performance status of the responders improved from 74.0 ± 6.3% to a post-chemotherapy value of 93.2 ± 4.6% (p < 0.05) CONCLUSIONS: High dose tamoxifen appears to be an effective biochemical modulator of doxorubicin in the treatment of HCC. Prospective randomized phase III studies comparing doxorubicin alone versus doxorubicin plus high-dose tamoxifen are needed. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032427203&partnerID=40&md5=d1d66db9032214db18cb761ed62c1c6b https://scholars.lib.ntu.edu.tw/handle/123456789/580466 |
ISSN: | 0172-6390 | SDG/關鍵字: | bilirubin; doxorubicin; tamoxifen; adult; bilirubin blood level; cancer regression; cardiotoxicity; clinical article; clinical trial; conference paper; controlled clinical trial; controlled study; diarrhea; drug response; female; gastrointestinal disease; granulocyte; human; intravenous drug administration; leukocyte count; leukopenia; liver cell carcinoma; male; nausea; oral drug administration; priority journal; prognosis; statistical analysis; stomatitis; thrombocyte count; thrombocytopenia; vomiting |
顯示於: | 醫學系 |
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