Showing papers by "Eastern Cooperative Oncology Group published in 1985"

Postoperative adjuvant 5-fluorouracil plus methyl-CCNU therapy for gastric cancer patients. Eastern Cooperative Oncology Group study (EST 3275).

Abstract: After en bloc resection of gastric adenocarcinoma, 180 patients were randomized to 2 years of 5-fluorouracil (5-FU) + semustine (MeCCNU) chemotherapy or to observation only. After a median follow-up time of 64 months, 48 of 89 control patients and 51/91 treated patients recurred (P less than 0.71). The sites of recurrent cancer were similar for both groups: liver, 32%; local esophagus or stomach, 51%; abdominal nodes and peritoneum, 38%; and extra-abdominal nodes, 14%. The survival curves overlap; 51/89 controls and 57/91 treated patients died with a median survival of 32.7 and 36.6 months, respectively (P less than 0.73). Treated patients experienced clinically important hematologic toxicity and two treated patients died of marrow failure with leukemia. Because of the toxicity and the lack of effectiveness, adjuvant 5-FU + MeCCNU is not recommended for patients with resectable gastric cancer.

A retrospective study of earliest indicators of recurrence in patients on Eastern Cooperative Oncology Group adjuvant chemotherapy trials for breast cancer. A preliminary report.

Abstract: A retrospective review of the Eastern Cooperative Oncology Group adjuvant chemotherapy studies EST 5177 and EST 6177 was performed in order to ascertain the first indicator of relapse in women with breast cancer and pathologically positive axillary lymph nodes. Of 856 evaluable patients, 208 have relapsed. In 175 patients who relapsed, the first indicator could be clearly identified: symptoms, 36%; patient self-examination, 18.3%; physical examination by the physician, 19.4%; abnormal blood chemistries, 12%; bone scans, 8%; chest x-rays, 5.1%; and mammograms, 1.1%. Although 74% of recurrences are therefore detected clinically, in a sizable proportion (26%), the ancillary tests were the earliest indicators of relapse. The manner of detection was not influenced by nodal, estrogen receptor (ER), or menopausal status. These results suggest that the follow-up schedule currently employed by ECOG appears reasonable.

The eastern cooperative oncology group experience with cyclophosphamide, adriamycin, and 5‐fluorouracil (CAF) in patients with metastatic breast cancer

Abstract: Data on 162 women (90 premenopausal and 72 postmenopausal) with metastatic breast cancer randomized to receive cyclophosphamide, Adriamycin (doxorubicin) and 5-fluorouracil (CAF) on two Eastern Cooperative Oncology Group (ECOG) protocols were analyzed Twenty-three percent had complete remission; 39% had partial remission; 28% had no change; and 3% had disease progression Of those patients in whom receptors were known, response rates were 65% for estrogen (ER)-receptor positive and 70% for ER-negative patients The median duration of response was 114 months The median survival time from the start of CAF was 202 months The response rate, time to treatment failure (TTF), and median survival time were superior in the premenopausal women These differences ceased, however, to be statistically significant in logistic models Factors significantly associated with longer TTF and longer survival were as follows: one or two organs with metastases (TTF, P less than 00001; survival, P less than 00001); dominant site other than soft tissue (TTF, P less than 00001; survival, P = 005); and an initial good performance status (TTF, P = 0007; survival, P = 002) Patients with ER-positive disease had a significantly longer median survival time (P = 0003)

A randomized comparison of cyclophosphamide, Adriamycin, and 5-fluorouracil with triethylenethiophosphoramide and methotrexate, both as sequential and as fixed rotational treatment in patients with advanced ovarian cancer.

Abstract: The combinations of triethylenethiophosphoramide and methotrexate (TM) and cyclophosphamide, Adriamycin (doxorubicin), and 5-fluorouracil (CAF) were compared, both as sequential and fixed rotational treatments for advanced ovarian cancer, with L-phenylalanine mustard (L-PAM). Treatment with CAF produced a higher response rate (25% complete responses plus 31% partial responses) than treatment with L-PAM (15% complete responses plus 18% partial responses). A fixed rotation of TM and CAF resulted in longer survival (median of 15 months and 75th percentile of 27 months) than sequential treatment with TM initially, followed by CAF upon failure (median of 12 months and 75th percentile of 22 months). The fixed rotation of TM and CAF also increased progression-free survival (median of 12 months and 75th percentile of 24 months) over that achieved by initial treatment with TM (median of 6 months and 75th percentile of 15 months) or L-PAM (median of 9 months and 75th percentile of 21 months). Most patients (96%) on the fixed rotation were treated with both TM and CAF. Fewer patients (62%) on the sequential schedule with TM actually received both combination regimens, and even fewer patients (37%) beginning on CAF ever crossed over to TM. Patient age of 50 years or younger was a favorable prognostic factor for response, survival, and time to first treatment failure (progression-free survival). Disease Stage IIIA or IIIB, surgery including a bilateral salpingo-oophorectomy plus hysterectomy, and treatment within 6 months of initial diagnosis were favorable predictors for both survival and time to first treatment failure. Ambulatory performance status and well-differentiated disease were favorable prognostic factors for survival. Patients with unevaluable disease failed later than those with evaluable disease who, in turn, failed later than patients with measurable disease.