Guide Sports medicine Volume 41 Issue 5 May 2011

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  2. Гарантированная безопасность и доступность
  3. William E. Garrett Jr., MD, PhD
  4. Pure and Applied Chemistry
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Diabetes Res ClinPract ; Indian Heart J ; Arterioscler Thromb Vasc Biol ; Curr Opin Lipidol ; Taskinen MR, Type 2 diabetes as a lipid disorder. CurrMol Med ; Krentz AJ, Lipoprotein abnormalities and their consequences for patients with type 2 diabetes. Natl Med J India ; Diabetes Nutr Metab ; J Assoc Physicians India; Ahead of print articles. Prevalence of type 2 diabetes mellitus among urban sikh population of Amritsar. Indian J Community Med ; Subjects and Methods.

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Table 4: Body mass index: waist hip ratio distribution in the sample population Click here to view. Table 5: Mean and SD values of the anthropometric physiological and biochemical parameters accordingly to age group Click here to view. Patients with ascites as judged by computed tomography or ultrasonography, hisotologically or cytologically confirmed peritoneal dissemination or diarrhea of three times a day or less were considered as high-risk group of irinotecan-induced severe diarrhea.

Irinotecan monotherapy regimen comprised a 1. S-1 was given per oral twice daily for 28 consecutive days, followed by 2 weeks of rest. Toxicity was assessed according to the National Cancer Institute common terminology criteria for adverse events, version 3. Efficacy was evaluated on the basis of the overall response rate and progression-free survival PFS. The same imaging method was used for baseline tumor measurements and tumor reassessments.

Total PFS was defined as the summation of PFSs in first- and second-line chemotherapies observed in respective patients. When patients did not receive second-line chemotherapy, the total PFS was equal to the PFS in first-line chemotherapy. A total of patients with advanced colorectal cancer received first-line chemotherapy from June through April These 87 patients were studied. First-line chemotherapy performed for advanced colorectal cancer patients in our institute from June to April Febrile neutropenia and Grade 3 diarrhea were seen in 2 3.

Febrile neutropenia and Grade 3 thrombocytopenia were observed in one patient 3. Grade 3 neuropathy occurred in 2 7. There were no treatment-related deaths in both groups. Median PFS was 7. Grade 3 anemia and diarrhea occurred in respective one patient 2. However, no other Grade 3 or 4 adverse events occurred. In second-line S-1, Grade 3 anemia occurred in one patient. No other Grade 3 or 4 adverse events occurred.

Grade 3 diarrhea occurred in 1 patient 9. In the second-line S-1, Grade 3 anemia occurred in one patient. No other Grade 3 or 4 adverse events were observed. Among three patients given second-line irinotecan monotherapy, two patients experienced respective Grade 3 or 4 neutropenia and one patient Grade 3 diarrhea.

The irinotecan doses in these patients for the next courses were reduced by the physicians in charge. The median total PFS in all 87 patients studied was The feasibility of this strategy was evaluated as follows:. The toxicities observed during the all first- and second-line chemotherapies were compared with those observed in representative studies. Patients who were assigned to FOLFOX because of ascites, peritoneal dissemination and diarrhea did not suffer from Grade 3 or higher gastrointestinal adverse events such as nausea, vomiting and diarrhea, which were relatively often observed in FOLFIRI.

The frequency of toxicities seen in the second-line irinotecan monotherapy was compared with that in the second-line FOLFIRI 5 , since i there have been few studies of second-line irinotecan monotherapy with large number of patients and ii we can evaluate the toxicity more severely in second-line irinotecan monotherapy, because FOLFIRI is stronger than irinotecan monotherapy in terms of toxicity. Because patients who had the risk factor for irinotecan-induced severe toxicity received second-line irinotecan monotherapy, frequencies of severe neutropenia and febrile neutropenia were higher than that previously reported.

In second-line S-1, the frequency of Grade 3 anemia was similar to that reported in previous study The frequencies of non-hematological toxicities such as nausea, diarrhea and mucositis were lower than those reported previously Collectively, the present regimen selection strategy appears to be feasible in terms of toxicities, except for the patients with risk for irinotecan-induced toxicity who received the second-line irinotecan monotherapy.

Гарантированная безопасность и доступность

Appropriate reduced dose should be determined and other chemotherapies without irinotecan should be developed for these patients. The median total PFS in all 87 patients evaluated was The median total PFS of Taking these considerations into account, the regimen selection of the first-line FOLFIRI or FOLFOX therapy based on the UGT1A1 genotyping in addition to patient physical conditions that are related to irinotecan-induced toxicity might be feasible, since it causes less toxicity and similar efficacy comparing to previous studies.

Determination of appropriate reduced dose in second-line irinotecan monotherapy or other standard second-line therapy for patients with high risk to irinotecan-induced toxicity might make this strategy more effective. To further confirm the present results, the prospective study involving larger numbers of patients should be planned to confirm our data, even though many patients are now treated with FOLFIRI or FOLFOX combined with monoclonal antibodies such as bevacizumab or cetuximab as the first-line therapy for advanced colorectal cancer in Japan 20— Further studies are necessary to confirm this point.

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