• 01 MAR 97

    Trattamento medico delle neoplasie neuroendocrine avanzate con fluorouracile, dacarbazina ed epiadriamicina

    Nel marzo 1997 é stato avviato uno studio sui tumori neuroendocrini avanzati.

    Lo studio (Protocollo 8/97) aveva l’obiettivo di valutare l’efficacia dello schema polichemioterapico e, più in generale, rendere disponibile per quei pazienti cui la via chirurgica era preclusa, una valida opzione terapeutica potenzialmente in grado di ricondurre all’operabilità alcuni pazienti.

    Sono stati arruolati 82 pazienti.

    Lo studio ha dimostrato che il regime polichemioterapico è efficace e ben tollerato sia nei NET ben differenziati che nella patologia con comportamento clinico più aggressivo.

    Centri partecipanti :                     Istituto Nazionale Tumori, MILANO

    Istituto Clinico Humanitas, ROZZANO (MI)

    Policlinico di PALERMO

    Istituto Tumori Fondazione Pascale, NAPOLI

    Ospedale di Correggio, REGGIO EMILIA

    Ospedale G. Rummo, BENEVENTO

    Ospedale Businco, CAGLIARI

    Ospedale Civile, SAN SEVERINO MARCHE

    Ospedale Civile, LECCO

    Ospedale S. Maria Goretti, LATINA

    Presidio Ospedaliero di PRATO

    Az. Ospedaliera S. Maria degli Angeli, PORDENONE

    Ospedale S. Luigi Gonzaga, ORBASSANO (TO)

    Az. Ospedaliera Pugliese, CATANZARO

    Policlinico P. Giaccone, PALERMO

    Ospedale S. Cuore Don Calabria, NEGRAR (VR)

    Ospedali Riuniti, REGGIO CALABRIA

    Ospedale G. Fortunato, RIONERO IN VULTURE (PZ)

    Università di SASSARI

     

    Riferimento Bibliografico:

    • Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours.
      (Bajetta E, Ferrari L, Procopio G, Catena L, Ferrario E, Martinetti A, Di Bartolomeo M, Buzzoni R, Celio L, Vitali M, Beretta E, Seregni E, Bombardieri E).
      Ann Oncol. 2002 Apr;13(4):614-21.

      Abstract
      OBJECTIVES:
      Neuroendocrine tumours (NETs) are heterogeneous neoplasms for which there is no standard treatment. We have previously proposed an effective polychemotherapy (5-fluorouracil, dacarbazine and epirubicin), which only produced objective responses of brief duration. The present study aimed to assess in a multidisciplinary manner the efficacy of the same regimen at intensified doses in patients with advanced NETs.

      PATIENTS AND METHODS:
      Eighty-two consecutive patients entered the study, of whom 21 had inoperable, locally advanced disease and 61 had metastatic disease. Seventy-two patients were evaluated for objective, biochemical and subjective responses. Response rate, time to progression (TTP) and overall survival (OS) were evaluated based on histotype.

      RESULTS:
      An objective response was observed in 20 patients (intention-to-treat and standard analysis 24.4% and 27.8%, respectively). Complete biochemical and subjective responses were obtained in 25.1% and 38.9% of the cases. The median duration of treatment was 4 months and the objective responses had a median duration of 38 months. After a 60-month follow-up the median TTP and OS were 21 and 38 months, respectively.

      CONCLUSIONS:
      Our polychemotherapy regimen is effective, with long duration, and is well tolerated both for gastroenteropancreatic and lung NETs, as well as for tumours with a more aggressive clinical behaviour. The new WHO endocrine tumour histotyping, examining also the tumour biology, may give additional information for selecting patients to chemotherapy.

      PMID: 12056713   [PubMed – indexed for MEDLINE]

      Download articolo: Ann Oncol-2002

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