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CNAA / Theses / 2009 / June /

Cisplatin combined chemotherapy in the treatment of metastatic mammary cancer resistant to anthracyclines


Author: Clipca Ivana
Degree:doctor of medicine
Speciality: 14.00.14 - Oncology and Radiotherapy
Year:2009
Scientific adviser: Iurie Bulat
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology
Scientific consultant: Larisa Sofroni
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology
Institution:
Scientific council:

Status

The thesis was presented on the 30 June, 2009
Approved by NCAA on the 1 October, 2009

Abstract

Adobe PDF document – 0.29 Mb / in romanian

Keywords

metastatic mammary cancer, chemotherapy, resistance of anthracyclines, Cisplatin, response rate, median survival, toxicity, BioR.

Summary

The mammary cancer has the highest incidence in women neoplasms, thus becoming a global problem. Metastatic mammary cancer is still incurable in its essence with an average survival of 2 years. The cytostatic treatment with anthracyclines is being proven the most effective in this disease, and the developed resistance conditioned the carrying out of a high number of clinical studies to appreciate the efficacy of other second line chemotherapy.

The objective of this paper was to improve the results of the treatment in patients with mammary cancer resistant to anthracyclines. The efficacy of 4 cytostatic schemes, which included Cisplatin in the second line treatment of metastatic mammary cancer, has been studied. The research included 126 patients with metastatic mammary cancer previously treated with anthracyclines. The prospective group consisted of 3 subgroups: the first subgroup, which included 32 patients, followed Cisplatin and Etoposid; the second, including 32 patients, followed Cisplatin and Xeloda; while the third subgroup, including 30 patients, followed Cisplatin and Paclitaxel. The retrospective group, including 32 patients, followed Cisplatin and Vinblastin representing, at the same time, the control group. BioR remedy extracted from Spirulina platensis has been used to test the possibility to diminish side-effects.

Cisplatin and Etoposid combination showed an efficacy of 37.5% and a medium toxicity. Progression ensued in 5.5 months, with a median survival of 14 months. Cisplatin and Xeloda combination showed an efficacy of 43.8% and a moderate toxicity. Progression ensued in 5.2 months with a median survival of 9 months. Cisplatin and Paclitaxel scheme showed an efficacy of 46.3% and an acceptable tolerance. Progression ensued in 5.3 months. Cisplatin and Vinblastin combination, used as a second line treatment in mammary cancer resistant to anthracyclines, showed an efficacy of 31.3% and an acceptable toxicity. Progression ensued in 4.5 months with an average survival of 11 months.

Usage of BioR helped to diminish hematological and non-hematological toxicity increasing the tolerance to cytostatic treatment.