Double alkylating agent therapy with @entity1260 and @entity786 for advanced @entity1149 . From the XXXX Group.

@entity1 @entity137 @entity5 @entity75 @entity1149 @entity786 @entity1431 @entity1260 @entity811
Forty-five @entity1 with advanced @entity1149 ( @entity1149 ), with progressive inoperable @entity5 were treated. Twenty-three @entity1 were of "limited" stage. Six @entity1 had received previous thoracic radiotherapy. @entity1 with central nervous system (CNS) metastases, Karnofsky scores of less than 30 or more than 70, and @entity1 over 70 years of age were excluded from the study. @entity786 (2.5 g/m2) was infused intravenously over 3 hours with the same Mesna dose. At the midpoint of the infusion, 3.5 g/m2 infosfamide was delivered as a bolus. Additional Mesna was administered over the next 8 hours. A maximum of four courses were given at three weekly intervals. One-hundred-thirty-eight courses were administered and 53% of @entity1 completed all four treatments. The response rate was 38%, with three (7%) complete responses. Seven additional @entity1 (15%) with stable disease symptomatically improved by two steps or more on the Karnofsky scale at the end of treatment. Median survival for all 45 @entity1 was 7 months, range less than 1 to 25 months. Sixteen courses were complicated by Grade 3 thrombocytopaenia and/or @entity1431 (Grade 4 on six occasions, Grade 3 on seven occasions) on the blood count taken immediately before chemotherapy. Intravenous antibiotics were required on 14% of the total number of courses; and three @entity1 died of probable treatment related causes. Two episodes of severe @entity1260 @entity75 occurred but recovery was complete, and four episodes of frank @entity811 also occurred. The Karnofsky score was more than 70 in 33% of @entity1 one month after the end of chemotherapy compared with 0% before treatment. Unlike many chemotherapeutic regimens for @entity1149 , double alkylating agent treatment with @entity1260 and @entity786 improved the performance status without major @entity137 in a selected @entity1 population. The overall survival, however, remains short and further alkylating agent combinations need to be considered in the future.
