Combined chemotherapy with bleomycin, adriamycin, and platinum in advanced thyroid cancer.
Twenty-two advanced consecutive thyroid cancer patients with varying histologies were treated with the so called BAP regime which consisted of bleomycin (B) 30 mg a day for three days, adriamycin (A) 60 mg/m2 iv in day 5, and cisplatinum (P) 60 to mg/m2 iv in day 5. Patients with progressive, symptomatic recurrent or disseminated disease unresponsive to hormonal and/or isotopic treatment were eligible. Nine patients had an objective response: two long-lasting complete and seven partial responses were observed out of 21 evaluable patients. Stable disease was observed in four additional patients. The median duration of response was 12 months (range, 6-29). The total series experienced a median survival of 11 months (range, 1 to 57), with 2 patients actually disease free. Several histologic types of thyroid carcinoma responded, but the best responses were observed in medullary and anaplastic giant-cell carcinomas. Toxicity was reversible in all but one patient. Of the patients failing on BAP chemotherapy three responded to a four drug second line combination containing vincristine, fluorouracil, BCNU and methotrexate. BAP regime can achieve reasonable palliation, and probably increases survival, in poor-prognosis thyroid cancers.
De Besi
P
P
Divisione Oncologia Medica, U.L.S.S. N. 21, Padova, Italy.
Busnardo
B
B
Toso
S
S
Girelli
M E
ME
Nacamulli
D
D
Simioni
N
N
Casara
D
D
Zorat
P
P
Fiorentino
M V
MV
D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001623:Betamethasone / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002277:Carcinoma / Q000188:drug therapy*; D002330:Carmustine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D013964:Thyroid Neoplasms / Q000188:drug therapy*; D014750:Vincristine / Q000008:administration & dosage
D000932:Antiemetics; D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D001623:Betamethasone; D008787:Metoclopramide; D002945:Cisplatin; D005472:Fluorouracil; D002330:Carmustine; D008727:Methotrexate