title: Continuous infusion cisplatin and etoposide chemotherapy for cancer of unknown primary site (CUPS) in Taiwan, a region with a high prevalence of endemic viral infections.
abstract: BACKGROUND
  To evaluate the efficacy and toxicity of cisplatin/etoposide continuous infusion chemotherapy for cancer of unknown primary site in Taiwan, a region with a high prevalence of endemic viral infections.
  
  
  METHODS
  Between April 1994 and February 1996, 20 patients with a diagnosis of CUPS were treated, including 15 males and five females, of average age 63.3 years (range 41-83 years). Continuous intravenous infusion of etoposide 80 mg/m2 and cisplatin 25 mg/m2 was given for 3 days every 3 weeks. Pretreatment tumor marker and viral serology studies were performed for baseline evaluation. Nearly two-thirds of the patients had poorly differentiated carcinoma. The average number of metastatic sites was 2.65 (range 1-4), with liver and lymph node involvement predominating.
  
  
  RESULTS
  The overall response rate was 25% (95% CI 17.7-32.3%); 30.7% for poorly differentiated cancers and 25% for well differentiated cancers. Median survival was 4 months (range 1-12 months), 4.8 months for patients attaining partial response. Toxicity was moderate, grade 3 and 4 neutropenia occurred in 55% and grade 3 and 4 thrombocytopenia in 40%; other toxicities were mild. CA125 and CA199 were elevated in more than 50% of patients. Viral serology studies were not significantly different from those of the indigenous population.
  
  
  CONCLUSIONS
  Etoposide and cisplatin combination chemotherapy has modest activity in patients with extensive CUPS and, at the schedule and dosage given, it is associated with moderate toxicity.
authors.affiliation: Division of Cancer Research, National Health Research Institutes, Taipei, Taiwan.
authors.forename: J M
authors.initials: JM
authors.lastname: Liu
authors.forename: Y M
authors.initials: YM
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Chao
authors.forename: S M
authors.initials: SM
authors.lastname: Liu
authors.forename: C M
authors.initials: CM
authors.lastname: Tiu
authors.forename: H W
authors.initials: HW
authors.lastname: Wu
authors.forename: T C
authors.initials: TC
authors.lastname: Chiou
authors.forename: R K
authors.initials: RK
authors.lastname: Hsieh
authors.forename: L T
authors.initials: LT
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Whang-Peng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000505:Alopecia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002353:Carrier State / Q000453:epidemiology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007262:Infusions, Intravenous; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D013624:Taiwan / Q000453:epidemiology; D013921:Thrombocytopenia / Q000139:chemically induced; D014777:Virus Diseases / Q000453:epidemiology*
chemical_list: D005047:Etoposide; D002945:Cisplatin