The Study Of Chronochemotherapy In Malignant Tumor

Background and objective:At present,most of the data from clinical and laboratory study indicated that the effect of chemotherapy is influenced by the timing of administration.Through many year's research,most of chemotherapy medicines have owned basic and clinic experiment data.After Hrushesky has taked Adriamycin(ADM)and Cisplatin(DDP)in ovarian cancer in 1985,the study of chronochemotherapy in malignant tumor had been become the warm spots in chemotherapy.At present,the chrono-chemotherapy have been used in all kinds of malignant tumors generally,for example,gastric cancer,rectal cancer,nasopharyngeal carcinoma,lung cancer, malignant lymphoma,renal carcinoma,breast cancer and so on.Based on the circadian rhythms of metabolism,selecting the suitable administration,we can obtain the highest performance and the lowest toxicity,so as to improve the survival quality,and prolong survival time.Through the study of chronochemotherapy and conventional chemotherapy in the treatment of gynecologic oncoma,we aim to evaluate the short term toxic side effects and efficacy.Methods:1.cervical cancer Cisplatin(DDP)was administered at 4 pm with fluorouracil from 0 am to 8am in group A.In group B the same doses of cisplatin and fluorouracil were given in daily working time from 8 am to 5 pm by the routine infusion method.The short term toxic side effects and efficacy were evaluated after completing two cycles of chemotherapy and then followed by radical hysterectomy or radiotherapy. 2.ovarian cancer In group A,cyclophosphamide(CTX)600mg/m~2 was administered at 10 am with Cisplatin(DDP)100mg/m~2/d from 4 pm to 6pm。In group B the same doses of cyclophosphamide and Cisplatin were given in daily working time from 8 am to 5 pm by the routine infusion method. The short term toxic side effects and efficacy were evaluated after completing two cycles of chemotherapy.3 trophoblastic neoplasia In chronochemotherapy group,Fluorouracil (5-fu)26～28mg/kg/d was administered at 12:00～8:00am with kengsengmycin (KSM)6μg(kg·d)from 2am to 6am.In conventional chemotherapy group the same doses of Fluorouracil and kengsengmycin were given in daily working time from 8 am to 5 pm by the routine infusion method.The short term toxic side effects and efficacy were evaluated after completed two cycles chemotherapy.Results 1.Cervical cancer Total response rate was higher in group A than that in group B(85.5%vs 77.4%,respectively)P values of＜0.05 were considered statistically significant.Grade 3 or 4 toxic side effects were mainly the decrease of white blood corpuscles which were remarkably lower in group A than in group B(P＜0.05).And there were no statistical differences in the other toxic sides effects.2.ovarian cancer Total response rate was higher in group A than that in group B(72.8%vs 66.3%,respectively)P values of＜0.05 were considered statistically significant.Grade 3 or 4 toxic side effects were mainly the decrease of white blood corpuscles and toxic properties of kidney which were remarkably lower in group A than in group B(P＜0.05).And there were no statistical differences in the other toxic sides effects.3.trophoblastic neoplasia There were considered difference between the chronochemotherapy group and the conventional chemotherapy group in terms of the decrease ofβ-HCG and drug resistance,we could have evaluated after completed two cycles conventional chemotherapy.Grade 3 or 4 toxic side effects were mainly the decrease of white blood corpuscles which were remarkably lower in group A than in group B(P＜0.05).Grade 3 or 4 toxic side effects were mainly alvi profluvium which were remarkably lower in group A than in group B(P＜0.05).And there were no statistical differences in the other toxic sides effects.Conclusion The short term efficacy of PF regimen in the neoadjuvant chemotherapy in locally advanced cervical cancer is apparently higher in the chronotherapy group A than in that the routine group B.However,there is no difference in the short term toxic side effects between these two groups.The chonomdulated infusion methods is useful in the neoadjuvent chemotherapy in locally advanced cervical cancer.The short term efficacy of PC regimen in the chronochemotherapy group in ovarian cancer is apparently higher than in the conventional chemotherapy group.And the short term efficacy of 5-fu and KSM regimen in the chronochemotherapy group in trophobla ticneoplasia is apparently higher than in the conventional chemotherapy group.So the chronochemotherapy infusion methods is useful in gynecologic oncoma.