122                                                                                                                  Carcinoma of Unknown Primary                     

 

19.    Carcinoma of Unknown Primary

 

19.1        General Considerations

The selection of a possible therapy regimen should take into consideration the most probable localization and the histology of the primary.

 

19.2        paclitaxel + carboplatin + etoposide

Paclitaxel                        200 mg /m2                          i.v. ( 1 h inf)                       d 1

Carboplatin                     AUC = 6                       i.v.(20-30 min inf)             d 1

Etoposide                         50 mg                          p.o.                                     d 1,3,5,7,9 and

                                         100 mg                        p.o.                                     d 2,4,6,8,10

            To be repeated every 3 weeks

 

            Literature:

                        GRECO et al, Cancer 89 (2000): 2655-2660

                        HAINSWORTH et al, J. Clin. Oncol. 15 (1997): 2385 – 2393

 

19.3         Cisplatin- based combination chemotherapy

Cisplatin, vinblastine, bleomycin ± doxorubicin or cisplatin , etoposide ± bleomycin  .

Usual dose of cisplatin 20 mg/m2  i.v. days 1 – 5, etoposide 100 mg/m2 i.v. days 1 – 5 , bleomycin 30 U/Wk. If response after two courses at three week intervals, four courses were given.

 

Literature:

     HAINSWORTH et al, J. Clin. Oncol. 10 (1992):  912 – 922

 

19.4     Docetaxel + carboplatin

Docetaxel                                65 mg/m2                 i.v.                           d 1

Carboplatin                             AUC = 6                 i.v.                            d 1

            To be repeated every 3 weeks (max 8 courses in stable or responding patients)

           

            Literature:

                        GRECO et al, Ann. Oncol. 11 (2000): 211 – 215

 

19.5     TFL

Paclitaxel                                 175 mg /m2                  i.v.(3 h inf)                   d 1

5 – Fluorouracil                       350 mg/m2                   i.v. (30 –60 min inf)    d 1 – 3

Folinic acid                              300 mg                        i.v. (30 – 60 min inf)    d 1 – 3

            To be repeated every 4 weeks

 

            Literature:

                        DOWELL et al, Cancer 91 (2001): 592 – 597

 

 

19.6        VAC

Vincristine                                   1.4 mg/m2                  i.v.                                 d 1

Doxorubicin                                 50 mg/m2                   i.v.                                 d 1

Cyclophosphamide                      500 mg/m2                 i.v.                                  d 1

To be repeated every 3 weeks

 

Literature:

            ANDERSEN et al, Eur. J. Cancer Clin. Oncol. 19 (1983): 49 – 52