A comparative analysis of the physical fitness profile of Korean women's national amateur boxers by weight category

The purpose of this study was to examine the differences in specific physical fitness of the national amateur women's boxer. The Korean women's national amateur boxers were classified into the lightweight category (LWC, n=21) and middleweight category (MWC, n=13), and body composition (percentage body fat and body mass index) and specific physical fitness (maximal muscle strength, anaerobic power, isokinetic muscle strength, cardiopulmonary endurance) were measured. The Mann-Whitney U-test was conducted to determine the differences in the body composition and specific physical fitness in women's boxers. The percentage body fat (P=0.004) and body mass index (P<0.001) were significantly higher in the LWC compared to MWC. In addition, LWC showed significantly higher isokinetic muscle strength (P<0.001), upper anaerobic mean power (P=0.002), maximal muscle strength (P=0.003), and maximal heart rate at anaerobic threshold (P=0.029), maximal oxygen consumption (P<0.001) and the 20-m shuttle-run exercise (P=0.004) compared to MWC. In conclusion, the body fat percentage and body mass index levels among body composition were significantly higher in the MWC than in the LWC, and the constant muscle strength, maximum muscle strength, and cardiopulmonary endurance levels were significantly higher in the LWC than in the MWC. The results of this study are expected to provide useful data for planning future strategies for efficient and scientific training programs for each weight category.

Effects of multimodal cognitive exercise program on cognitive function, bone density, blood lipid, fitness, and depression in old women with mild cognitive impairment

The purpose of this study is to verify the effects of participation in 12-week multimodal cognitive exercise program on cognitive function, bone mineral density, blood lipids, senior functional fitness, and depression of the old women with mild cognitive impairment and osteopenia. As a result, the exercise group showed significant effects in cognitive function, depression, bone mineral density, blood lipid, lower extremity flexibility, upper extremity flexibility, dynamic balance, and body endurance. Such results prove that multimodal cognitive exercise program is an effective interventional exercise program for improving cognitive function in the old women with mild cognitive impairment.

EFEITOS DO EXERCÍCIO DE REABILITAÇÃO ACELERADA DEPOIS DE TBM SOBRE A FUNÇÃO E A FORÇA NA INSTABILIDADE DO TORNOZELO

RESUMO Introdução: Os atletas de taekwondo com instabilidade lateral crônica do tornozelo (ILCT) podem apresentar dificuldades com propriocepção e força muscular do tornozelo. Depois da cirurgia, um programa de exercícios de reabilitação convencional pode ser ineficaz, porque a propriocepção ou a força muscular podem não se restaurar e, portanto, resultar em melhora mínima. Objetivos: Este estudo teve como objetivo avaliar os efeitos de um programa de ERA depois de TBM sobre a propriocepção, força isocinética e resistência do tornozelo. Métodos: Trinta atletas com diagnóstico de ILCT foram submetidos à TBM. Eles foram divididos em grupo ERA (n=15) e grupo controle CON (n = 15). O grupo ERA realizou exercícios ERA precoces seis vezes por semana durante 4 semanas. Os parâmetros aplicados para testar a força muscular do tornozelo foram velocidade angular de 30°/s e 180°/s (inversão: Inv e eversão: Eve, respectivamente). A propriocepção foi medida pela capacidade de sentir a posição articular de 15° de Inv e 5° de Eve Resultados: Foram observadas diferenças significativas entre os grupos ERA e CON na força do tornozelo 30°/s (Inv: p < 0,001, Eve: p < 0,001), 180°/s (Inv: p < 0,001, Eve: p < 0,001), e propriocepção a 15° (Inv: p < 0,001) e 5° (Eve: p < 0,001). Conclusões: Registramos efeitos de curto prazo significativos com ERA precoce em atletas de taekwondo com ILCT depois da TBM. Os resultados fornecem dados de referência para o reabilitador esportivo ou ATC (Certified athletic trainer) na avaliação da fase de reabilitação e informar os pacientes sobre as expectativas depois da TBM em termos de condições de desempenho e momento de retorno ao esporte. Nível de evidência III; Estudos terapêuticos – Investigação dos resultados do tratamento - Estudo de caso-controle.

EFFECTS OF ACCELERATED REHABILITATION EXERCISE AFTER MBO ON ANKLE FUNCTION AND STRENGTH IN ANKLE INSTABILITY

ABSTRACT Background: Taekwondo athletes with lateral chronic ankle instability (LCAI) may experience difficulties with proprioception and ankle muscle strength. After surgery, a conventional rehabilitation exercise program can be ineffective, as it may not restore proprioception or muscle strength and, thus, result in minimal improvement. Objective: This study aimed to assess the effects of an ARE program following MBO on the proprioception, isokinetic strength, and endurance of ankle. Methods: Thirty athletes diagnosed with LCAI underwent MBO. They were divided into the ARE group (n=15) and the control group (CON, n=15). The ARE group performed early ARE exercises six times per week for 4 weeks. The parameters applied to test ankle muscle strength were angular speed of 30°/sec and 180°/sec (inversion: Inv. and eversion: Eve., respectively). Proprioception was measured as being able to sense a joint position of 15° of Inv. and 5° of Eve. Results: Significant differences were observed between the ARE and CON groups in ankle strength 30°/sec (Inv.: p<0.001, Eve.: p<0.001), 180°/sec (Inv.: p<0.001, Eve.: p<0.001), and proprioception at 15° (Inv.: p<0.001) and 5° (Eve.: p<0.001). Conclusions: We recorded significant short-term effects from early ARE in Taekwondo athletes with LCAI after MBO. The results provide reference data for the sports rehabilitator or ATC in evaluating the rehabilitation phase and informing patients about expectations after MBO in terms of performance status and the timing of return to sports. Level of evidence III; Therapeutic studies–Investigation of treatment outcomes - Case-control Study.

THE EFFECTS OF TRAINING ON DIFFERENT SURFACES, ON BALANCE AND GAIT PERFORMANCE IN STROKE HEMIPLEGIA

ABSTRACT Although many studies have focused on balance exercises for elderly or stroke patients, no comprehensive studies have investigated the use of training on different surfaces (TDS) with analysis of gait performance in elderly male stroke patients. The active properties of balance and subjective reporting of functional gait ability were used to identify the effects of TDS. Static balance (SB), dynamic balance (DB) and gait analysis was measured in 30 elderly stroke patients. The patients were divided into the TDS group (n=15) and a control group (CG, n=15). Fifteen elderly stroke patients underwent TDS five times a week for 12 weeks. The data was analyzed using repeated measures analysis of variance. Significant differences were observed between the two groups (TDS and Control): SB (p < 0.0001), DB (OSI: p < 0.0001, APSI: p < 0.001, MLSI: p < 0.004) and gait analysis (right: temporal step time: p < 0.0001, temporal cycle time: p < 0.001, temporal double support time: p < 0.0001; left: temporal step time: p < 0.0001, temporal cycle time: p < 0.0001, temporal double support time: p < 0.0001). TDS in elderly male stroke patients suggests that the characteristics of gait performance in these patients may be improved by increasing static balance, dynamic balance and gait velocity. It is hoped that the results of this trial will provide new information on the effects of TDS on balance stability and gait ability in stroke patients, through changes in stability of the lower extremities. Level III, Case-control Study.

Vascular Endothelial Integrity Affects the Severity of Enterovirus-Mediated Cardiomyopathy

Coxsackievirus and adenovirus receptor (CAR) is present in epithelial and vascular endothelial cell junctions. We have previously shown a hemorrhagic phenotype in germ-line CAR knock-out mouse embryos; we have also found that CAR interacts with ZO-1 and β-catenin. However, the role of CAR in vascular endothelial junction permeability has not been proven. To understand the roles of CAR in the vascular endothelial junctions, we generated endothelium-specific CAR knockout (CAR-eKO) mice. In the absence of CAR, the endothelial cell layer showed an increase in transmembrane electrical resistance (TER, Ω) and coxsackievirus permeability. Evans blue dye and 70 kDa dextran-FITC were delivered by tail vein injection. We observed increased vascular permeability in the hearts of adult CAR-eKO mice compare with wild-type (WT) mice. There was a marked increase in monocyte and macrophage penetration into the peritoneal cavity caused by thioglycolate-induced peritonitis. We found that CAR ablation in endothelial cells was not significantly increased coxsackievirus B3 (CVB3) induced myocarditis in murine model. However, tissue virus titers were significantly higher in CAR-eKO mice compared with WT. Moreover, CVB3 was detected in the brain of CAR-eKO mice. Endothelial CAR deletion affects the expression of major endothelial junction proteins, such as cadherin and platelet endothelial cell adhesion molecule-1 (PECAM-1) in the cultured endothelial cells as well as liver vessel. We suggest that CAR expression is required for normal vascular permeability and endothelial tight junction homeostasis. Furthermore, CVB3 organ penetration and myocarditis severities were dependent on the endothelial CAR level.

The effects of instrument-assisted soft tissue mobilization rehabilitation exercise on range of motion, isokinetic strength, and balance in chronic ankle instability taekwondo players

We aimed to investigate change the instrument-assisted soft tissue mobilization (IASTM) rehabilitation exercise on range of motion (ROM), isokinetic ankle strength, and balance. We included 20 elite taekwondo players (chronic ankle instability) in Korea. They were divided into the IASTM group (n=10), control group (n=10). IASTM group were exercised with IASTM rehabilitation exercise four times per week for 8 weeks. The remaining control group did not receive exercise intervention between tests and served as the control. A goniometer was used to measure dorsi-flexion (D/F), plantar-flexion (P/F), a dynamometer was used to measure ankle isokinetic strength, and plantar foot pressure was used to measure static balance. The data were analyzed using repeated-measures analysis of variance. Significant differences were observed between the two groups in IASTM group and control group: ROM (right P/F, P<0.001; right D/F, P<0.01; left P/F, P<0.000; left D/F, P<0.000), isokinetic strength (right P/F 60°, P<0.000; right D/F 60°, P<0.000; left P/F 60°, P<0.000; left D/F 60°, P<0.000; right P/F 180°, P<0.000; right D/F 180°, P<0.000; left: P/F 180°, P<0.000, left D/F 180°, P<0.000), and balance test (static eye open, P<0.000; static eye close, P<0.000; postural stability, P<0.041). These results suggest that IASTM rehabilitation exercise improves ankle stability, muscle power, and body balance in chronic ankle instability taekwondo players.

Erratum: Comparison of performance-related physical fitness and anaerobic power between Korean wheelchair badminton national and backup players

[This corrects the article on p. 663 in vol. 15, PMID: 31723554.].

Comparison of performance-related physical fitness and anaerobic power between Korean wheelchair badminton national and backup players

The purpose of this study was to compare performance-related physical fitness factors and anaerobic power between national and backup players to enhance the performance of wheelchair badminton players and to discover and foster new athletes. This study included 12 wheel-chair badminton players divided into two groups: national players (n=7) and backup players (n=5). Collected data included cardiorespiratory endurance, muscle endurance, muscle strength, power, agility, and anaerobic power. Results indicated that the national players achieved a significantly higher level of muscle endurance, peak power, and mean power than the backup players. Although none of the parameters showed statistically significant differences, the performance levels of the national players were higher than those of the backup players. Because the physical fitness aspects of wheelchair players vary according to their ability and are essential factors, individualized training programs for enhancing performance and preventing injuries among wheelchair badminton players should be developed.

Effects of Telephone Follow-Up Intervention on %Body Fat, Inflammatory Cytokines, and Oxidative Stress in Obese Hispanic Children

This study investigated whether 10 month telephone follow-up intervention effectively stabilizes reductions in %body fat, and markers of inflammation and oxidative stress obtained from summer camp in obese Hispanic children. Fifty-six obese children (19 SUTI: summer camp and 10 months of follow-up telephone intervention, 18 SU: summer camp intervention only, and 19 CON: no intervention) completed this study. Anthropometric data and blood samples were obtained before (PRE), after 8 weeks of summer camp, and a 10month follow-up telephone intervention to measure markers of inflammation and oxidative stress. Eight weeks of summer camp significantly reduced %body fat, and levels of tumor necrosis factor-alpha, C-reactive protein and 8-hydroxydeoxyguanosine. It also elevated levels of adiponectin and total antioxidant status in SUTI and SU (p < 0.05). However, results of the 10month follow-up measurement were reverted back to PRE in SU, whereas the results for SUTI remained different to PRE (p < 0.05). Results confirm that levels of inflammation and oxidative stress are correlated to changes in %body fat, indicating that fat loss is effective in preventing and managing obesity-associated disorders. It is suggested that a telephone intervention is an effective follow-up tool for stabilizing reductions in %body fat as well as levels of inflammation and oxidative stress that were obtained from an intensive summer camp program in obese Hispanic children.

Antiaging strategy considering physiological characteristics

Aging is a complex process that has a profound impact on health problems, and it is difficult to maintain a healthy daily life due to a gradual decrease in physiological function. In order to prevent aging, it is vital and valuable to study the reduction of physiological function. This study focused on the physiological factors associated with aging and discussed lifestyle changes to prevent aging. This study suggests if the national government should strive to develop and distribute programs, such as physical activity, cognitive function, dementia, and fall for the prevention of geriatric diseases, the old people will be able to live a healthier and happier life.

Effects of the senior welfare center exercise program on body shape, physical fitness level, and cardiovascular health-related factors in old man from Korean rural areas

The purpose of this study was to investigate changes in body shape, physical fitness, and cardiovascular health-related factors after a 1-year combined exercise program in rural old men. Subjects were fourteen old men with more than 65 years of age living in Korean rural areas. The combined exercise program consisted of 90-min dynamic and static exercise sessions at a frequency of 3 days per week. Body shape (body weight [BW], body fat percentage [%BF], muscle mass [MM], body mass index [BMI], waist hip ratio [WHR]) and physical fitness levels (grip strength, standing up-right, one leg standing, sit and reach, and 2-min walking) were measured before, 6 months and 1 year after the program started. Cardiovascular health-related factors, including blood glucose, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglyceride (TG) were measured. There were no significant changes in BW, BMI, %BF, and MM after the training. WHR was significantly decreased at 6 months and 1-year follow-up points compared to baseline. There was no statistically significant difference in grip strength, but there was a significant increase after 6 months and 1 year after standing up right, one leg standing, sit and reach, and 2-min walking tests. There were no significant differences in the levels of glucose, SBP, DBP, TC, LDL-c, and TG, but there was a significant increase in HDL-c after 1-year.

The effects of combined aerobic and resistance training on inflammatory markers in obese men

It is important to treat obesity and the related noncommunicable diseases. The main objective of this study is the effect of different training types on inflammatory and immune markers in obesity. Seventeen obese men with body mass index (BMI)≥26 kg/m² were randomly divided into two groups: aerobic training group (AT; n=9) and combined aerobic and resistance training group (CT; n=8). Body composition (weight, BMI, %body fat), factors of physical performance (one-repetition maximum [1RM], maximal oxygen uptake [VO_2max]), inflammatory markers (interleukin-6, tumor necrosis factor-alpha [TNF-α]), immune markers (leukocyte, natural killer cell) were analyzed before and after 8-week training. Body composition (weight, BMI, and %body fat) was significantly reduced after training in both the AT and CT groups (P<0.05). As a result of training, VO_2max of all training groups was increased and 1RM of CT group was partially improved. In particular, the inflammatory marker, TNF-α was significantly reduced (P<0.05) and the change was correlated with %body fat in the posttraining CT group. In this study, we found that combined training for 8 weeks improved physical fitness, body composition, and inflammation. It is suggested that restoring obesity through combined training of aerobic and resistance exercise is related to changes in serum TNF-α levels.

The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players

Although many studies have focused on stretching techniques for athletes, no comprehensive studies have investigated the use of the instrument-assisted soft tissue mobilization (IASTM) technique in young basketball players. The active properties of muscle and subjective reporting of functional ability were used to identify the effects of IASTM on the calf muscle. Active range of motion (AROM), functional fitness, and isokinetic lower strength in the knees and ankles were measured in 40 healthy young basketball players. They were divided into the IASTM group (n= 20) and a control group (CG, n= 20). Twenty asymptomatic young basketball players were treated with IASTM six times per week for 8 weeks. The remaining 20 participants did not receive a treatment intervention between tests and served as the control. Ankle AROM (two knee positions of 0∘ and 45∘ flexion), functional fitness at the knee and ankle (side-step and vertical jump), and isokinetic peak torque were determined during ankle dorsiflexion (DF) and plantar flexion (PF) and knee extension (EX) and flexion (FX). The data were analyzed using repeated-measures analysis of variance. Significant differences were observed between the two groups in IASTM and control AROM 0∘ knee flexion (right: DF; p< 0.001 and PF; p< 0.001; left: DF; p< 0.001 and PF; p= 0.011), AROM 45∘ knee flexion (right: DF; p< 0.001 and PF; p= 0.009; left: DF; p< 0.001 and PF; p= 0.001), functional fitness (side step; p= 0.001, sit and reach; p= 0.025, vertical jump; p= 0.001), ankle isokinetic strength 30∘/sec (right: DF; p= 0.001 and PF; p= 0.001; left: DF; p< 0.001 and PF; p= 0.002), ankle isokinetic strength 120∘/sec (right: DF; p= 0.049 and PF; p= 0.001; left: DF; p= 0.023 and PF; p< 0.001), knee isokinetic strength 60∘/sec (right: EX; p= 0.001, FX; p= 0.001 and hamstring and quadriceps ratio [H/Q]; p= 0.001, left: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001), and knee isokinetic strength 180∘/sec (right: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001; left: EX; p= 0.001, FX; p= 0.010 and H/Q; p= 0.001). These results suggest that IASTM improves functional fitness and lower body muscle strength in young basketball players.

Effects of 16-week spinning and bicycle exercise on body composition, physical fitness and blood variables of middle school students

The purpose of this study was to investigate the effects of 16 weeks of spinning and bicycling exercises on body composition, physical fitness and blood variables in female adolescents. Subjects participated in this study were 24 female middle school students (12 spinning cycles, 12 general bicycles) attending to Seoul Yeoksam middle school. Each group was trained for 16 weeks, 3 times a week, and 1 hr per day after school. Body composition, physical fitness (1,200 running, sit-ups, back strength, sit and reach, side-steps) and blood variables (low-density lipoprotein cholesterol, glucose, reactive oxygen species, and malondialdehyde) were examined before and after 16 weeks of training. As the results, body weight did not show any significant difference; however, body mass index, and % body fat were significantly difference in spinning group. The enhancement in physical fitness factors were recognized in both groups, which was greater in spinning group in sit-ups, back strength, and side steps. Blood parameters were significantly difference between groups, but between group and time interactions were significantly difference in glucose and reactive oxygen species. In conclusion, this study suggests that 16 weeks of bicycle exercises were positive changes in body composition, physical fitness and blood constituents, indicating that spinning cycle is more beneficial as compared to ordinary bicycle.

Acute effects of aerobic stretching, health and happiness improving movement exercise on cortical activity of children

Acute high-intensity physical exercise is known to improve cognitive performance of children, including those with attention-deficit/hyperactivity disorder (ADHD). In this work, we investigated the acute effect of an aerobic stretching and moderate-intensity, health and happiness improving movement (HHIM) exercise on the cortical activity of children with and without ADHD using electroencephalography (EEG). Children aged 12 to 14 yr with combined-type ADHD and age-matched healthy controls participated in the study, performing two individual movements (n=79, 35 controls) and a single exercise bout (n=45, 18 controls). electroencephalographic signals were recorded before and immediately after each movement, and before and after acute exercise under resting conditions, to obtain absolute and relative power estimates for the theta (3.5-8 Hz), alpha (8-12 Hz), sensory motor rhythm (12-16 Hz), and beta (16-25 Hz) bands. After acute HHIM exercise, all children showed significant changes in their relative EEG, mainly in the theta and alpha bands. Individual movements were found to influence relative theta, alpha and beta, and theta-to-beta ratios. He presents aerobic stretching HHIM exercise has demonstrated acute effect on the cortical activity of children.

The effects of isometric exercise types on pain and muscle activity in patients with low back pain

The purpose of the present study is to evaluate the effects of isometric exercise types on low back pain (LBP) patients. Isometric exercise types were mat exercise and I-Zer exercise. Subjects were divided into 3 groups: LBP control group, LBP mat exercise group, and LBP I-Zer exercise group in 23-25 aged men. Visual analogue scale (VAS) and electromyography (EMG) were used to evaluate the degree of pain and the muscle activity in LBP patients. Root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were checked by EMG power spectrum analysis on longissimus thoracic (LT), iliocostalis lumborum (IL), mulitifidus (M), and rectus abdominis (RA). LBP mat exercise program and LBP I-Zer exercise program were conducted 5 sets once time, 3 times per week during 6 weeks. The two-way ANOVA with repeated measure was used to check the pain degree and muscle activity. The present results showed that muscle activity in the LBP I-Zer exercise group was increased compared to the LBP mat exercise group and LBP control group (P<0.05). LBP I-Zer exercise group and LBP mat exercise group showed increased mean frequency in LT, IL, M, and RA muscles than the LBP control group. Therefore, LBP patients performed isometric exercise may have positive effect to reduce pain degree and to increase muscle activity. Especially, LBP I-Zer exercise type showed more effectiveness in reducing pain degree and enhancing muscle activity.

The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity

The purpose of this study was to examine whether a six-week elastic band exercise program using proprioceptive neuromuscular facilitation (PNF) can increase isotonic strength of abductor muscles in the lower extremity. Twenty-eight healthy students from S university were divided into an experimental group and control group. Each group was participated in pre and post-measurement in isotonic strength using an isotonic analyzer, En-treeM. Experimental group performed elastic band exercise using PNF pattern for a six-weeks, in contrast, control group did not take any exercise. In the results of this study, isotonic strength measurements of abductor muscles in lower extremity in experimental group were significantly different after exercise, but control group did not show any significant changes. Therefore, we hope that resistive exercise would be very valuable for healthy people as well as the old people with weakened muscle strength.

The effects of ketogenic diet on oxidative stress and antioxidative capacity markers of Taekwondo athletes

The purpose of this study was to investigate the effects of the ketogenic diet through 3 weeks on oxidative stress and antioxidative capacity markers in Taekwondo athletes. The participants selected for this research were 18 high school taekwondo contestants aged 15-18 who had at least 5 yr of career as contestant. The subjects were randomly assigned to the ketogenic diet (KD) group and the Non ketogenic diet (NDK) group. Body composition and oxidative stress and antioxidative capacity markers (LDH, MDA, ROS, HDL, and SOD) were analysed before and after 3 weeks of ketogenic diet. No significant difference was found between the groups in body composition, ROS and SOD level. The KD group showed an elevated HDL level and NKD group showed an elevated LDH and MDA level after ketogenic diet by 3 weeks. This result suggests that weight loss by 3 weeks of calorie restriction and exercise can cause oxidative stress, and that ketogenic diet can be effective for preventing it. It could also be inferred that ketogenic diet can be effective for increasing blood antioxidative capacity.

The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors and cytokines of Taekwondo athletes

The purpose of this study was to investigate the effects of the weight loss through 3 weeks of ketogenic diet on performance-related physical fitness and inflammatory cytokines in Taekwondo athletes. The subjects selected for this research were 20 Taekwondo athletes of the high schools who participated in a summer camp training program. The subjects were randomly assigned to 2 groups, 10 subjects to each group: the ketogenic diet (KD) group and the non-ketogenic diet (NKD) group. Body composition, performance-related physical fitness factors (2,000 m sprint, Wingate test, grip force, back muscle strength, sit-up, 100 m sprint, standing broad jump, single leg standing) and cytokines (Iinterleukin-6, Interferon-γ, tumor necrosis factor-α) were analyzed before and after 3weeks of ketogenic diet. No difference between the KD and NKD groups in weight, %body fat, BMI and fat free mass. However, the KD group, compared to the NKD group, finished 2,000 m sprint in less time after weight loss, and also felt less fatigue as measured by the Wingate test and showed less increase in tumor necrosis factor-α. This result suggests that KD diet can be helpful for weight category athletes, such as Taekwondo athletes, by improving aerobic capacity and fatigue resistance capacity, and also by exerting positive effect on inflammatory response.

Paclitaxel, 5-fluorouracil, and cisplatin combination chemotherapy for the treatment of advanced gastric carcinoma

BACKGROUND

Although the clinical efficacy of paclitaxel in the treatment of gastric carcinoma has not been clearly defined, recent reports have suggested a possible role in the treatment of upper gastrointestinal carcinomas in vitro and in vivo. In this study, the authors evaluated the efficacy and toxicity of a combination chemotherapy that included paclitaxel, 5-fluorouracil (5-FU), and cisplatin in the treatment of patients with advanced gastric carcinoma.

METHODS

Forty-one gastric carcinoma patients with metastatic disease, unresectable advanced disease, or relapsed disease were treated with the following regimen, administered every 28 days: paclitaxel 175 mg/m2 by 3-hour intravenous (i.v.) infusion on Day 1, 5-FU 750 mg/m2 by 24-hour continuous i.v. infusion on Days 1-5, and cisplatin 20 mg/m2 by 2-hour i.v. infusion on Days 1-5. Twenty-six patients had measurable disease, and 15 had evaluable disease. All patients were assessable for toxicity.

RESULTS

Twenty-one of the 41 patients (51%; 95% confidence interval [CI], 36.5-65.7%) demonstrated an objective response, including 4 complete responses (10%; 95% CI, 3.9-22.5%). Sixty-five percent of the patients with measurable disease (17 of 26; 95% CI, 58-92.5%) and 27% of the patients with evaluable disease (4 of 15: 95% CI, 11.1-52.3%) achieved a complete response or a partial response. The median response duration was 17 weeks (range, 4-90 weeks), and the median survival duration for all patients was 26 weeks (range, 8 to 118+ weeks). The major toxicity of this treatment was myelosuppression with neutropenia of World Health Organization Grade 3 and 4 in 24% and 10% of the patients, respectively. Nonhematologic toxicity included mucositis, nausea/vomiting, diarrhea, neurotoxicity, and alopecia. Fluid retention occurred in two patients, and one patient had an anaphylatic reaction. Dose reduction was necessary for one patient, because Grade 4 neutropenia and mucositis occurred.

CONCLUSIONS

Paclitaxel, 5-FU, and cisplatin was an active combination regimen in the treatment of advanced gastric carcinoma. The toxicity of this regimen was tolerable. Based on these findings, this combination regimen could be an attractive treatment in the preoperative setting.