Firstly participants will be supported to create a week by week graded set of walking goals to work towards (goal setting).
Twenty years ago, when I was a senior at Yale, the graduate students embarked on a two-week "grade strike," during which they refused to hand in the fall grades of the undergraduates they were teaching.
For these purposes, hypertension was defined as sustained grade 1 for at least 4 weeks, grade ⩾2 or the initiation or increase in anti-hypertensive medications.
A DLT was defined as grade 4 mucositis that interrupts treatment for over 2 weeks, grade 4 thrombocytopenia, grade 2 nephrotoxicity, or grade 3 or 4 nonhaematologic toxicity, excluding alopecia, nausea, vomiting, anorexia and fatigue.
One patient died of pulmonary embolism, probably unrelated to TMZ administration; one discontinued treatment due to prolonged (7 weeks) grade 4 pancytopenia.
For grade 4 neutropenia persisting for >7 days, a dose delay >2 weeks, grade 4 thrombocytopenia or an episode of thrombocytopenic bleeding, the dose was reduced by 20 mg m or one dose level.
Persistent (⩾3 weeks) grade 3 or 4 AEs, or any significant AE that compromised the subject's ability to participate in the study, were also cause for study discontinuation.
When treated at a dose of 100 mg m− 2 once every 3 weeks, grade 4 neutropenia and febrile neutropenia occur in 75%, respectively 11%, of patients; a dose of 75 mg m− 2 only moderately reduces this incidence (http://www.taxotere.com).com
In phase II trials of single-agent topotecan in adult patients with solid tumours receiving 30-min infusions of 1.5 2.0 mg m−2 day−1 for 5 days every 3 or 4 weeks, grade III IV neutropenia was observed in 71 75% of all courses (Creemers et al, 1995; Perez-Soler et al, 1996).
