ISSN:0378-584X    

DOI:10.1159/000218478

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

ISSN:0378-584X    

DOI:10.1159/000218479

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Clinical resistance of malignant tumors against cytostatic agents is a major obstacle to effective chemotherapy. A cell surface molecule (P-170) which acts as a pump has been identified as the underlying mechanism of the so-called multidrug resistance (MDR). Several compounds have been identified which can effectively block the action of P-170 and are able to render resistant tumor cells chemosensitive. Unfortunately, most modulators display intolerable side effects at therapeutic doses and are therefore not useful clinically. Preclinical studies show that dexverapamil (D-VPM), an optical isomer of the MDR modulator verapamil (Isoptin®), is able to effectively block the function of P-170. Cardiovascular effects are significantly reduced as compared to racemic verapamil, permitting dose escalations to plasma levels which modulate MDR in vitro assays. Promising clinical responses were observed in lymphoma patients, especially in the non-Hodgkin population. These encouraging trials deserve thorough succession studies

ISSN:0378-584X    

DOI:10.1159/000218480

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Background: Serum prostate-specific antigen (PSA) has proven to be the most useful tumor marker for prostate cancer. We previously reported the decline rate of PSA levels in patients with cancer of the prostate during radiotherapy; however, on the basis of a small number of patients, no definite conclusions were drawn. Material and Methods: In this report, we update our findings from a prospective study in which changes in PSA levels during radiotherapy (RT) were determined. Pre-RT and weekly PSA levels during 7-8 weeks of RT were measured in 76 stage A-C patients with prostate cancer. Results: In a majority (78%) of patients, the PSA levels declined. The mean rate of PSA decline was 1.3% /day or about 9%/week during RT. 13 patients received hormonal therapy prior to RT; their mean rate of decline (1.8%/day) was not significantly different from the average rate in 63 patients who had no hormonal treatment (1.2%/day). 11 patients had one or more digital rectal examinations (DRE) during the RT course; the mean rate of PSA decline (0.5%/day) was significantly less than the mean rate of decline in 65 patients who had no DRE (1.5%/day; p = 0.033); however, the median rates of decline between these groups were not statistically different. There was a significant (p = 0.0004) transient increase in the PSA values 24 h after the first RT fraction. No significant association was found between rate of decline and age, stage, grade, or race in the group of patients with no hormonal therapy. Tumor volume was calculated from prostate volume and initial PSA level prior to RT; a highly significant correlation was found between tumor volume and the rate of decline (p < O.001). In a multivariate model which included age, stage, grade, race and tumor volume, the latter remained significantly associated (p < 0.001) with the rate of PSA decline. A similar univariate and multivariate analysis showed that PSA density also was associated with the rate of PSA decline during RT (p < 0.001). Conclusion: The rate of PSA decline during RT is associated with the calculated tumor volume; PSA density is also similarly correlated with the rate of PSA decline.

ISSN:0378-584X    

DOI:10.1159/000218481

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Background: The value of radiation therapy (RT) and hormonal therapy (HT) in stage Dl prostatic cancer was to date only sporadically compared with radical prostatectomy (RP) and hormonal therapy Patients and Methods: From 1975 to 1991, 82 patients with pelvic lymph node dissection (PLND)-proven stage Dl prostatic carcinoma underwent RT. Twelve patients were excluded from analysis because treatment started when local tumor progression was observed. Of the remaining 70 patients 30 initially had an RP with orchiectomy and 40 patients had only a biopsy with orchiectomy. All patients had an additional androgen blocking. Fifty-five out of 70 patients were treated with photons up to a total dose of 4,000-5,000 cGy to the pelvic lymphatics and an additional boost to the prostatic region to deliver 6,000-7,000 cGy. In 12 out of 67 patients 14-MeV fast neutrons were used for the boost. Three patients had only a local RT. Results 0.05). Major complications occurred in 6% (4 patients); all of these were treated following RP. Conclusions: In the present series no significant advantage was seen for patients treated with RP, RT and HT, compared to RT and HT. RT in combination with immediate HT seems to be able to achieve results comparable with those of RP when using immediate HT. This should be proven in prospective clinical trials.

ISSN:0378-584X    

DOI:10.1159/000218482

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Background: A retrospective study of 946 patients with medullary thyroid carcinoma (MTC) was carried out by the German MTC Study Group. Material and Methods: By questionnaire, data from 42 co-operating centres were collected and computerized. There were 714 patients with sporadic MTC (75%) and 232 (25%) with familial disease. Details of the surgical procedures were documented from 433 patients. Results: 604 patients out of 946 are still alive (63.8%), 174 patients died (18.4%), many of them from tumour recurrency (n = 96); further information of 168 patients (17.8%) is missing. A total of 711 patients were followed up 1-278 months. The overall age-adjusted 5-year survival rate was 94% (men 93%, women 96%), the 10-year rate was 85% (men 74%, women 92%). In the first surgery, total thyroidectomy (TT) was done in 354 of 433 patients (81.8%); additionally, lymphadenectomy (LA) of various extent was performed in 48.5%. If diagnosis was known pre-operatively, rates of TT and LA were remarkably higher: 88.3% for TT and 76.5% for LA. For 271 patients the TNM classification was available; of these 51, 104, 92 and 24 presented at stages I, II, III and IV, respectively. In uni- and multivariate analyses, tumour stage and sex are the main risk factors; the form of tumor (sporadic/familial) and age are not significant. Conclusion: In MTC, surgery is the main factor of therapy. Total thyroidectomy and standardized systematic lymphadenectomy are considered to be the treatment of choice.

ISSN:0378-584X    

DOI:10.1159/000218483

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Background: Brain tumours produce insulin-like growth factors (IGFs) and IGF-binding proteins (IGFBPs). It is therefore feasible that cyst fluid from these tumours also contains detectable concentrations of IGFs and IGFBPs. This was the reason for measuring and characterizing these factors in prolactinoma cyst fluid. Patients and Methods: The cyst fluid underwent gel chromatography at low pH, and the IGF levels were determined by radioimmunoassay. In addition, sodium dodecyl sulphate – polyacrylamide gel electrophoresis (SDS-PAGE) and Western ligand blotting as well as binding studies with radiolabelled IGFs were performed. Results: The immunoreactive IGF-I, IGF-II and IGFBP-1 concentrations were 22,74 and 20 ng/ml, respectively. SDS-PAGE and subsequent Western ligand blotting using radiolabelled IGF-II gave bands with an estimated molecular weight of ≈200, 34, 28 and 24 kD. Additional binding studies showed specific binding of labelled IGF-I and IGF-II to these IGF-binding proteins. Conclusions: These results suggest that IGFs and IGFBPs are secreted by prolac-tinomas and that these factors may alter the growth characteristics of these tumours. Furthermore, the distinct pattern of IGFBPs might be used as a tool for differential diagnosis in various brain tumo

ISSN:0378-584X    

DOI:10.1159/000218484

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

摘要:

Background: High-dose-rate (HDR) remote afterloading intracavitary brachy-therapy has been widely used and is important for the treatment of carcinoma of the uterine cervix. Material and Methods: Experiences with a new flexible intracervical applicator after 56 afterloading treatments for carcinoma of the cervix in 17 patients are reported. Results: There where no complications due to the applicator or the technical system. The insertion of the flexible applicator was possible without dilatation of the cervix in all cases and without anesthesia in 19/56 applications (34%). Risk of perforation is minimal. Conclusion: We conclude that the use of flexible applicators instead of rigid steel applicators improves the technique for the delivery of high-dose-rate afterloading intracavitary brachytherapy for carcinoma of the cervix and can improve the quality of life of these patients.

ISSN:0378-584X    

DOI:10.1159/000218485

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

ISSN:0378-584X    

DOI:10.1159/000218486

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger

ISSN:0378-584X    

DOI:10.1159/000218487

出版商:S. Karger GmbH    

年代:1994

数据来源: Karger