摘要:

AbstractIn order to determine the extent of implementation of adjuvant chemotherapy for stage II carcinoma of the breast in the St. Louis area, records of all patients with stage II carcinoma of the breast treated with standard or modified radical mastectomy in five different St. Louis hospitals were reviewed. Between July 1, 1976, and July 1, 1977 (17 months after publication of preliminary L‐PAM results and 4 months after publication of preliminary CMF results), 73% of 24 premenopausal patients and 55% of 58 postmenopausal patients received adjuvant chemotherapy. Ten percent of premenopausal and 31% of postmenopausal patients received therapy other than CMF or L‐PAM. Compared to premenopausal patients in university‐affiliated hospitals, premenopausal patients in community hospitals tended to receive radiation therapy more commonly and chemotherapy alone less often (P<0.1). Compared to postmenopausal patients in university‐affiliated hospitals, postmenopausal patients in community hospitals more commonly received chemotherapy alone, and less often received no adjuvant therapy (P<0.05). We conclude that results of adjuvant chemotherapy trials can be rapidly implemented into standard practice both in university‐affiliated and community hospitals. Since 12 of 52 patients receiving adjuvant chemotherapy in fact received non‐standard, unpublished regimens, improvements in phase IV drug development may be required to prevent potentially deleterious modifications of published reco

ISSN:0098-1532    

DOI:10.1002/mpo.2950080102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractAntithrombin III levels were measured in serum before, during, and after therapy with three different dosage regimens of L‐asparaginase in 11 children with acute lymphoblastic leukemia. Levels determined by both functional and immunologic methods were transiently reduced during alternate‐day or daily L‐asparaginase treatment but not affected when the drug was administered only every 10 days. The probable mechanism of this effect is impaired hepatic synthesis of antithrombin III, resembling the acute and transient deficiency of other asparagine‐rich proteins during L‐asparaginase admin

ISSN:0098-1532    

DOI:10.1002/mpo.2950080103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractA pilot study of the toxicity and efficacy of a new treatment schedule for childhood non‐Hodgkin's lymphoma was conducted by members of the Children's Cancer Study Group (CCSG) prior to its use in a randomized phase III trial. Chemotherapeutic agents used were cyclophosphamide (CPM), vincristine (VCR), and prednisone, together with intravenous (IV) and intrathecal methotrexate (IT MTX). Radiation therapy was also employed.From September 1976 to April 1977, 27 eligible, newly diagnosed patients with non‐Hodgkin's lymphoma were entered onto this pilot study. Toxicity was acceptable with minor adjustments in dosage and timing of the myelosuppressive agents. Fourteen of the 22 patients entered onto maintenance remain entirely disease‐free, and all have completed the prescribed course of chemotherapy. None of the 12 patients characterized as having a “favorable” prognosis has relapsed, with a median follow‐up of 27 months fr

ISSN:0098-1532    

DOI:10.1002/mpo.2950080104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractThe cerebral spinal fluid (CSF)‐protein profiles of ten children with previously untreated acute lymphoblastic leukemia (ALL) were investigated by agarose gel electrophoresis. The profiles were determined at diagnosis and during the fifth to eighth week of treatment when preventive therapy for central nervous system (CNS) leukemia (skull) irradiation, intrathecal methotrexate (ithMTX) was administered. The profiles were compared with those obtained from a control group of 67 children and those from 42 patients with acute aseptic meningitis. The data from the latter group demonstrated the CSF‐protein pattern of partial blood‐CSF barrier (B‐CSF‐B) breakdown. The children with ALL showed no or only minor signs of a B‐CSF‐B impairment at diagnosis and after four weeks of systemic treatment. However, CSF changes indicative of a lesion of the B‐CSF‐B increased in all children continuously during CNS prophylaxis. The protein profile at the end of combined chemotherapy and radiotherapy was very similar to that in patients with acute aseptic meningitis. These observations point to neurotoxic side effects on the CNS barrier system with the combination of cranial radiation and ithMTX. A striking finding was restricted heterogeneity of γ‐globulin, observed in the CSF of nine out of the ten children with ALL before or during treatment. The significance of this ab

ISSN:0098-1532    

DOI:10.1002/mpo.2950080105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractSixty children survived for five years after the diagnosis of histiocytosis X. Serious disabilities were seen in 50% of children whose disease involved soft tissue and bone. Late deaths from pulmonary failure were associated with opportunistic infections in two cases.Future treatment approaches must weigh the risks of therapy‐related complications against the probability of significant disability if the disease continues for many year

ISSN:0098-1532    

DOI:10.1002/mpo.2950080106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractHistiocytic medullary reticulosis (HMR) is a rare, malignant disorder with unsatisfactory response to various chemotherapeutic agents that have been used up to the present time.The purpose of this communication is to describe the first patient with this disease in whom an immediate, complete remission was obtained using only adriamycin. Four months after institution of this treatment, a staging laparotomy and splenectomy revealed residual disease in the spleen only. Adriamycin was continued as the sole agent, to the full calculated dose, followed by maintenance therapy consisting of cyclophosphamide. The patient continues to be in complete remission 35 months after diagnosis was established.

ISSN:0098-1532    

DOI:10.1002/mpo.2950080107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractA randomized study of intestinal decontamination was undertaken in 68 children with leukemia and solid tumours. Framycetin, colymycin, nystatin, and metronidazole were given in 35 neutropenic episodes in 33 children, while co‐trimoxazole and lactobacilli preparation were administered in 35 episodes in 35 children. The diseases, severity of neutropenia, and incidence of infection at entry into study were comparable in the two groups. There was no significant difference in the incidence of infections developing during the phase of neutropenia. The median and range of time required to recover from neutropenia were also not different. Co‐trimoxazole and lactobacilli were significantly better tolerated, there being no nausea and vomiting, no refusal to take medication, no dose reduction or change to an alternative regimen. We conclude that co‐trimoxazole and lactobacilli preparation improve quality of life during a neutropenic episode and have the additional advantage of being relatively inexpe

ISSN:0098-1532    

DOI:10.1002/mpo.2950080108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractCase histories of 47 patients with histologically confirmed carcinoma of extra‐hepatic bile ducts presenting to M. D. Anderson Hospital and Tumor Institute over a 30‐year period were studied. The disease was more common in males during the sixth and seventh decades of life. A third of the patients had history of cholelithiasis. Four patients had prior history of chronic ulcerative colitis and one patient had congenital choledochal cyst prior to development of cancer of the bile duct. Jaundice was the earliest and the most common presenting sign. The tumor was located in the common bile duct more often than in the hepatic ducts. The overall median survival was eight months with two‐year and five‐year survival rates of 15% and 3%, respectively. The respective values for patients who had resectable tumors were 21.7 months, 57% and 20%. Ascending cholangitis was a frequent complication in patients treated with dilation and intubation and, overall, hepatic failure and systemic infection were more frequent causes of death than distant met

ISSN:0098-1532    

DOI:10.1002/mpo.2950080109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractIn a controlled, randomized prospective clinical trial the utility of intravenous hyperalimentation (IVH) in the administration of and tolerance to chemotherapy was tested. The conclusions reached were 1) IVH is safe with a tolerable infection rate; 2) infectious complications correlate significantly with the nutritional status of the patient, with the presence of IVH being only a secondary factor; 3) IVH may be used to rehabilitate patients nutritionally, even those on intensive chemoterhapy; 4) the ability to deliver chemotherapy to patients seems to be improved by IVH, especially in malnourished patients in a late stage of disease.

ISSN:0098-1532    

DOI:10.1002/mpo.2950080110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY

摘要:

AbstractA child with widespread metastases successfully treated with chemotherapy alone is described. One course of combination chemotherapy using cis‐platinum, vinblastine, and bleomycin produced disappearance of multiple pulmonary metastatic lesions. Four courses of therapy produced shrinkage and tumor sterilization of an abdominal mass. Twenty‐six months after initiation of chemotherapy the patient is well, off of all therapy for fourteen months, and free of disease or drug related complication with normal creatinine clearance and alpha‐fetoprotein determinations.The published adult experience demonstrates that this therapy is extremely effective for the treatment of metastatic embryonal cell carcinoma of the testis in young adults, and our case report extends this favorable experience into childhood. Toxicity is substantial, but justifiable considering the poor outlook associated with widespread metastatic disease. Collectively, the reviewed data suggest that further trials of this type of therapy are indicated in chi

ISSN:0098-1532    

DOI:10.1002/mpo.2950080111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1980

数据来源: WILEY