摘要:

AbstractThe adrenal glands of 58 patients undergoing adrenalectomy for advanced breast cancer were reviewed and correlated with the subsequent course of the patients' disease. Three patients had thecomatous metaplasia in the adrenal cortex, six patients had myelolipomatous changes, and 13 patients had metastatic breast cancer in their adrenal glands at the time of adrenalectomy. Neither the presence of metastases nor myelolipomatous changes were associated with a long disease‐free interval, a long period from mastectomy to adrenalectomy, or a prolonged postadrenalectomy survival The patients with metastatic breast cancer in the adrenal glands had more widespread disease than patients without adrenal metastases. The presence of breast cancer metastases in the adrenal glands at the time of adrenalectomy identifies patients further advanced in the course of their disease, but is not related prognostically to the effect of adrenalectom

ISSN:0098-1532    

DOI:10.1002/mpo.2950030102

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

年代:1977

数据来源: WILEY

摘要:

AbstractBecause of the frequent reports of hepatic toxicity associated with long‐term administration of methotrexate, a rat model was developed utilizing daily methotrexate administration. This model revealed an incidence of fatty metamorphosis of over 80 percent, atrophy and necrosis of 30 percent, and fibrosis of 10 percent. Fatty liver changes did not differ substantially from control animals in those animals receiving long‐term hydroxyurea, an agent which, like methotrexate, inhibits DNA synthesis but unlike methotrexate, does not impair methylation reactions. Because choline has a lipotropic effect and because its synthesis requires methylation, an attempt was made to block the liver toxicity of methotrexate by simultaneous administration of choline. Animals so treated did not show the pathologic changes in the liver characteristic of methotrexate treatment alone. Furthermore, the accumulation of triglycerides in the liver which was characteristic of methotrexate administration was markedly reduced in those animals receiving choline.These data strongly suggest that, in the rat model, methotrexate produced liver toxicity by virtue of an effect other than inhibition of DNA synthesis; and that this toxicity can be blocked without impairing methotrexate effect on bone marrow by the administration of choline, a lipotropic agent requiring methylation for its synthesis. It is suggested that these results may have implications for human therapeutic situations involving long‐term administration of methotr

ISSN:0098-1532    

DOI:10.1002/mpo.2950030103

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

年代:1977

数据来源: WILEY

摘要:

AbstractFour cases of cicatricial ectropion secondary to prolonged systemic administration of 5‐fluorouracil are described. In 1 patient ectropion resolved with conservative treatment and discontinuation of 5‐FU. Another patient developed the ectropion terminally and died before its resolution. In 2 patients surgical repair of the ectropion was unsuccessful in relieving conjunctival symptoms while 5‐FU was continued. With prolonged adjuvant chemotherapy programs utilizing 5‐FU, this complication may be seen with increasing frequency. Conservative management should be attempted, and patients with this problem should be reassured that symptoms will resolve when 5‐FU i

ISSN:0098-1532    

DOI:10.1002/mpo.2950030104

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

年代:1977

数据来源: WILEY

摘要:

AbstractFrom May, 1970 through December, 1972, Children's Cancer Study Group entered 112 patients on an amended treatment program for rhabdomyosarcoma and undifferentiated sarcoma in children. These patients had Group II disease with residual tumor remaining after surgery, or metastatic disease at onset. Another group consisted of patients who previously had treatment with surgery and radiotherapy and had recurrent disease. Cyclophosphamide was added to a previously used drug regimen which consisted of actinomycin D and vincristine. The drugs were given sequentially in repeated cycles for 18 months. Of 97 evaluable patients, there were 24 with microscopic residual disease, 37 with gross residual disease, 22 with metastatic disease at onset, and 14 patients who were treated with chemotherapy for the first time with recurrent or metastatic disease. All patients have been followed for 3 or more years. Survival in each group was 70.8%, 43.2%, 27.2%, and 28.2%, respectively. Although the number of complete remissions was greater than with two‐drug therapy, survival with three‐drug therapy was not significantly different than that seen in the earlier st

ISSN:0098-1532    

DOI:10.1002/mpo.2950030105

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

年代:1977

数据来源: WILEY

摘要:

AbstractSeventeen patients with advanced, previously treated Hodgkin's disease received therapy with a combination of streptozotocin 500 mg/m2/day i.v. days 1–5, CCNU 100 mg/m2orally day 1, adriamycin 45 mg/m2i.v. day 1, and bleomycin 15 mg/m2i.m. days 1 and 8 at 28‐day intervals (SCAB). The overall response rate was 59% with six patients (35%) achieving complete remission and four patients (24%) entering partial remissions. No maintenance therapy was given and the median duration of complete remission was 8+ months (range 2+–18+ months), while the median duration of partial remission was only 2 months (range 2–3 months). The median duration of survival from the start of therapy for the complete responders was 16+ months (range 5+–25+ months) while the median survival for the partial and nonresponders was only 5 months (range 2–13 and 3–11+ months, respectively). Toxicity was a major problem with this drug combination. Myelosuppression occurred regularly and was severe after 25% of courses. There were two death directly related to drug‐induced myelosuppression. Other serious toxicities included bleomy cin‐induced pulmonary toxicity in three patients, with one death; renal tubular dysfunction secondary to streptozotocin in three patients; hepatic dysfunction in three patients and severe weight loss in three patients. SCAB has proven to be an active although toxic combination which is not cross‐resistant to MOPP‐type regimens. Alterations in drug dosages and scheduling are being evaluated in an effort to ameliorate toxicity

ISSN:0098-1532    

DOI:10.1002/mpo.2950030106

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

年代:1977

数据来源: WILEY

摘要:

AbstractSixty patients with non‐Hodgkin's lymphomas were treated with a cyclophosphamide, vincristine, and prednisone (CVP) induction regimen, either alone (stage IV) or in combination with radiotherapy (stages I, II, III).The response rates for lymphocytic and histocytic lymphomas were 82 and 86%. The complete remission (CR) rates were 66 and 71% with a median duration of 13 and 5.5 months respectively. Nodular types responded better than diffuse ones in both lymphocytic (CR rate 85% vs 45%; median duration 24+ months vs 2.5 months) and histiocytic lymphoma (CR rate 100% vs 0%).In lymphocytic lymphomas, survival in the responder group was 90% at 24 months vs only 20% in the nonresponder group (median survival 14.5 months). In the group with nodular lymphocytic lymphoma responding to therapy, there was a 100% survival rate at 24 months. The median survival for patients treated with chemotherapy alone (stage IV) and not responding to therapy, was 22 months vs 14.5 months in the whole nonresponder group (stages I, II, III, IV), suggesting a detrimental effect of radiotherapy in the nonresponder group.In histiocytic lymphomas, the median survivals in the responder and nonresponder groups were 19 months and 3 months respectively. These results corroborate the excellent efficacy of the CVP regimen. They also indicate that, after CVP induction, 2 major prognostic factors are the histologic type and the nature of the response to therap

ISSN:0098-1532    

DOI:10.1002/mpo.2950030107

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

年代:1977

数据来源: WILEY

摘要:

AbstractThis report describes the results of a study of central nervous system (CNS) prophylaxis and combination chemotherapy for the maintenance of remission in adult acute lymphoblastic leukemia. Adults with acute lymphoblastic leukemia who achieved complete remission were treated with 2,400 rads cranial irradiation and intrathecal methotrexate for CNS prophylaxis followed by continuation systemic chemotherapy with oral methotrexate, 6‐mercaptopurine and cyclophosphamide. There were no CNS relapses following treatment. One‐half of the patients relapsed within 11 months, with 5 patients remaining in remission for 27+ to 31+ months. The toxicity was acceptable with no treatment‐related deaths. This regimen is capable of producing long remissions in a significant proportion of adults with acute lymphoblastic leukemia and appears to be effective in reducing the incidence of CNS relapse. It has the additional advantage of ease of administration and can be largely administered in the comm

ISSN:0098-1532    

DOI:10.1002/mpo.2950030108

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

年代:1977

数据来源: WILEY

摘要:

AbstractIntrathoracic stretch receptors regulate adjustments of the vasculature to gravitational changes and influence urinary water and solute excretion. Few reports of pathologic states involving interruption of these regulatory mechanisms have appeared. Two patients with orthostatic hypotension related to advanced intrathoracic carcinoma were studied, utilizing tilt‐table examinations and immersion of the entire body in water to test the function of their intrathoracic baroreceptor reflex arcs. Both patients showed abnormalities of antidiuretic hormone level and sodium excretion as compared with normal controls. This suggests that total immersion is a safe and convenient test of the low‐pressure baroreceptor system in patients with suspected dysfunction. Three patients are also reported whose charts were reviewed posthumously. Although they were not tested in the laboratory, their clinical data suggest that they too had been suffering from an interference with the transmission of impulses from the intrathoracic recept

ISSN:0098-1532    

DOI:10.1002/mpo.2950030109

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

年代:1977

数据来源: WILEY

摘要:

AbstractIn stage IV non‐Hodgkin's lymphomas, CVP (cyclophosphamide, vincristine, and prednisone) was randomly compared to ABP (adriamycin, bleomycin, and prednisone). Of 62 patients entered into the study, 57 (CVP 27, ABP 30) were considered evaluable for comparison. In patients with liver and/or marrow involvement a second biopsy was performed to define complete remission (CR). CR occurred in 48% of patients treated with CVP and in 50% of those given ABP. The median duration of CR was 10.5 and 20.5 months, respectively. The difference is not statistically significant. Also the survival of complete responders was not significantly different between the two treatment groups. After cross‐over, secondary treatment with CVP produced an overall response rate of 40% (six of 15), compared to 50% (six of 12) obtained with ABP. In the ABP group, four patients developed a reversible interstitial penumonia. In two other patients, cardiomyopathy (fatal in one) was observed. In conclusion, although complete remission was similar in both groups, cumulative toxicity occurred in few patients given ABP. However, this combination could represent in effective alternative treatment to be used either in CVP failures or in sequence with

ISSN:0098-1532    

DOI:10.1002/mpo.2950030110

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

年代:1977

数据来源: WILEY

摘要:

AbstractIn four children with previously untreated acute leukemia the stathmokinetic effect of a single IV dose of vincristine (in two children with AML), or of a single IV dose of vincristine combined with daily prednisone (in one child with AMMoL and one with ALL), were investigated. The kinetics of bone marrow blast cells from all patients, and of red cell precursors from the patients with ALL, were studies by conventional methods (determinations of mitotic index and pro – + metaphase/ana – + telophase ratios). In two of the four patients (one AML and one AMMoL) the progression of cells through S, the incorporation pattern of tritiated thymidine, and the nuclear projection area changes during S were analyzed by a combination of autoradiographic and cytophotometric techniques.The results suggest that the doses of vincristine used (0.05 and 0.075 mg/kg body weight) did not influence the progression of cells from G0/G1into S nor from S into G2, and had no effect on the incorporation pattern of tritiated thymidine or on the nuclear projection area changes during S. The results suggest, however, that the duration of the metaphase block induced by vincristine varied from one cell system to another. Differences in the time course of regeneration processes in neoplastic and normal cell systems might be one of the mechanisms responsible for the antineoplastic effect of vincristine in

ISSN:0098-1532    

DOI:10.1002/mpo.2950030111

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

年代:1977

数据来源: WILEY