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Biomedical subjects

A Dindogru

Publications and source records attributed to A Dindogru.

12 recordsLinked to original sources
PubMed1984

Cisplatin. An active drug in the treatment of disseminated gastric cancer.

Cis-diamminedichloroplatinum (DDP) was administered at 100 mg/m2 intravenously bolus with every 3-week schedule in patients with measurable and nonmeasurable incurable gastric cancer. Twenty patients were treated, 12 with measurable and 8 with nonmeasurable disease. Four of the 12 (33%) patients with measurable lesions had objective remissions. One remission was complete, lasting 60+ weeks. Patients with nonmeasurable disease were not eligible for response evaluation; they were followed for toxicity and survival. Hematologic, renal, and gastrointestinal toxicities were similar to those reported in other patient populations receiving DDP. Neurotoxicity proved to be dose limiting in two patients. The median survival was 38+ weeks for responders, 24 weeks for all patients, and 13 weeks for those 8 patients with nonmeasurable disease. DDP should be considered an active drug against gastric cancer. A better understanding of the dose response relationship for DDP in gastric cancer is necessary before the best dose and schedule can be chosen for DDP in combination with other active agents.

Adenocarcinoma↗
PubMed1984

Preoperative chemotherapy and radiation therapy for patients with cancer of the esophagus: a potentially curative approach.

Twenty-one patients with squamous cell cancer of the esophagus were entered into a pilot clinical trial using preoperative chemotherapy (5-fluorouracil and cis-platinum) and radiation with the intent of improving cure rate and survival. After the preoperative treatment was complete, 15 patients (71%) were resected for cure. Seven (47%) of 15 had no histologic evidence of cancer in the resected esophagus, but two of these had microscopic cancer in resected lymph nodes. The median survival for all patients entered in the trial was 18 months, whereas for those with no cancer in the resected esophagus the median survival was 24 months. The six patients who either refused surgery (two patients) or were unresectable at surgery (four patients) died within nine months. Our conclusion in this trial is that survival and potential cure are clearly linked to successfully clearing the esophagus and nodes of histologic evidence of tumor through preoperative treatment.

Adult↗
PubMed1983

Management of malignant bronchoesophageal fistulas.

Twenty-four patients with a bronchoesophageal fistula due to a malignant lesion were seen during the eight years from 1974 to 1981. Twenty of the patients had carcinoma of the esophagus, and four patients had carcinoma of the lung. All three patients who had a Celestin tube inserted had gastric reflux, and in two, the fistula was not completely occluded. Four patients who had a cervical esophagostomy, feeding jejunostomy and ligation of the gastroesophageal junction died in the immediate postoperative period. The best palliative result was achieved in 17 patients who had a bypass of the fistula with the stomach. Fourteen had a substernal gastric bypass to the cervical portion of the esophagus, and three patients had a gastric bypass to the upper thoracic portion of the esophagus by way of a right thoracotomy. Although the operative deaths occurred in six of 17 patients, the surviving patients resumed oral feeding within ten to 14 days after operation, and the pneumonias cleared. These patients had, by far, the best palliative result. We, therefore, advocate substernal or intrathoracic bypass of the bronchoesophageal fistula as soon as the general condition of the patient permits.

Adult↗
PubMed1981

Complete eradication of squamous cell carcinoma of the esophagus with combined chemotherapy and radiotherapy.

Chemotherapy (with 5-fluorouracil and either mitomycin-C or cis-platinum) combined with radiotherapy was used either for palliation or as preoperative therapy in 67 patients with squamous cell carcinoma of the esophagus. In 25 patients having chemotherapy and 5000-6000 rads, good local palliation was obtained in 11 (49%) without surgery. In the remaining 25 patients, swallowing was restored with a variety of procedures (primarily Celestine tube or gastric bypass). The average survival time was seven months and two patients are still alive at 9 and 12.5 months. Of 42 patients receiving preoperative chemotherapy and radiotherapy, 35 had surgery. Of these, 13 (37%) had complete eradication of their tumors with no histologic evidence of carcinoma in the resected esophagus or associated lymph nodes. In another six (17%), the only evidence of tumor was small microscopic foci of cancer cells in the wall of the esophagus. The 6-, 12-, and 24-month survival rates for patients having surgery after the combined preoperative chemotherapy and radiotherapy were 83 per cent, 52 per cent, and 30 per cent, respectively. These results are far superior to those previously obtained.

Adult↗
PubMed1981

Eradication and palliation of squamous cell carcinoma of the esophagus with chemotherapy, radiotherapy, and surgical therapy.

Between April, 1977, and March, 1981, 86 unselected patients with proved squamous cell carcinoma of the esophagus were treated with a combination of chemotherapy and radiotherapy followed by operation whenever feasible. The preoperative chemotherapeutic agents used initially were 5-fluorouracil, and mitomycin C. After December, 1979, cis-platinum was used instead of mitomycin C. Radiotherapy (3,000 rads) of the tumor was begun at the same time as the chemotherapy. An esophagectomy was performed on suitable candidates 3 to 4 weeks after the chemotherapy and radiotherapy were completed. The mucosal lesion disappeared in 69 of the 86 patients, and dysphagia was relieved at least temporarily in 57 of 62 patients. Recurrent dysphagia resulting from fibrosis at the tumor site caused a secondary stenosis in 11 patients. Excellent palliation was obtained in five patients with bronchoesophageal fistulas who had an initial substernal gastric bypass followed by chemotherapy and radiotherapy. Of the 48 patients who had an esophagectomy, 15 (31%) had no tumor in the resected specimen. Eleven of these 15 patients are still alive with no evidence of disease. All patients with a lesion less than 5.0 cm in length had complete regression of the tumor. We believe that this combination of chemotherapy, radiotherapy, and surgical therapy provides excellent palliation, increases resectability, and has a potential for cure.

Adult↗
PubMed1980

Total parenteral nutrition in leukopenic cancer patients.

Over 12 months, 26 malnourished patients had 30 episodes of leukopenia while receiving total parenteral nutrition (TPN). There were 22 episodes of leukopenia associated with high temperatures (greater than 37.8 degrees C) A TPN-induced septicemia was the cause of fever in one patient. One patient with slight transient fever received no antibiotics, and 21 febrile patients were treated with various broad-spectrum antibiotics. The average duration of leukopenia was 6.9 days, and the average nadir of leukopenia was 789/cu mm. Eleven patients died during or within two weeks of the neutropenic episode. No deaths were related to TPN-induced septicemia. With proper care, TPN can be given to neutropenic patients without additional risk of sepsis.

Antineoplastic Agents↗
PubMed1978

Electrocardiographic changes following adriamycin treatment.

Two hundred and fifty-six patients with a wide variety of advanced neoplasms who were treated with adriamycin at Roswell Park Memorial Institute were studied for electrocardiographic changes. All the patients had pre- and posttreatment electrocardiograms (ECG's) and changes were found in 85 (33.2%). In the group of 1-8 patients with normal pretreatment ECG's, changes occurred in 51 (30.3%). In the group of 88 patients who had abnormal pretreatment ECG's, 34 (38.6%) developed further changes following treatment. Twenty-five patients received cytoxan concomitantly and ECG changes developed in 12 (48%); however, this and the above difference were not statistically significant. Frequency of ECG changes was higher and the extent of histologic abnormality in the myocardium was greater in those patients who received high doses of adriamycin. Arrythmias were rather benign and only a small number of patients required treatment. ECG changes following adriamycin treatment occurred more frequently than previously reported.

Arrhythmias, Cardiac↗
PubMed1978

Phase II trial of ftorafur with mitomycin C versus ftorafur with methyl-CCNU in untreated colorectal cancer.

In an attempt to substitute ftorafur for burdensome 5-fluorouracil (5-FU) infusions, 52 previously untreated patients were randomized to receive ftorafur with either mitomycin C or methyl-CCNU. Ftorafur was administered monthly as a 2-hour infusion daily x 5 days. Mitomycin C and methyl-CCNU were repeated every 8 weeks. A response rate of 27% (seven responses among 26 patients) was demonstrated on the mitomycin C arm compared to a response rate of 15% (four responses among 26 patients) on the methyl-CCNU arm (P = 0.25). There was no significant difference in the median survival between treatment arms. Central nervous system toxicity occurred in greater than 30% of the patients and appeared to be the limiting factor with ftorafur administration. Alternate schedules of ftorafur should be explored since there appears to be little advantage of a daily ftorafur schedule over conventional 5-FU infusions.

Adenocarcinoma↗
PubMed1976

Thyrotoxicosis secondary to involvement of the thyroid with malignant lymphoma.

A patient with malignant lymphoma developed goiter and thyrotoxicosis during the course of her disease. A thyroid biopsy revealed involvement of the thyroid gland with a malignant lymphoma. This was associated with the high levels of circulating thyroglobulin and thyroid hormones. The patient was treated with propylthiouracil, local radiotherapy, and nitrogen mustard and prednisone. The patient became euthyroid with the disappearance of goiter. Circulating levels of thyroglobulin and thyroid hormones returned to the normal range.

Adult↗
PubMedDate not supplied

Total parenteral nutrition in cancer patients.

One hundred and twenty-one cancer patients received 134 courses of total parenteral nutrition (TPN); almost all were treated with chemotherapy and/or radiotherapy. The average weight loss prior to TPN was 6.7 kg and albumin 3.1 g%/patient; 25% glucose solution with 4.25 g% amino acids was used as a calorie and nitrogen source. The average weight gain was 2.6 kg for those who received TPN less than 2 wk and 4.5 kg if TPN was given for greater than 2 wk. Complications were low; 3% had proven TPN-related septicemia. Mild to moderate reversible metabolic complications were common, although severe complications were rare; no one died because of TPN. Our experience confirms the previous reports that TPN can be given safely to malnourished compromised cancer patients.

Amino Acids↗