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Biomedical subjects

A Kessinger

Publications and source records attributed to A Kessinger.

At least 163 records · Page 9Linked to original sources

Hexamethylmelamine and melphalan as salvage therapy in advanced ovarian carcinoma.

Ten patients with advanced ovarian carcinoma were treated with hexamethylmelamine and melphalan after failing first-line combination chemotherapy. In eight patients residual disease was evident only at second-look laparotomy. Surgical debulking was accomplished in four patients but only two patients had residual disease of less than 2 cm. Two of these four patients are alive without evidence of disease to 20 and 24 months. The remaining patients have expired (median survival 6 months). The combination of hexamethylmelamine and melphalan after surgical debulking at second-look operation may improve the salvage of patients with advanced ovarian carcinoma.

Adenocarcinoma, Papillary↗

Five-day continuous infusion of 5-fluorouracil for advanced colorectal, gastric, and pancreatic adenocarcinoma.

In a retrospective study, 58 patients with advanced colorectal carcinoma received one or more 5-day infusions of 5-FU at 20 mg/kg per 24 hours followed by weekly IV 5-FU at 15 mg/kg. In 36 patients who received the infusion as first treatment (Group A), the response rate was 23% with a median duration of response of 8.0 months. No improvement in survival was noted. In 22 patients treated with the infusion after relapse on weekly 5-FU (Group B), the response rate was 10.5% with a median duration response of 4.5 months. Stable disease for 3-6 months was seen in 21%. Survival in Group B was improved when compared with a similar group of patients treated by weekly 5-FU without infusion (Group CB), but statistical significance was not obtained. Twenty percent of patients were alive two years after relapsing on weekly 5-FU when given the five-day infusion 5-FU and re-initiated on weekly 5-FU. Toxicity to the five-day infusion of 5-FU was minimal. Three of 69 (4.3%) infusions were not completed because of toxicity. A separate review of procarbazine indicated that it was minimally active in colorectal carcinoma. Other patients with gastric and pancreatic carcinoma were reviewed but no statistical significance for 5-FU infusion was seen for survival. A five day continuous infusion of 5-FU is recommended for colorectal cancer patients who relapse on weekly 5-FU therapy. Further study of the infusion in combination with other chemotherapy is warranted.

Adenocarcinoma↗

VM-26 as a second drug in the treatment of brain gliomas.

Twenty patients previously treated with surgical resection, radiation therapy, and a nitrosourea for malignant gliomas of the brain were given VM-26 as a second chemotherapeutic agent when evidence of tumor progression occurred. Thirty-five percent achieved an arrest or decrease of neurologic symptoms, with a median length of response (arrest and tumor regression) of 22 weeks.

Antineoplastic Agents↗

Sequential and adjuvant chemotherapy for malignant astrocytoma of the brain.

Twenty-nine patients with grade III or IV astrocytomas were treated with 1,3 bis(2-chloroethyl)-1-nitrosourea (BCNU), 75--100 mg/M2 intravenously (IV) for two consecutive days every four to six weeks, in an effort to improve the quality and length of their survival following surgical resection. Twenty-one of these patients received adjunctive chemotherapy as soon as they recovered from surgery and 18 received concomitant adjunctive radiation therapy as well. Eight patients were treated with radiation therapy after surgery, and BCNU was not added until evidence of tumor growth appeared. BCNU was discontinued and the epipodophyllotoxin, VM-26, was given at a dose of 100 mg/M2 IV weekly when further tumor growth occurred. Patients receiving adjuvant chemotherapy had a shorter mean and median survival than patients receiving BCNU when progression appeared following radiation therapy. Six patients with progressive disease following surgical resection and radiation therapy for grade II astrocytoma were treated with BCNU. Improvement or stabilization of neurologic symptoms occurred in four of these patients. This trial of lower-dose BCNU therapy produced survival rates similar to higher-dose studies and permitted fewer physician visits by the patient.

Brain Neoplasms↗

Small cell undifferentiated bronchogenic carcinoma: current status with emphasis upon the role of chemotherapy.

Current opinions concerning tumor biology and clinical characteristics of small cell undifferentiated bronchogenic carcinoma are reviewed. Special emphasis is placed upon chemotherapy for this lung cancer subtype and presently achievable response rates and survival times are presented. A series of 16 patients with small cell undifferentiated bronchogenic carcinoma is also presented. All patients were given cyclophosphamide, methotrexate, vincristine, and procarbazine as treatment for this neoplasm. Sixty-eight percent of patients responded and the survival time in partial responders was 33.4+ weeks as compared to 13.7 weeks with nonresponders. These data correlate well with the previous data of Alberto et al [Alberto P, Brunner KW, Martz G, Obrect JP: Cancer 38:2208--2216, 1976], who investigated the same agents for this tumor, but at higher dosages.

Adult↗

The glucagonoma syndrome and its management.

The glucagonoma syndrome occurs in some but not all patients with a benign or malignant islet cell tumor and hyperglucagonemia. Manifestations may include anemia, diabetes mellitus, pruritic skin rash, glossitis, stomatitis, weight loss, diarrhea, flexible fingernails, venous thromboses, low plasma amino acid levels, and coarse folds of the jejunum and ileum. Most patients are postmenopausal women, but men and women ages 40 to 65 have been affected. The course is variable depending upon the nature of the underlying tumor. Twenty-two cases of probable glucagonoma syndrome have been reported; twelve documented with glucagon levels. The hyperglucagonemia results from elevation of the proglucagon and true glucagon immunoreactive fractions of pancreatic glucagon. Management of the rash can be accomplished rarely with topical or systemic antibiotics or corticosteroids. If the tumor is resectable, surgery reverses the syndrome. Patients with metastatic disease have responded to streptozotocin and DTIC.

Adenoma, Islet Cell↗

Distribution of plasma glucagon immunoreactivity in a patient with suspected glucagonoma.

Gel filtration of plasma from a patient with a clinical syndrome of glucagonoma and a total plasma glucagon level of 2600 pg/ml, revealed the four glucagon immunoreactive fractions found in normal subjects. The total hyperglucagonemia observed was due to high levels of true glucagon and proglucagon moieties. The so-called "big plasma glucagon" (BPG) measured 190 pg/ml (normal average 113 +/- 79 pg/ml, Mean +/- SD, N = 10); the large glucagon immunoreactivity, LGI (9000 mol wt), measured 625 pg/ml (normal average 11 +/- 16 pg/ml); the true glucagon accounted for 1435 pg/ml (normal average 31 +/- 29 pg/ml); and the small glucagon immunoreactive fraction (approximately 2000 mol wt) measured 35 pg/ml (normal average 26 +/- 18 pg/ml). The high levels of LGI, considered a candidate for proglucagon, may reflect the increased secretory activity of the tumor.

Adenoma, Islet Cell↗

Quadrichemotherapy for advanced ovarian carcinoma.

In an effort to improve the length and rate of objective responses in patients with advanced ovarian carcinoma, a combination of four drugs was administered. Vincristine (10 mug/kg intravenously weekly), actinomycin D (500 mug intravenously weekly), oral methotrexate (1.25 mg daily), and oral cyclophosphamide (50 mg daily) were given to 25 evaluable patients with FIGO Stage III and IV ovarian carcinoma. After 12 weeks the vincristine and methotrexate were discontinued; cyclophosphamide and methotrexate were continued until disease progression was evident. Objective responses occurred in 56% of the patients. Toxicity was minimal. Patients not previously treated with radiotherapy or chemotherapy had a higher complete response rate (30%) than patients previously treated (13.3%). Mean length of complete response was 10.6+ months. The 1-year survival rate of these patients was 69.5% and the 5-year rate 22.7%. While the results are encouraging, single agent chemotherapy with an alkylating agent produces similar responses.

Carcinoma↗