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Biomedical subjects

C G Schmidt

Publications and source records attributed to C G Schmidt.

At least 163 records · Page 9Linked to original sources
PubMed1981

[Brain metastases in malignant testicular teratomas].

Between 1974 and 1979 a total of 344 patients with testicular teratomas were treated at the West German Tumor Center, Essen. Brain metastases were encountered in 16 patients by means of neurologic symptoms as well as scintigraphy and computerized tomography. Cerebral involvement was closely related to preexistent lung metastases (n = 162) and the risk appeared to increase with the duration of pulmonal disease amounting to about 10% (16/162) in this group. Radiotherapy was the treatment of choice and produced objective and subjective improvement in 13 of 16 cases. Thus, long-term prognosis of patients with brain metastases was mainly determined by the preexistent metastatic involvement of the lungs.

Brain Neoplasms↗
PubMed1980

[Sequential combination chemotherapy with vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) in non-seminomatous testicular cancer. I. Results of a prospective randomized phase III-study with 71 patients with disseminated disease (stage IV) (author's transl)].

74 patients with disseminated non-seminomatous testicular cancer were randomly entered on a prospective sequential combination chemotherapy regimen with mandatory crossover, consisting of either vinblastine/bleomycin or adriamycin/cis-dichlorodiammineplatinum (II) (DDP) as initial therapy. Independent of the randomization the overall remission rate in 71 evaluable patients was 89% including 54% complete remissions. 35% of the patients remained disease-free at 2+ to 28+ months with a median of 12 months. By additional surgical removal of residual pulmonary metastases in two patients the complete remission rate was increased to 40/71 (56%), and the number of patients with no evidence of disease to 27/71 (38%). According to the life-table method the two-years survival rates were 63% for complete responders and 29% for all other patients, which was significantly lower. 53 patients (75%) were alive at 3 to 28 months with a median of 9 months. Additional advanced abdominal disease, initially elevated beta-HCG and LDH and extension of pulmonary disease were of significant negative influence on the prognosis. The evaluation of single chemotherapy courses revealed equal efficacy of both combinations. However, response to adriamycin/DDP occurred in 46% of the courses, when vinblastine/bleomycin had failed, while response to vinblastine/bleomycin occurred only in 21% of the courses when adriamycin/DDP had failed. Thus different patterns of cross-resistance between these alternative regimens may exist.

Bleomycin↗
PubMed1980

[Sequential combination chemotherapy with vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) in non-seminomatous testicular cancer. II. Long-term results of a study with 140 patients with retroperitoneal disease (stage II) (author's transl)].

Following orchiectomy and retroperitoneal lymph node dissection (RND) 140 patients with stage II non-seminomatous testicular cancer were treated by sequential combination chemotherapy consisting of vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum(II) (DDP), plus/minus radiotherapy. 68 stage IIA-patients (complete RND and normal tumor-markers thereafter) received 6 courses of chemotherapy, followed by radiotherapy in 35 patients. 40 stage IIB-patients (minor residual disease after RND or elevated tumor-markers after RND) and 32 stage IIC-patients (advanced residual disease after RND) were treated by at least 12 chemotherapy courses and optional intermittent radiotherapy and/or relaparotomy. In stage IIA and IIB disease the actuarial 4-year survival rates were between 80 and 100%. These favourable results were not significantly influenced by additional radiotherapy and corresponded to the survival rates for 34 stage I-patients. For stage IIC-patients the prognosis was significantly worse with a 12% 4-year survival rate.

Bleomycin↗
PubMed1980

[Improved antiemetic treatment with levomepromazine (author's transl)].

The antiemetic effect of levomepromazine (Neurocil) was tested in 76 patients treated for metastasizing malignancies with cis-dichlorodiammineplatinum (II) (Platinex). In all patients conventional antiemetics had been ineffective against gastrointestinal side effects of platinum. Using levomepromazine vomiting and nausea could be successfully prevented in 47 out of 63 patients on conventional cis-platinum doses (20 mg/m2 for 5 consecutive days) and in 5 out of 13 patients on high single day dosages (100 mg/m2). In most other patients clear-cut subjective improvement occurred. The antiemetic effect of levomepromazine against cis-platinum, which ranks among the most widely used cytostatics and causes gastrointestinal symptoms, is of importance in medico-oncological practice as it causes relief for the patients.

Cisplatin↗
PubMed1980

[Combined chemo- and radiotherapy in inoperable small-cell anaplastic bronchial carcinoma (author's transl)].

Combined treatment with adriamycin, cyclophosphamide and vincristine (ACO) was used in 50 out-patients with histologically verified small-cell bronchial carcinoma. In 26 patients with locally and regionally limited metastases ("limited disease") radiotherapy (3000 rad focal dose) to mediastinum, hili and tumour opacity as well as prophylactic cranial irradiation (3000 rad focal dose) were performed after 3 cycles of chemotherapy. Complete clinical remission (without endoscopic control) was achieved in 32 out of 50 patients. Remissions in patients with bilateral pulmonary or extrathoracic metastases ("extensive disease", n = 24, 12 complete remissions) only led to limited asymptomatic prolongations of life (median survival time 10 months, median remission period 5 months) despite maintenance therapy. On the other hand patients with "limited disease" had considerable life prolongation (median survival 21 months, historical control value 3--4 months). Seven out of 26 patients in this group survived for 30 months after the onset of the disease, 6 out of 26 are now in their third year after starting therapy without signs of tumour recurrence. The results show that early recognition of patients with local and regional metastases has considerable prognostic value.

Carcinoma, Small Cell↗
PubMed1980

Peripheral neuropathy and ophthalmologic toxicity after treatment with cis-dichlorodiaminoplatinum II.

A 57-year-old woman with inoperable bladder cancer received radiation treatment. Thirteen years later she relapsed at locoregional, retroperitoneal, and mediastinal sites. During treatment with cis-dichlorodiamineplatinum II (DDP) (30 mg/day for 5 days repeated every 4 weeks) she achieved a partial remission. After seven courses of DDP-chemotherapy she complained of numbness of her hands and legs and of diminished visual acuity of both eyes. After 4 weeks these symptoms grew less but intensified severely after another DDP-treatment. The temporal relationship of neurologic symptoms and their intensification by the last administration of DDP suggest this drug to be the causative agent for peripheral neuropathy and ophthalmologic toxicity.

Cisplatin↗
PubMed1980

Combination chemotherapy with ifosfamide and cis-dichlorodiammineplatinum (II) in advanced malignant melanoma.

Twenty-five patients with measurable lesions of advanced malignant melanoma received a combined chemotherapy containing cis-dichlordiammineplatinum (II) (cisplatin) 30 mg daily at days 1, 3, 5, 7, 9, and ifosfamide 45 mg/kg at days 2, 4, 6, 8, and 10. Most of the patients had been previously treated with DTIC or DTIC-containing combinations. An objective response was observed in 10 patients including three complete and seven partial remissions. Medium survival was 3 months for nonresponders and 6 months for responders. Nausea and vomiting during chemotherapy could be reduced effectively be the use of levomepromacine (Neurocil). Hematologic toxicity was considerable in extensively pretreated patients and made it necessary to postpone subsequent courses in two cases.

Adult↗
PubMed1980

[Adriamycin, cyclophosphamide and vincristine (ACO) in small cell bronchial cancer. Course of the disease and long-term follow-up].

This report summarizes our experience in 94 patients with inoperable small cell bronchogenic carcinoma treated with protocols "ACO I" and "ACO II" at the West German Tumor Center Essen. Long-term follow-up is documented for a group of 50 patients who were fully ambulatory. Complete responses were obtained in 20 of 26 patients with "limited disease" and in 12 of 24 patients with "extensive disease". The median survival of all 50 patients was 12 months (10 months in "extensive disease", 21 months in "limited disease"). An analysis of relapse patterns indicated that the local intrathoracal recurrence, especially in patients with "limited disease", remains one of the main problems. The report also includes a detailed analysis of long-term survivors. With the "ACO II" protocol which is designed to study the value of maintenance therapy after aggressive induction treatment in patients with complete response, 44 patients have thus far been evaluated for response (CR 50%). The number of patients randomized for maintenance chemotherapy is still too small to draw further conclusions at this point.

Aged↗
PubMed1980

[Results of cytostatic therapy with cyclophosphamide, vincristine, adriamycin and DTIC (CYVADIC) in localized and metastasized osteosarcoma. A retrospective analysis].

From December 1973 to november 1978, 31 patients with osteosarcoma were treated with combination chemotherapy consisting of cyclophosphamide, vincristine, adriamycin and DTIC. 11 out of 19 patients with localized osteosarcoma are alive with no evidence of disease, 14+ to 40+ months after initiation of adjuvant postoperative chemotherapy. The probability of relapse-free survival for this group was calculated as 62% at 2 years and 48% at 3 years. Considering the 15 patients with osteosarcoma of the limbs relapse-free survival will be 79% at 2 years and 62% at 3 years. In 10 of 11 patients with no relapse the primary tumor has been located in the metaphysis of the proximal tibia or the distal femur. All patients with osteosarcoma of the trunk have died from metastases. Most of the 12 patients with metastasizing osteosarcoma died within one year after onset of chemotherapy. In none of these patients a complete remission could be achieved. For patients receiving adjuvant chemotherapy results are comparable with those reported by other investigators. In patients with disseminated osteosarcoma alternative chemotherapy regimens including adriamycin, cis-dichloro-diammine-platinum and ifosfamide may prove superior. In a pilot-study using vincristine-adriamycin-DDP or ifosfamide-DDP response to chemotherapy was noted in 4 out of 7 patients with two continuing complete remissions for 13+ and 5 1/2+ months, respectively.

Adolescent↗
PubMed1980

[Microbiological surveillance in patients treated by bone marrow transplantation (author's transl)].

Patients suffering from acute leukemia were treated by bone marrow transplantation under strict gnotobiotic conditions. The microbiological surveillance was performed during three phases: the admission phase, the phase of decontamination and reverse isolation and the reconventionalisation phase. During the second phase no infections of exogenous origine occurred. All clinically manifest infections in this phase were induced by unsuppressed endogenous bacteria. In our study the bacteria of oropharynx was the main source of infections therefore this biotop deserves special attention during the microbiological surveillance of the immune compromised host. In leukemia patients selective decontamination will be the method of choice, but considering the possibility of GvHR in patients with bone marrow transplantation a complete decontamination should be achieved.

Anti-Bacterial Agents↗
PubMed1979

Sister chromatid exchange in Ph1-positive chronic myelocytic leukemia.

The sister chromatid exchange (SCE) frequency in bone-marrow cells of 12 untreated patients with chronic myelocytic leukemia (CML) was analysed and compared with the SCE frequency in bone-marrow cells of nine healthy persons. In normal persons the SCE ranged from 3.64 to 5.15 per cell. In CML patients the SCE was significantly lower, ranging from 2.32 to 3.44 per cell. The differences found were unrelated to patients' age and contraction state of the chromosomes. It is suggested that the leukemic process could account for the low SCE rate.

Adolescent↗