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Biomedical subjects

D G Haller

Publications and source records attributed to D G Haller.

85 records · Page 5Linked to original sources
PubMed1988

Integration of full-dose adjuvant chemotherapy with definitive radiotherapy for primary breast cancer: four-year update.

Controversy exists over the effect of definitive radiotherapy on the ability to administer full doses of adjuvant chemotherapy in primary breast cancer. Ninety-six consecutive women with clinical stage I and II breast cancer were treated with radiotherapy plus chemotherapy. Three combinations of drugs were used: cyclophosphamide and 5-fluorouracil (CF); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP). Chemotherapy consisted of two cycles of CF (cyclophosphamide at a dosage of 100 mg/m2 orally on days 1-14+5-fluorouracil at 600 mg/m2 iv on days 1 and 8) during concurrent radiotherapy, followed by six cycles of CMFP (same CF dosages+methotrexate at 40 mg/m2 iv on days 1 and 8+prednisone at 40 mg/m2 orally on days 1-14). The study included 63 premenopausal and 33 postmenopausal patients; 72 had 1-3 positive nodes, had greater than or equal to 4 positive nodes, and 9 had negative nodes and negative estrogen receptors. The mean CF doses delivered during concurrent radiotherapy were 95% of the optimal doses, and the mean CMF doses administered during the six cycles after radiotherapy were 89%. The CMF was delivered at level I (greater than or equal to 85% of optimal doses) to 73% of the patients. With a median follow-up of 36 months, 16 relapses have been observed. Two of these patients had treatment failure only in the breast or axilla and are disease free after mastectomy. Of the 72 patients with 1-3 positive nodes, 10 relapsed in distant sites, while 4 of 15 patients with greater than or equal to 4 positive nodes have had distant failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Aminothiadiazole (NSC #4728) in patients with advanced colon cancer. A phase II study of the Eastern Cooperative Oncology Group.

The Eastern Cooperative Oncology Group (ECOG) studied 29 patients with advanced measurable colon cancer who were treated with Aminothiadiazole (NSC #4728) 125 mg/m2 intravenously. Allopurinol 300 mg daily was taken by all patients during treatment. Three patients (12%) demonstrated partial responses on this regimen. Hematologic toxicity did not occur. Gastrointestinal toxicity was severe in 16% of patients and consisted primarily of vomiting and diarrhea. No life-threatening toxicity was encountered. A lack of appreciable toxicity together with the few responses seen suggest that further studies at higher dose may be indicated.

Allopurinol↗
PubMed1987

Actual versus ideal weight in the calculation of surface area: effects on dose of 11 chemotherapy agents.

This study of 2382 breast, 182 rectal, 817 colon, and 351 lung cancer patients treated with combination chemotherapy on eight phase III Eastern Cooperative Oncology Group protocols indicates that 69% would receive a higher dose of at least one drug if surface area were calculated from actual weight rather than from the minimum of actual and ideal weight. Forty-eight percent of the patients would have at least a 10% increase in drug dose based on actual weight. Only on the premenopausal adjuvant breast cancer protocol and among women on the rectal adjuvant study do the differences in dose based on actual rather than ideal weight increase significantly with age. On the postmenopausal adjuvant breast study and on the lung cancer study, the differences in dose decrease significantly with age. For all age decades and both sexes within each protocol, the mean differences between dose based on actual and dose based on ideal weights were on the same order as the rounding factors for the 11 drugs studied. From the literature on the effect of doses of common chemotherapies on leukopenia, it appears that the percent of hematologic toxicity would not be raised to unacceptable levels by using actual weight to set doses.

Adult↗
PubMed1986

Progestational agents in advanced breast cancer: an overview.

Progestational agents, such as megestrol acetate and medroxyprogesterone acetate, are effective hormonal treatments for metastatic breast cancer in postmenopausal women. Clinical trials of these agents have demonstrated that 30% to 60% of patients will experience objective tumor response, depending on pretreatment prognostic variables. Although optimal doses and schedules have not been fully defined, current studies are investigating the therapeutic effectiveness of high-dose progestins. Toxicity of these drugs is mild and generally limited to weight gain related to their anabolic activity. Progestins are active second-line agents for metastatic breast cancer in postmenopausal women. In selected patients, they appear to be equivalent to tamoxifen as first-line therapy for metastatic disease. As more patients are exposed to prolonged adjuvant tamoxifen therapy, the role of progestins as first-line hormonal therapy at the time of relapse is likely to expand.

Antineoplastic Agents↗
PubMed1985

Conservative surgery and irradiation in the treatment of early breast cancer.

The treatment of early (stage I and II) breast cancer over the past 10 years has shown a trend towards conservative use of surgery. The role of mastectomy in achieving local-regional control has been challenged by procedures that preserve the breast, in which tumor excision and axillary node dissection are followed by breast irradiation. Data from retrospective studies as well as prospective randomized trials have shown that in selected patients conservative surgery and radiation achieve results comparable to those of mastectomy in terms of 10-year survival and local-regional recurrence. Studies have shown that conservative surgery, radiation, and adjuvant chemotherapy can be combined effectively in patients at high risk for systemic disease. Although the optimal treatment of early breast cancer remains controversial, the non-mastectomy approach represents major progress.

Actuarial Analysis↗
PubMed1984

Non-Hodgkin's lymphomas.

The non-Hodgkin's lymphomas, although sharing a common origin, often present physicians with wide variations in natural history and prognosis. The proper therapy of these diseases is based on an understanding of these differences and upon the information gained by pathologic review and staging, as well as the available chemotherapeutic and radiotherapeutic options.

Acquired Immunodeficiency Syndrome↗
PubMed1983

The effect of adjuvant chemotherapy on cosmesis and complications in patients with breast cancer treated by definitive irradiation.

From 1978 to 1981, 46 patients received primary radiotherapy following excisional biopsy and axillary staging procedure for Stages I and II carcinoma of the breast. The patients were divided into 2 groups: 27 patients who received radiation and completed 12 cycles of adjuvant chemotherapy (CMF or CMFP) and 19 patients who received radiation alone. All patients received radiation to the breast and regional nodes (4600-5000 rad) and a boost to the site of the primary tumor (1500-2000 rad). Median follow-up from completion of radiation was 26 months in the non-adjuvant and 24 months in the adjuvant group with a range of 12 to 49 months. Cosmesis was judged to be good to excellent in 89% (17/19) of the patients receiving radiation alone and 81% (22/27) of the patients receiving adjuvant chemotherapy. Fair to poor cosmesis in the adjuvant group was attributed primarily to increased fibrosis and reduction of breast size. The single complication for which there was an increased incidence in the adjuvant group was arm edema (22 vs. 0%). The incidence of arm edema was unrelated to T stage, type of axillary surgical procedure, number of positive nodes, addition of prednisone or sequencing of chemotherapy. Further efforts should be directed towards minimizing complications and maximizing cosmesis without sacrificing relapse-free survival in patients receiving primary radiotherapy and adjuvant chemotherapy for early breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Adjuvant chemotherapy in colon and gastric cancer.

The adjuvant chemotherapy of colorectal and gastric cancer is being actively investigated. Studies of both single antineoplastic agents and combinations of several drugs have been used. In colorectal cancer, single-agent therapy has not resulted in improved survival. Combination chemotherapy studies are at too early a stage to be evaluated. In gastric cancer, single-agent chemotherapy has not been effective as adjunctive treatment to surgery. Combinations of active agents in gastric cancer hold promise as effective surgical adjuvant therapy.

BCG Vaccine↗
PubMed1979

A phase II trial of ftorafur: adriamycin and mitomycin-C (FAM II) in advanced gastric adenocarcinoma.

Fifteen patients with advanced gastric cancer were treated with the combination of Ftorafur, Adriamycin and mitomycin-C (FAM II). Three patients showed partial responses, in five the disease remained stable for at least 3 months and seven showed progression while on treatment. All responding patients showed survival in excess of 12 months. Hematologic toxicity was of only moderate severity. Median white count nadir was 3500 cells/mm3 and median platelet nadir was 187,000 cells/mm3. Four patients had white count nadirs from 2000--2500 cells/mm3 and three had nadirs from 500--1500 cells/mm3; also there were four with platelet nadirs less than 100,000/mm3. However, no drug-related infections occurred and no platelet transfusions were required. The major non-hematologic toxicities of the regimen were nausea, vomiting, dizziness, vertigo, and rhinorrhea. These toxicities were limiting and resulted in termination of the trial because of poor patient acceptance and the failure of the combination to exhibit a therapeutic advantage over the similar combination (FAM) that employed weekly 5-fluorouracil in place of Ftorafur.

Adenocarcinoma↗
PubMed1978

Phase II trial of 5-fluorouracil, adriamycin, and mitomycin C in advanced colorectal cancer.

Thirty-five patients with advanced measurable colorectal cancer were treated with a combination of 5-fluorouracil (5-FU), adriamycin, and mitomycin C (FAM). Objective regression of tumor was observed in six patients (17%); seven patients (20%) demonstrated stabilization of disease. The FAM regimen was generally well tolerated with toxic effects limited to bone marrow depression and mild-to-moderate nausea and vomiting. FAM combination chemotherapy did not significantly improve survival in responding patients, nor was it more effective than 5-FU alone in achieving objective regression of disease.

Adenocarcinoma↗
PubMedDate not supplied

An overview of adjuvant therapy for colorectal cancer.

Adjuvant therapy of colorectal cancer is one of the most active areas of clinical oncology research. Although the data for the benefits from early trials of adjuvant therapy were inconclusive, these trials suffered from inadequate sample sizes, poor staging, potentially suboptimal treatment regimens and ill-defined prognostic subgroups. More recently, larger trials of higher scientific quality have demonstrated that regimens of fluorouracil plus levamisole in stage III colon cancer and fluorouracil with postoperative radiation in stages II and III rectal cancer can reduce mortality. Such regimens have now become standard practice in settings in which treatment is believed to be both efficacious and tolerable, and when the overall impact of therapy is considered to be clinically relevant. More recent advances in adjuvant treatment of colorectal cancer further support the role of fluorouracil-based regimens. Peri-operative portal vein infusions of fluorouracil demonstrate improved relapse-free and overall survival, and infusional fluorouracil administered with radiation for rectal primaries appears superior to less intensive bolus fluorouracil regimens. Completed trials of fluorouracil plus leucovorin combinations are awaiting maturation, with expectations for superior adjuvant activity based on demonstrated improved response rates for biochemically modulated fluorouracil in advanced metastatic colorectal cancer. New systemic agents are also entering large-scale adjuvant trials, including monoclonal antibody 17-1a, given alone and in conjunction with standard fluorouracil regimens. Additional cytotoxic drugs, including CPT-11 and Tomudex, offer new opportunities for alternative adjuvant regimens for the large, heterogeneous population of patients with resected colorectal cancer.

Antimetabolites, Antineoplastic↗