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Biomedical subjects

D T Carr

Publications and source records attributed to D T Carr.

At least 37 records · Page 2Linked to original sources
PubMed1983

Is staging of cancer of value?

Complete and accurate classification of all cases of cancer is essential for planning optimal management, estimating prognosis, communicating about individual patients or groups of patients, comparing results of various treatments and evaluating cancer control programs. For most types of cancer, the stage, or the anatomic extent of the cancer, is as important as other characteristics such as the primary site of the tumor, the histologic cell type, and the grade of the malignancy. The TNM system of staging recommended by the American Joint Committee on Cancer and the International Union against Cancer is used throughout the world, and there is convincing evidence of its value in selecting treatment and estimating prognosis. For example, Stage I squamous cell or adenocarcinoma of the lung is almost always amenable to surgical resection and five-year survival rates of about 70% are being reported by many cancer centers. In contrast, stage III lung cancer is usually not resectable and the five-year survival rate of this group is less than 10%.

Autopsy↗
PubMed1978

Incidence, trend, and outcome of bronchogenic carcinoma in Olmsted County, Minnesota, 1935--1974.

The 40-year incidence trends of bronchogenic carcinoma in Olmsted County, Minnesota, are presented and analyzed. The incidence in men has risen rapidly with each decade. During the last decade this increase was due to an increase of the rate among men over 65, rates in men under 65 appearing to have plateaued. The incidence in women increased for the first time in the decade 1965 to 1974. During the period 1935 through 1974, rates for all cell types increased in men, with that for squamous cell carcinoma increasing most. In women the recent overall increase was due mainly to an increase of adenocarcinoma, which has been the predominant cell type in women throughout. Among all cases together the 5-year survivorship was 11%, which comprised 24% for squamous cell carcinoma, 11% for large cell carcinoma, 12% for adenocarcinoma, and 0 for small cell carcinoma.

Adenocarcinoma↗
PubMed1976

Combination chemotherapy of advanced lung cancer: a randomized trial.

A controlled clinical trial comparing two-drug and three-drug combination chemotherapy was performed in 206 patients with advanced bronchogenic carcinoma, comprised of 26.2% with epidermoid carcinoma, 30.1% with small cell anaplastic carcinoma, 27.2% with adenocarcinoma, and 15.6% with large cell carcinoma. Each drug combination consisted of agents with different modes of action and included a cell-cycle-stage nonsensitive and a cell-cycle-state-sensitive agent. The overall response rate was highest for small cell carcinoma (48.2%) and adenocarcinoma (23.6%); it was less than 10% in epidermoid and large cell carcinoma. Similarly, the overall median survival was twice as long for the first two cell types (7 months) as compared with that recorded for the other two cell types (3 1/2 months). The combination of 1 (2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), cyclophosphamide, and methotrexate was shown to be statistically superior to cyclophosphamide and methotrexate with regard to objective respones rate, duration of response, and median survival for adenocarcinoma. Responders lived significantly longer than nonresponders (254 versus 90 days for small cell anaplastic carcinoma patients and 244 versus 184 days for adenocarcinoma patients). No difference in survival or objective response rate was observed between the different treatments for the other two cell types of lung cancer.

Adenocarcinoma↗
PubMed1976

Comparison of split-course radiation therapy and continuous radiation therapy for unresectable bronchogenic carcinoma: 5 year results.

One hundred and eighty-eight patients with inoperable or unresectable bronchogenic carcinoma were stratified by cell type, TNM staging, and prior surgery and then randomized into two treatment groups: continuous radiation therapy and split-course radiation therapy. There was no difference in clinical or objective improvement in the two groups. Survival rates for cases of squamous cell carcinoma, small cell carcinoma, and adrenocarcinoma were the same after both regimens of therapy. Split-course therapy resulted in a significantly better survival rate in cases of large cell carcinoma but the number of cases was small. We doubt that the difference is clinically significant. Objective roentgenographic response was accompanied by improved survival in squamous cell carcinoma, but not in the other three cell types. Split-course radiation therapy is superior to continuous radiation therapy because it is better tolerated by the patient and because re-examination of the patient prior to the second half of split-course therapy permits the detection of new metastatic disease that has become manifest during the rest period and spares the patient the futile second half of radiation therapy.

Adenocarcinoma↗