Search PubMed⌕ Search

Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 271 records · Page 15Linked to original sources

Treatment of advanced gastric carcinoma with 5-fluorouracil adriamycin, and mitomycin C (FAM).

Thirty-three evaluable patients with advanced gastric adenocarcinoma were treated with a combination of 5-fluorouracil, adriamycin, and mitomycin C (FAM). Two complete and five partial remissions (21% response rate) were observed. The overall median survival of all 33 patients was 5.9 months. Responding patients had significantly better survival than the non-responders (P less than 0.02). Analysis of the results according to sex, pretreatment performance status, and the histologic differentiation of the tumor failed to demonstrate that any of these factors influenced therapeutic results. The low response rate to FAM found in this study might be related to the fact that in the majority of the patients (85%) the primary gastric tumor had not been resected. The side-effects of this regimen were moderate. Taking into account the low response rate and the moderate myelotoxicity observed, a more intensive use of these three drugs in combination is suggested.

Adult↗

Combined adjuvant therapy of radically operated colorectal cancer patients. (chemotherapy, radiotherapy, and MER-BCG).

Seventy-three patients with Dukes' B2 and C colorectal cancer were randomized to adjuvant therapy after radical surgery. One group was treated with chemotherapy either alone or in combination with radiotherapy (RC). The second group was treated by chemotherapy (with or without radiotherapy) plus MER/BCG (RCM). In patients with Dukes' C disease, the survival at 54 months and the disease-free interval up to 24 months were significantly better in the RCM than in the RC subgroup. There were no significant differences in the survival and disease-free interval between RC- and RCM-treated patients with Dukes' B2 disease. Entry of additional patients and further follow-up are needed before we can decide whether the combination of RCM increases the cure rate in Dukes' C cancer or merely delays recurrence and prolongs survival.

Adult↗

Four-drug combination chemotherapy in advanced lung cancer: methotrexate, doxorubicin, cyclophosphamide and CCNU.

One-hundred-twenty patients with advanced lung cancer were treated by the MACC (methotrexate, doxorubicin (Adriamycin), cyclophosphamide and CCNU) regimen. Ninety-eight patients were evaluated. Objective complete response occurred in one case for 27+ months. Partial response was observed in 20 patients lasting for a median of 4.7 months. The overall objective response rate was 21% and the median duration of response was 5.5 months. Stable disease was noted in 44 patients with a median time to progression of 4.7 months from the start of treatment. Tumor progression occurred in 33 cases. There was a significant prolongation of median actuarial survival of responders (11.2 months) vs. stable disease (6.2 months) or vs. non-responders (3.8 months, P less than 0.05). The median actuarial survival for the whole group was 7.3 months. Bone marrow toxicity including thrombocytopenia (less than 100,000 cells/mm3) occurred in 16 patients and leukopenia (less than 3000 cells/mm3) in 24 patients. Forty-seven patients had no hematologic toxicity. Other adverse reactions were nausea and vomiting (50%), stomatitis (16%), alopecia (5%), cardiotoxicity (1%) and fever during leukopenia (1%).

Adenocarcinoma↗

[Combination chemotherapy in metastatic breast cancer].

Combination chemotherapy was administered to 62 patients with metastatic breast cancer in the years 1977-9. The combination consisted of cyclophosphamide, methotrexate and 5-fluorouracil. The average age was 52.5 years, and the range from 27-76. Complete or partial remission for a period of 11.5 months (median) was achieved in 56.5%. Among 23 cases of lung metastases 48% had partial or complete remissions, among 16 cases of lymph node metastases 81%, and among 32 cases of bone metastases, 37.5%. Of six cases of local recurrence, 33.3% had partial remissions. Among four cases of liver metastases, 50% had objective responses. Among five cases of miscellaneous metastases, all had complete or partial responses. The median survival of the complete responders was 17 months, while that of the nonresponders was only 11 months. Side effected were tolerable and no deaths were attributed to the treatment.

Adult↗

Lymphocyte transformation in competent and in immunodepressed individuals. 3 ways of results presentation.

Lymphocytes from 107 healthy individuals and 34 patients with lung cancer were cultured and stimulated with PHA. Wide variation in lymphocyte transformation reactivity was observed, ranging from significantly low responses to high blastogenesis. Low spontaneous blastogenic responses were not always associated with a simultaneous decrease in PHA-induced lymphocyte transformation in the same individuals. The results are presented by the (disintegrations per minute) values of the stimulated and nonstimulated cultures and by the stimulation index. A new index termed the Blastogenic Cumulative Index is proposed. It is defined as the sum of the logarithms of the values of the spontaneous and the PHA-induced lymphocyte transformation. A better relationship was observed in immunocompetent and in immunodepressed individuals between the dpm values and Cumulative Indices than between the dpm and the Stimulation Indices.

Cells, Cultured↗

Ultrastructural and clinical observations on skin metastases from breast cancer patients following intralesional treatment with MER/BCG vaccine.

Ultrastructural and clinical investigations were carried out on skin metastases in patients with advanced breast cancer, following intralesional therapy with MER/BCG vaccine. A total of 65 tumoral lesions in 5 patients were injected with MER. Clinical responses were correlated with light and electron microscopic observations. Regressing tumor lesions showed substantial macrophage and lymphocyte infiltration and severe damage to tumor cells. Activated macrophages with secondary lysosomes and contacts between macrophages and tumor cells were widely observed. In 1 patient with limited cellular immune response, clinical regression was not evident and many tumor cells were ultrastructurally intact.

BCG Vaccine↗

Long survival following combined treatment of inoperable cholangiocarcinoma: surgery, radiotherapy, and chemotherapy.

A jaundiced patient due to inoperable bile duct carcinoma was treated by a combination of surgery, radiotherapy, and chemotherapy. At the operation an intra-abdominal, extra-choledochal bypass of the tumor was performed with a T-tube obstruction 10 months after diagnosis, and no evidence of malignancy was seen. The T-tube was replaced by an Argyle tube. One year later jaundice reappeared, due to displacement of the tube, and islets of metastatic tumor ce and additional cytotoxic treatment was given. Three months later, after the patient's demise due to an unrelated cause, no evidence of the disease was found. This case demonstrates the importance of palliative by-passing of the tumor in order to relieve obstruction, thus enabling further oncological treatment, which may be, as in the present case, highly effective.

Adenoma, Bile Duct↗

Results of postoperative treatment of colorectal cancer by radiotherapy, chemotherapy and immunotherapy.

Adjuvant therapy was given to patients with colorectal cancer stage Duke's B2 and C. The 53 patients were randomized and stratified after surgery. One arm received radiotherapy and chemotherapy and the other radiotherapy, chemotherapy, and MER. The survival and disease-free interval up to 2 years were longer and better in the radiochemo-MER arm. It is too early to conclude whether this combination increases the cure rate or delays the appearance of metastases. The time interval between the cytotoxic therapy and the immunotherapy and the dose of the immunotherapeutic agent is very important for the success of the combination therapy. Further follow-up is necessary and more patients need to be entered into the trial.

BCG Vaccine↗

Early detection of doxorubicin cardiotoxicity by M-mode echocardiography.

The influence of increasing doses of doxorubicin on the heart was examined in 30 patients with solid tumors, M-mode echocardiography being used to evaluate left ventricular contractility. The function of the left ventricle remained normal in 26 subjects, whereas four patients had evidence of cardiotoxicity after cumulative doses of 220, 380, 420, and 450 mg/m2. Transient overt heart failure was noted in one subject only. Doxorubicin cardiotoxicity can be detected by M-mode echocardiography, a simple and non-invasive technique, prior to the appearance of overt congestive heart failure. Patients demonstrating left ventricular dysfunction are probably not candidates for receiving further therapy with anthracycline antibiotics. Limitation of M-mode echocardiography include a 28% incidence of inadequate studies in this group of patients, and a relative inaccuracy of the technique in evaluating patients with prior myocardial infarction.

Adolescent↗

Intensive plasma exchange in the management of severe Rh disease.

Fourteen high-risk cases of Rh alloimmunized women were treated by intensive plasma exchange on the cell separator throughout their pregnancies. The mean volume of plasma exchanged per week was 3.21 with a total volume of 10-123 1. The replacement fluid was mainly plasma protein fraction (PPF) supplemented with fresh frozen plasma (FFP). The mean duration of treatment was 131/2 weeks, ranging from 2 to 22 weeks, commencing at 12-30 weeks gestation. The complications encountered and the selection of the optimal time for delivery are discussed. The expected stillbirth rate in this series as determined by their past obstetric histories and anit-D levels was 62%. Intrauterine transfusion was given to only two of the infants and both were later stillborn. It was possible to reduce and maintain a lower level of anti-D in the serum of most of the patients and a successful outcome was achieved in nine of the 12 cases included for analysis (75%). Plasma exchange commenced early in pregnancy is recommended as a non-hazardous form of treatment in the management of severe Rh haemolytic disease. However, if the mean level of anit-D cannot be maintained at less than 35 iu/ml then the outcome is more likely to be fatal. Amniocentesis should be delayed where possible until 28 weeks gestation and intrauterine transfusion reserved for those cases where the anti-D level becomes uncontrollably high and the fetal death is imminent.

Amniocentesis↗