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Biomedical subjects

F A Calvo

Publications and source records attributed to F A Calvo.

At least 55 records · Page 3Linked to original sources

[Changes in radiation lesions using platinum derivatives. Biological bases and clinical experience].

The biological basis of radiation damage modulation with platinum derivatives are reviewed. Cisplatin and Carboplatin are cytostatic agents used increasingly in the treatment of different human tumours. In vitro and in vivo studies have established the interest of the simultaneous combination of platinum compounds and radiation in tumor cells and neoplastic tissue, describing potentiation, sensitization, and inhibition of sublethal damage repair effects from radiation. Clinical trials have been recently activated in order to explore a possible benefit from the biological modulation with platinum compounds of radiotherapy. In the frame of developmental therapeutic protocols in modern oncology, this approach might explore a positive effect on the therapeutic index of radiotherapy for malignant tumors. The initial clinical results reported indicate that the available platinum derivatives used in human oncology behave as radiopotentiating and radiosensitizing agents.

Animals↗

Undifferentiated epithelial-rich invasive malignant thymoma: complete response to cisplatin, vinblastine, and bleomycin therapy.

Two cases of complete remission plus one almost complete and another partial response of undifferentiated, invasive epithelial malignant thymoma using the combination of cisplatin, vinblastine, and bleomycin (PVB), are reported in four patients treated with this combination. Radiotherapy was instituted after completing the fourth course of chemotherapy in three patients. One patient died from intercurrent infection after the fourth cycle of combination chemotherapy. Three patients remain free of disease at the end of the treatment program. PVB appears to be highly active in this disease and deserves more extensive evaluation in multicenter clinical trials.

Adult↗

Simultaneous radiotherapy and cis-platinum for the treatment of brain metastases. A pilot study.

Thirteen patients with the established diagnosis of brain metastases were treated with weekly intravenous or intra-arterial cis-platinum (40-60 mg/m2) during whole-brain irradiation (5,000 cGy over 5 weeks). Objective tumor response was observed in 12 patients (seven complete responses [CRs] and five partial responses [PRs]), and one patient showed stable disease (NC) following treatment. Chemotherapy- and radiation therapy-related toxicity was mild. There was no enhanced radiation therapy side effects on the normal tissues. Intracarotid cis-platinum with radiotherapy resulted in five CRs, two PRs, and one NC. Intravenous cis-platinum with conventional radiation therapy resulted in two CRs and three PRs. Responses according to tumor type were as follows: lung cancer (three adenocarcinoma, one mixed type, and one small-cell anaplastic carcinoma), two CRs and three PRs; breast cancer, one CR; thyroid cancer, one CR; unknown primary cancer, one CR; and melanoma, one NC. These results represent a relatively high CR rate (53.8%) for an otherwise barely manageable complication of malignant disease. Further controlled studies are recommended.

Adult↗

Whole abdominal irradiation in non-Hodgkin's lymphomas. I. Tolerance and outcome.

Thirty patients, over a 16-year period, treated with whole abdominal irradiation for non-Hodgkin's lymphoma were reviewed. Therapy tolerance, acute toxicity, and long-term outcome were determined. When adequate protection of vital intraabdominal organs was instituted properly, patient tolerance required only conservative medical management. Peripheral hematologic values exhibited mild depressions to nadir values near completion (3,500-4,000 rad) of treatment. Blood count recovery and general functional normalization occurred within the first post-treatment month. Average total weight loss was only 3.5 pounds with a similar pattern of recovery following therapy completion. Sixteen patients with average follow-up of 6 years still survive. Comparative studies involving total abdominal irradiation for human malignancies are also discussed.

Abdomen↗

Whole abdominal irradiation in non-Hodgkin's lymphomas. II. Therapeutic criteria.

Three hundred ninety-one patients treated for non-Hodgkin's lymphoma from 1966 until 1983 were reviewed to discover a subset of 29 patients for whom whole abdominal radiation was the common modality of treatment. Seventeen patients were studied with staging laparotomy. the remainder by biopsy. Histologic characteristics revealed a diffuse-type pathology in 15 patients and a nodular-type in 14. Patients were further subselected into "favorable" (DWDLL, NPDLL, NML) and "unfavorable" (DULL, DML, DHL, DPDLL) histologies. Radical treatment for this series included 19 patients given a combined radio-chemotherapy program and 10 patients more conservatively treated with radiation alone. Follow-up for 16 living patients ranges from 2 to 16 years. Three patients developed secondary solid tumors and four patients died of intercurrent disease free from lymphoma. The possible role of whole abdominal radiation as definitive or adjunctive therapy is discussed.

Abdomen↗

Intra-arterial and intravenous chemotherapy for the treatment of malignant glioma. Preliminary results.

Twenty-one patients with malignant glioma were treated with cis-diamminedichloroplatinum II (CDDP II) 60-90 mg/m2 intra-arterial (I.A.) bolus on day 1 and Carmustine (BCNU) 100 mg/m2 intravenously (I.V.) on days 1 and 2. Three patients received additional Aziridinylbenzoquinone (AZQ) 7 mg/m2 (I.V.) on days 1 and 2. At the time of this treatment, seven patients had local recurrence after previous surgery and radiotherapy. Nine patients had subtotal tumor resection or biopsy, one patient had macroscopic tumor resection, and four patients had no previous surgery because of medical contraindication. Six patients received five or more courses of I.A. and I.V. chemotherapy. Five of these patients showed complete remission (CR) and one had a partial remission (PR) by brain computerized tomography (CT scan). Another 15 patients treated with two to four courses of I.A., and I.V. chemotherapy showed eight partial responses (PR), and seven showed no changes (NC) by brain CT scan. Five patients died with disease. Patients who achieved CR also received radical radiotherapy for remission consolidation. Sixteen patients are still alive; five patients are off treatment, four of these with no evidence of disease (NED), one alive with disease (AWD); and the remaining 11 patients are still on treatment. Toxicity, symptomatic neurological recovery, disease stabilization, and causes of death will be discussed.

Adult↗

Radiation therapy in craniopharyngiomas.

Eighteen patients with cranipharyngiomas, who were studied and treated between 1970-1980, are presented. Each patient was treated with surgery and radiotherapy (50-60 Gy). Six patients were treated with radiotherapy because the tumor recurred after surgery. An extensive representation of the clinical symptomatology typical of this tumor was seen. In 3 patients an improvement in visual symptoms was demonstrated; in 11 the headaches and vomiting were controlled after treatment. The 18 treated patients are still alive without evidence of progression of the tumor, after a period of 2 to 12 years. Our experience supports the contention that conservative surgery coupled with radical radiotherapy remains the treatment of choice for the craniopharyngioma.

Adolescent↗

Intracranial tumors with risk of dissemination in neuroaxis.

The experience of the Radiotherapy Service, Clínica Puerta de Hierro, Madrid (Spain), in the treatment of intracranial tumors with risk of neural axis dissemination is analyzed. In 15 years (1964-1979) 415 primary central nervous system tumors were studied and treated; 67 corresponded to tumors with risk of meningeal dissemination. Clinical dissemination in cerebrospinal fluid was proven in 14 patients. The actuarial survival of 10 years for patients with neural axis dissemination, without prophylactic treatment to the neuroaxis, is 14% with an average survival of 10.5 months. In approximately 20% of meduloblastomas, ependymal and pineal region tumors, meningeal metastases at some distance from the primary tumor can take place. Patients at risk wtih these types of neoplasia must be identified, and an adequate radical therapeutic focus devised, not only for the primary tumor, but also for the risk of dissemination.

Adolescent↗

[Intraoperative radiotherapy with accelerated electrons for urinary bladder carcinoma: principles and results].

OBJECTIVE: To describe intraoperative radiotherapy with accelerated electrons, a highly selective method of administering irradiation for radical treatment of bladder cancer. METHODS: We reviewed the experience reported in the literature since this treatment modality was utilized in Japan and its application extended to the western countries. RESULTS: Animal experiments have shown an acceptable clinicopathological tolerance to 20 Gy intraoperative irradiation of partial bladder volume. The local recurrence rate was 9% for early solitary tumor (> T2) and 27% for early multicentric tumor, according to the Japanese clinical experience. In the western countries, intraoperative radiotherapy plus external irradiation with or without systemic chemotherapy achieves a pT0 of about 65% (in total cystectomy specimens) and an intravesical tumor control rate of 88% in organ-sparing protocols. CONCLUSIONS: The results achieved by the groups with wider experience demonstrate that highly selective intraoperative radiotherapy is feasible, well-tolerated and effective in terms of inducing complete pathological remissions and definitive control of intravesical tumor. These selected clinical experiences must be corroborated by multicenter studies.

Electrons↗

Innovative techniques in modern radiation oncology: the economic and organizational impact.

An overview of the impact of innovative techniques in modern radiotherapy on economic and organizational issues is proposed. The analyzed innovative procedures are: intraoperative radiotherapy, stereotactic radiosurgery, conformal radiotherapy and high dose rate brachytherapy. They are approached separately in terms of cost-benefit analysis, optimized management and estimated productivity. The introduction of these innovative techniques in the daily practice of radiation oncology departments is vital in the quest for excellence. The strictly monetary implications of programs for the implementation of innovative radiotherapy techniques are hindered by the present planned containment of public health care expenditure in western European countries.

Cost-Benefit Analysis↗

Research methodology and new radiotherapy technology.

In the last 25 years there were major dramatic advances in radiotherapy technology with the improvement in treatment quality and a stimulus to clinical research in an era of rigorous control of information in oncology. In radiation oncology, research methodology has aimed at the application in clinical practice of the information provided by basic research, always considering the related ethical principles. A number of trials based on boosting techniques with dose-escalation are in progress and an improved long-term survival is expected; however a prospective analysis of unexpected late side-effects is required. Some personal recommendations for clinical researchers involved in new radiotherapy technology are suggested.

Humans↗

[Treatment of supratentorial glioma with intracarotid cisplatin and intravenous carmustine].

We report the results of intracarotid (IC) cisplatinum and intravenous carmustine (BCNU) in 26 patients with supratentorial malignant glioma and recurrent low grade glioma. A response rate of 53.84% (95% confidence interval 33.3%-73.4%) was found. The median survival for the whole group was 11 months (range 3-70), with 35% of patients surviving for 2 years. At the present time, 5 patients are still alive, with a median follow up of 68 months (range 56-70). Neurological toxicity has been low and transient, being attributable to the technical degree of care in catheter positioning, cisplatin dosage and the technique of drug administration into the carotid artery.

Antineoplastic Combined Chemotherapy Protocols↗