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Biomedical subjects

F A Greco

Publications and source records attributed to F A Greco.

At least 253 records · Page 14Linked to original sources
PubMed1982

Effects of high-dose cytarabine.

Plasma, urine, cerebrospinal fluid, and tear concentrations of cytarabine (ara-C) were measured in 15 patients receiving 3 gm/m2 IV ara-C given as a 1 hr infusion every 12 hr for 6 days. The two assay methods used for measuring ara-C concentrations (high-pressure liquid chromatography and radioimmunoassay) gave much the same results. Peak plasma ara-C concentrations (2.0 microM) after high-dose therapy were 50 times those achieved with more conventional (100 to 300 mg/m2) doses. High doses of ara-C were not sufficient to saturate cytidine deaminase; plasma ara-C half-lifes (t1/2) after high-dose therapy (distribution t1/2 = 6.2 min; elimination t1/2 = 154 min) were much the same as those after conventional ara-C doses. Kinetics of ara-C were not altered by repeated dosing over a 6-day period. Cerebrospinal fluid ara-C concentrations after high-doses (mean = 7.8 microM) were 10 times those after conventional intravenous dosing, bot were 0.5% to 1.0% those achieved by intrathecal ara-C doses. Tear concentrations of 22 and 38 micro M were measured in two patients who developed conjunctivitis after high-dose therapy so that the presence of ara-C in tears may be a cause of the conjunctivitis seen in some patients.

Adult↗
PubMed1982

Pancoast's syndrome and small cell lung cancer.

Four patients with small cell lung cancer (SCC) presenting with Pancoast's syndrome are described. Superior sulcus tumors are usually caused by epidermoid carcinoma or adenocarcinoma of the lung, and are routinely treated with radiotherapy followed by radical surgery. SCC, on the other hand, is widely disseminated at diagnosis and is best treated with chemotherapy. Although not previously reported as a cause of Pancoast's tumor, these four cases of SCC presenting as such clearly indicate the need for pretreatment histologic diagnosis to avoid unnecessary surgical intervention. Transcutaneous needle aspiration biopsy is a means by which the diagnosis can be safely made in patients presenting with apical lung tumors.

Biopsy↗
PubMed1982

Advanced extragonadal germ-cell tumors. Successful treatment with combination chemotherapy.

Thirty-two patients with primary extragonadal germ-cell tumors were treated at Vanderbilt and Indiana University Hospitals during the period from 1967 to 1981. Thirty-one patients had far-advanced disease when treatment was begun. All patients received intensive cisplatin-containing combination chemotherapy regimens. Tumors remaining after chemotherapy were surgically removed when feasible. Of the 31 evaluable patients, 18 have been continuously disease-free after therapy, 21 patients had a complete remission; the remaining 10 had partial response. Eighty-nine percent of patients with complete remission remain free of disease after median follow-up of 30 months. No relapses occurred after 12 months of complete remission. Patients with partial response had a median survival of 9 months with no long-term survivors. Response rates and survival are similar to patients with advanced-stage testicular germ-cell tumors. Extragonadal germ-cell tumors are as curable as testicular germ-cell tumors when treated with intensive cisplatin-containing combination chemotherapy regimens, and surgical resection when necessary.

Adolescent↗
PubMed1981

The role of maintenance therapy in disseminated testicular cancer.

We concluded a prospective study of the value of maintenance therapy in disseminated testicular cancer after chemotherapy-induced complete remission or chemotherapy cytoreduction followed by surgical resection of residual teratoma. A group of 171 patients were randomized to treatment consisting of cisplatin, vinblastine, and bleomycin, or these drugs plus doxorubicin. There was no apparent difference between these two induction regimens. Complete remission was achieved in 113 patients (66 per cent), and 19 (11 per cent) were free of disease by surgical resection of residual tumor. Of the 171 who started, 113 were eligible to receive either maintenance doses of vinblastine (58 patients) or no further therapy (55 patients) after remission-induction therapy. There was a 9 per cent relapse rate during maintenance with vinblastine and a 7 per cent relapse rate with no maintenance therapy; the overall relapse rate was 8 per cent (nine of 113). Our data indicate that maintenance therapy is unnecessary in disseminated testicular cancer.

Adolescent↗
PubMed1981

Cancer and the kidney: complications of neoplasms.

Various renal complications occur during the course of neoplastic disease. The therapeutic and prognostic implications differ according to the reversibility of both the underlying malignancy and the superimposed complications in the kidney. Since the mechanisms of renal failure vary significantly in patients with different types of malignancy, it is essential to avoid generalizations about etiologic factors or likely outcomes of the disease processes. The pathophysiologic abnormalities should be determined in each patient, and the reversibility of both the neoplastic and problems assessed before therapeutic decisions are made. This often requires a team effort by the internist, oncologist, nephrologist, urologist and, most importantly, the patient.

Amyloidosis↗
PubMed1981

Klinefelter's syndrome and mediastinal germ cell neoplasms.

We describe 2 patients with Klinefelter's syndrome in whom mediastinal germ cell neoplasms developed. This association also has been noted in the literature in 6 other cases. The pathogenesis of these otherwise rare neoplasms probably is related to the genetic abnormality and the abnormal hormonal status in Klinefelter's syndrome. Patients with Klinefelter's syndrome appear to have an increased risk of development of extragonadal mediastinal germ cell neoplasms and should be followed closely, while patients with mediastinal germ cell neoplasms should have karyotypes performed.

Adolescent↗
PubMed1981

Unusual survival after pulmonary artery sarcoma.

A 46-year-old man with a primary sarcoma of the pulmonary artery is presented. The tumor was responsive to radiotherapy, and the patient is the longest reported survivor of this rare disease. The tumor spread distally in the pulmonary vasculature, with probable embolization to the central nervous system, and he died 27 months after the initial diagnosis, with sudden massive hemoptysis. Pulmonary artery sarcomas are a rare cause of obstruction of the right ventricular outflow. The course of our patient suggests that early recognition and therapy may provide some of these patients with effective palliation and prolonged survival.

Humans↗
PubMed1981

The unrecognized extragonadal germ cell cancer syndrome.

Within 3 years we saw 12 patients diagnosed initially as having poorly differentiated or undifferentiated carcinomas who, we believe, actually had extragonadal germinal cancers. Serum levels of the beta subunit of human chorionic gonadotropin (beta-HCG) or alpha-fetoprotein were useful in suggesting and supporting the diagnosis: Levels of one or the other were elevated in six of 10 patients in whom they were measured but levels of both, in only one patient. Staining of histologic specimens for beta-HCG or alpha-fetoprotein showed intracellular localization of one of these markers in the cancer cells of all four patients studied. All patients responded to therapy (11 treated with chemotherapy with or without radiotherapy, one with excision and radiotherapy only), with complete remissions in seven of 12. Two of the patients who had a complete remission have experienced relapse, and five have continued in disease-free remission from more than 8 to more than 56 months. Histologically atypical extragonadal germ cell neoplasms may be commoner than previously supposed. Physicians should consider this treatable and potentially curable cancer in selected patients having poorly differentiated or undifferentiated carcinomas.

Adult↗
PubMed1981

Advanced ovarian cancer: brief intensive combination chemotherapy and second-look operation.

The effects of brief intensive combination chemotherapy have been evaluated in 59 patients with advanced epithelial ovarian cancer. Following surgery and before chemotherapy, 16 patients had limited residual cancer (tumor nodules 3 cm or less in diameter) and 43 had bulky disease (tumor nodules greater than 3 cm). Chemotherapy with hexamethylmelamine, cyclophosphamide or 5-fluorouracil, doxorubicin, and cisplatin was given intensively. Myelo-suppression was the most serious side effect, although gastrointestinal, neurologic, and renal toxicity was also observed. Fifty-five of the 58 (95%) evaluable patients had either a partial clinical response or no clinically detectable tumor following therapy. Forty-five of these 55 patients underwent a second-look surgical evaluation at 6 months; 17 of 45 patients (14 of 16 patients with limited residual disease and 3 of 29 with bulky disease) had no evidence of residual cancer, and 9 patients had all known cancer resected. Sixteen of 17 patients who attained a complete response as judged by laparotomy remain in remission; median follow-up has been 19 months (range, 9 to 30 months) following chemotherapy. This combination chemotherapy produces marked tumor regression as judged by second-look evaluation, and most patients who had limited residual disease have all evidence of cancer eradicated. Longer observations is required to determine how many of these patients will remain continuously free of ovarian cancer.

Adult↗