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F R Eilber

Publications and source records attributed to F R Eilber.

119 records · Page 7Linked to original sources
PubMed1970

Immunological factors which influence response to immunotherapy in malignant melanoma.

Antimelanoma antibodies previously demonstrated in the serum of melanoma patients by immunofluorescence have now been detected by a sensitive and quantitative complement fixation technique. The melanoma-specific antibodies detected by both of these techniques show a remarkable correlation with the stage of disease. Study of serums from 63 melanoma patients showed that both the incidence and titer of antibodies to the tumor antigens of malignant melanoma were found to be higher in patients with localized melanoma than in those with widespread metastatic disease. Furthermore, study of serial serum specimens on melanoma patients revealed a drop in antibody titer to undetectable levels with advancing metastatic disease. Additional evidence for the importance of immunological factors in this disease came from studies of delayed cutaneous hypersensitivity in melanoma patients. All patients with localized melanoma were capable of being sensitized to DNCB, whereas all patients who could not manifest delayed cutaneous hypersensitivity to this chemical had widespread metastatic disease. Eight melanoma patients were treated with immunotherapy using BCG as an immunological adjuvant. This therapy produced a rising titer of antimelanoma antibody and temporary tumor regression in five patients. However, only one of these patients has had a complete regression and remains free of disease at two years following treatment. There was a good correlation between the patient's immunological competence and his response to immunotherapy. All patients who could be sensitized to DNCB or tuberculin and developed a fourfold rise in antibody titer had some response to immunotherapy, whereas anergic patients failed to respond to this therapy. These studies indicate that the host immune response to malignant melanoma is an important factor in controlling the progression of this disease. Therefore, immunotherapy may become a useful adjunct to the primary surgical therapy of malignant melanoma.

Antibodies, Neoplasm↗
PubMedDate not supplied

Head and neck sarcoma: report of the Head and Neck Sarcoma Registry. Society of Head and Neck Surgeons Committee on Research.

A Head and Neck Sarcoma Registry was established by the Society of Head and Neck Surgeons to review treatment results of a rare tumor by surgeons with special interest in this anatomic site. Two hundred fourteen patients were analyzed. There were 194 adult tumors and 20 pediatric tumors. The major sites included parotid and neck, 20%; face and forehead, 18%; maxilla and palate, 13%; scalp, 12%; mandible, 11%; paranasal sinuses, 7%; larynx, 2%; and oral cavity, 5%. Eighty-four percent were resectable. The disease-free survival was 56%; overall survival was 70% at 5 years. Major determinants of survival were adequacy of resection (margins free of tumor) and tumor type. Survival differed according to tumor cell type (tumor grade was not available). Patients with chondrosarcoma and dermatofibrosarcoma had survival approaching 100%. Patients with malignant fibrous histiocytoma (MFH) and fibrosarcoma (FSA) had intermediate survival of 60% to 70%. The worst survival, less than 50% at 5 years, occurred in patients with osteosarcoma, angiosarcoma, and rhabdomyosarcoma in decreasing order. This suggests a rationale for identifying high-risk patients for prospective adjuvant protocols. This study emphasizes the value of recording uncommon tumors to provide relevant information for future study and possibly therapy.

Adolescent↗
PubMedDate not supplied

Malignant melanoma of the head and neck.

Sixty-nine patients with head and neck melanoma were prospectively evaluated from 1971 to 1977. Patients presenting for initial therapy underwent wide excision of their primary tumor, and those with deeply invasive melanoma also underwent regional lymphadenectomy, whether their nodes were clinically positive or negative. The results suggest that the prognosis of this tumor is similar to that of melanoma arising at other sites. Clinical stage and primary-tumor histopathologic microstage both correlated with disease recurrence. At 1 to 75 months, patients with clinical Stage I disease had a 13% recurrence rate, while 58% of those with Stage II disease developed recurrence. Patients with superficially invasive melanoma had a 10% recurrence rate, while 17%-33% of those with deeply invasive disease developed recurrence. However, the presence of node metastases, rather than the microstage of the primary tumor, appeared to be the dominant indicator of outcome. Radical excision of the primary tumor may reduce the incidence of local disease recurrence. We believe that regional lymphadenectomy is indicated for deeply invasive melanoma.

Head and Neck Neoplasms↗
PubMedDate not supplied

Surgical resection and intraperitoneal chemotherapy for recurrent abdominal sarcomas.

BACKGROUND: Recurrent abdominal sarcomas have an extremely high rate of recurrence and poor overall survival. A prospective study was initiated to assess the feasibility, toxicity, and benefit of surgical resection and intraperitoneal chemotherapy for improving local control of disease and overall survival. METHODS: Fifty-four patients underwent surgical excision of all gross disease and postoperative intraperitoneal chemotherapy with mitoxantrone. Thirty-five patients had peritoneal disease only (stage II), and 19 patients had peritoneal disease with hepatic metastases (stage III). RESULTS: Nine (17%) patients remain free of disease with a mean follow-up of 37 months. The remaining 45 patients (83%) have had recurrence, with a mean interval to recurrence of 11 months. Stage (P = .001) and grade (P = .005) were the only two variables found to significantly affect recurrence. There was an overall peritoneal recurrence rate of 48% and an overall hepatic failure rate of 69%. Nineteen (35%) of the patients are alive, with a mean follow-up of 46 months. The overall 5-year survival was 31%. The 5-year survival for stage II patients was 46%; for stage III patients, it was only 5%. Stage (P = .001) and grade (P = .056) were the only two variables found to significantly affect survival. There were no treatment-related deaths, and only 5 patients (9%) developed local complications. CONCLUSIONS: Aggressive surgical resection and intraperitoneal chemotherapy for recurrent abdominal sarcomas is a feasible treatment approach with minimal toxicity. Although this treatment had little effect on the hepatic spread of this disease and thus overall survival, it appears to have significantly lowered the rate of peritoneal recurrence and may provide a survival benefit for patients with disease limited to the peritoneum.

Abdominal Neoplasms↗
PubMedDate not supplied

Soft tissue sarcomas: current trends in diagnosis and management.

Sarcomas (fleshy tumors) were distinguished from carcinoma (crab leg tumors) at the time of Hippocrates. Sarcomas are related embryologically to leukemias and lymphomas because all are thought to be malignancies of mesodermal embryologic origin. Neurosarcomas, however, are an exception, since they arise from tissue of neuroepidermal origin. Malignant sarcomas of the soft tissue represent an unusual primary malignant tumor. These lesions are characterized by their diversity in the histologic appearance and in their biologic behavior, as well as in anatomical origin. Currently there are approximately 7,400 newly diagnosed bone and soft tissue sarcomas, and approximately 4,200 deaths per year in the United States.1 The incidence of sarcomas varies by histologic type in various age groups. Embryonal rhabdomyosarcoma in the orbit peaks in the 4-year-old, and in the urinary tract in adolescence.2 Osteosarcoma has peak incidence in the teenage years, and Ewing's sarcoma develops between the ages of 15 and 30. Other sarcomas such as malignant fibrous histiocytoma and chondrosarcoma generally occur in patients aged more than 55 years. The incidence of osteosarcoma in whites and nonwhites is equal; Ewing's sarcoma is predominantly a disease of Caucasians.3 The relatively infrequent occurrence of these tumors plus their diverse histology and diverse presentations have made it difficult for any one institution to have enough patients to directly compare, in a randomized prospective fashion, one treatment with another in order to determine the optimal primary therapy. The purpose of this monograph is to review recent concepts in terms of pathology, surgery, radiation therapy, chemotherapy, and multimodality therapy.

Combined Modality Therapy↗
PubMedDate not supplied

Cis-dichlorodiammineplatinum(II) alone and combined with DTIC for treatment of disseminated malignant melanoma.

Twenty-one patients with disseminated malignant melanoma were treated with cis-dichlorodiammine-platinum(II) (cis-DDP): ten with cis-DDP alone at a dose of 20 mg/m2 iv x 4 days every 4 weeks and 11 with cis-DDP at a dose of 15 mg/m2 iv x 4 days combined with DTIC at a dose of 200 mg/m2 iv x 5 days every 4 weeks. Two of 21 patients (10%) showed a partial response to therapy. There were no complete responses and no apparent increases in length of survival for responders compared to nonresponders. One drug-related death occurred. Otherwise, drug toxicity was acceptable and appeared to be diminished by iv hydration and prolonged administration. In this study, cis-DDP was not effective for treatment of disseminated malignant melanoma.

Adolescent↗