Hyperbaric oxygen in radiation therapy: the role of respiratory hyperoxia.
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Biomedical subjects
Publications and source records attributed to G Ewert.
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The realisation of a "medical record linkage" concept to achieve a lifelong medical surveillance requires the evaluation of the size and structure of the expected data. From this point of view the accessible health documentations of 120 persons of a small town covering the life period from birth to the age of 72 were evaluated retrospectively. The "epidemiological life report" resulting from this procedure enables the compilation of data on the reasons for utilising the health care system according to diagnostic-therapeutic and preventive aspects, and on the total number of medical expertises and paraclinical examinations. The number of data per person is considerable. In the course of a persons life he or she will come to the doctor for medical consultation about 600 times and will undergo 200 paraclinical examinations. A few aspects regarding the incidence of outpatient consultations are described in some detail.
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Report on a patient suffering from severe lung sarcoidosis and HTLV III-infection. Under combined treatment with cortisone and thymostimulin the patient recovered surprisingly well. The X-ray showed a frank improvement of the lung alterations, and in addition an extensive normalization of leucocytes and lymphocytes could be noticed. No side-effects could be observed under this treatment.
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Thirty-six patients with squamous cell carcinoma of the head and neck were treated with sequential methotrexate-5-fluorouracil followed by leucovorin rescue. The frequency of objective tumor regression obtained was 64% (complete response + partial response) with 19% complete regression. In 20 not previously treated patients, the objective response rate was 70%. Approximately the same result was obtained for tumors of different anatomical sites of the head and neck. The degree of differentiation of the squamous cell carcinoma did not seem to be of prognostic importance for the initial tumor response. Toxicity was very mild and usually disappeared when the interval between the chemotherapy courses was prolonged from 1 to 2 weeks. Radiotherapy could be added sequentially to the treatment without measurable escalated toxicity.
Since experimental data strongly suggest a synergistic cytotoxic effect when methotrexate (MTX) and 5-fluorouracil (5-FU) are administered sequentially, we investigated antitumor effects and toxicity with sequential MTX/5-FU followed by leucovorin rescue in 52 patients with carcinoma of the head and neck. MTX (200 mg/m2) was given as an i.v. infusion over 1 hr. At 2 hr, 5-FU (600 mg/m2) was started as an i.v. infusion for 2 hr. At 24 hr, the leucovorin rescue was started. The chemotherapy course was repeated every week until toxicity (mainly gastrointestinal) occurred, after which the interval between courses was prolonged to 2 wk. Toxicity was mild and usually disappeared when the interval between the chemotherapy courses was prolonged to 2 wk. The regression rate was 15% for complete and 48% for partial regression (response rate, 63%). In 31 of the patients not previously treated, the objective response rate was 74%. About the same results were obtained for tumors of different anatomic sites of the head and neck. Radiotherapy could be added sequentially without measurable escalation of toxicity. We conclude that sequential MTX/5-FU treatment, which produces a very mild toxicity to normal tissue, is effective in inducing antitumor response in patients with carcinoma of the head and neck.