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Biomedical subjects

G R Prout

Publications and source records attributed to G R Prout.

At least 145 records · Page 8Linked to original sources
PubMed1977

Five-year follow-up results of a collaborative study of therapies for carcinoma of the bladder.

Results after 5 years of follow-up in a cooperative trial of therapies for operable bladder cancer confirmed preliminary indications of a beneficial effect of preoperative irradiation. Improved survival was experienced by the one-third of the irradiated patients who experienced complete eradication of the tumor as indicated from the resected specimen 30-60 days after a 30-day course of 4,500 rads. These patients had a 55% chance of surviving 5 years as opposed to a 32% chance for those where irradiation did not eradicate the tumor, or similarly for those not irradiated. A postoperative course of chemotherapy with 5-fluorouracial appeared to act detrimentally when given to patients irradiated preoperatively, but may have had a slight benefit when given after surgery alone.

Clinical Trials as Topic↗
PubMed1977

Prognosis of clinically undiagnosed prostatic carcinoma and the influence of endocrine therapy.

A 10-year series of 100 patients with clinically undiagnosed prostatic adenocarcinoma is presented. In 50 per cent of these patients the tumor was well differentiated and the survival was normal, while the remainder of the patients had moderately to poorly differentiated tumors and survival rates significantly less than normal. Of 8 deaths caused by cancer 7 were associated with less-than-well differentiated tumor. Patients who received endocrine therapy and died of causes other than cancer had a significantly shorter interval to death and a higher incidence of cardiovascular deaths than those who were untreated. While the majority of patients with incidental, clinically undiagnosed prostatic carcinoma is not at risk from the disease a minority exists who may benefit from radical therapy.

Adenocarcinoma↗
PubMed1977

Long-term unmaintained remissions after agressive multidisciplinary treatment of advanced non-seminomatous testicular germ cell tumors.

Five patients with disseminated non-seminomatous testicular germ cell tumors are described. These patients have been clinically free of disease for 25 to more than 99 months and may be cured, since the interval after last treatment ranges from 13 to more than 76 months. Two patients, including 1 with pure choriocarcinoma, represent chemotherapeutic successes. In 3 patients the advantages of an individualized, multidisciplinary approach with surgery, radiotherapy and chemotherapy are shown. The benefits of continued aggressive treatment using residual therapeutic modalities despite prior failure with other therapy are documented.

Adult↗
PubMed1977

Minocycline diffusion into benign prostatic hyperplasia.

Minocycline, a broad-spectrum, highly lipid soluble tetracycline that has generated interest in the treatment of chronic prostatitis, was evaluated for its possible ability to be concentrated in benign prostatic hyperplasia. Drug levels in the prostate, plasma, fat, muscle and urine were measured in patients undergoing open prostatectomy after preoperative intravenous minocycline. The concentrations of the drug in the prostate and serum were close (4.16 versus 3.01 microgram. per gm.), while drug levels in striated muscle and fat were consistently lower (2.92 and 0.77 microgram. per gm). Higher preoperative doses of drug yielded higher tissue levels. Drug delivery closer temporally to the operation yielded higher serum and prostatic levels as opposed to striated muscle and fat, suggesting a rapid diffusion of the drug into benign prostatic hyperplasia.

Adipose Tissue↗
PubMed1977

Positive urinary cytology in patients without evident tumor.

Of 267 patients with a positive urinary cytology during a 5-year period 9 did not have a tumor identified at the initial diagnostic stidy, which included cytoscopy. However, a tumor was documented in 8 of these 9 patients between 1 and 61 months later.

Biopsy↗
PubMed1977

One-stage radical cystectomy for bladder carcinoma: operative mortality, cost/benefit analysis.

An analysis of cystectomies performed between September 1, 1969 and December 31, 1974 was conducted to determine the rates of morbidity (59 per cent) and operative mortality (4.1 per cent). Comparison of these figures for single operations with data published form other sources concerning staging of the therapeutic procedures suggests that there is no benefit for the patient relative to surgical morbidity or mortality if the latter course is followed. Conversely, prolongation of hospital experience, multiple operations, absence from productive activity and increased health care cost are associated with the staged procedures. Application of cost-benefit analysis suggests that this experience may act as a model to evaluate competing forms of therapy involving other disorders. When costs are not equivalent and benefits are the same the more expensive form of therapy should not be offered except for unusual circumstances.

Absenteeism↗
PubMed1977

Cell cycles in two cell lines of human bladder carcinoma.

Cell cycle analysis was performed on two established cell lines of human bladder transitional carcinoma, MGH-U1 and T24 cells. The cells were cultured on round cover slips for three days, autoradiograms were prepared after pulse-labeling with 3H-TdR and the fractions of labeled mitoses (FLM) were calculated every 2 hours through 36 hours. The FLM curves were analyzed by the empirical half-height level method as well as Mendelsohn-Takahashi's asymmetry method which is a global type of FLM analysis based on Takahashi's generalized model. The results did not show any distinct differences in the cell cycle parameters between MGH-U1 and T24 cell lines. A remarkable discrepancy, however, was observed between the cell cycle times analyzed by the asymmetry method and by the half-height level method. Although there is no evidence that the asymmetry method is biologically correct up to now, Mendelsohn and Takahashi tested this method repeatedly and mathematically proved that it had much less error than that of the traditional boundary method.

Autoradiography↗
PubMed1976

Chemotherapy of advanced prostatic cancer. Evaluation of response parameters.

A total of 125 patients with progressing advanced prostatic cancer were entered into a chemotherapy study comparing cyclophosphamide, 5-fluorouracil, and standard therapy. Parameters of response were studied in 110 patients who could be evaluated. Thirty-six patients (33 per cent) were considered to have an objective response, that is becoming stable (29 patients) or in partial regression (7 patients). Negative response parameters (predictors of a poor response to chemotherapy or standard theraphy leading to progress) included (1) bone marrow evidence of prostatic cancer, (2) abnormal liver scan, (3) prior radiation therapy (indirectly through increased toxicity to chemotherapy), and (4) lack of bilateral orchiectomy prior to randomization. Positive indicators (predictors of good responses) included (1) reduction of primary tumor mass, especially after administration of 5-fluorouracil or cyclophosphamide, and (2) hemoglobin values. There were more objective responders to cyclophosphamide than standard therapy whether the hemoglobin was initially normal or low. Indeterminate parameters of response included weight gain, presence of bony or soft tissue metastases, relief of pain, performance status, excretory urography, and biochemical determinations of liver and renal function.

Aged↗
PubMed1976

Endocrine changes after diethylstilbestrol therapy. Effects on prostatic neoplasm and pituitary-gonadal axis.

This study was undertaken to determine the effects of DES (diethylstilbestrol) on prostatic neoplasms and of different dosage levels on the pituitary-gonadal axis. It is recommended that when DES is chosen for treatment plasma testosterone be monitored carefully and for long periods of time to evaluate the ability of the dose to achieve levels comparable to castration in each patient.

Diethylstilbestrol↗
PubMed1976

Clinical significance of serum acid phosphatase levels in advanced prostatic carcinoma.

This cooperative study was sponsored by the National Prostatic Cancer Project to determine the usefulness of serum acid phosphatase levels as a predictive indicator with regard to performance status, sites of metastases, response to treatment, and survival in patients with advanced prostatic carcinoma. The results indicate that survival was significantly shorter for those patients who had elevation of thier on-study (pretreatment) total serum acid phosphatase ler cent reduction of primary tumor mass, relief of pain, and acid phosphatase activity. No correlation could be demonstrated between serum acid phosphatase and performance status, site of metastases, and other criteria of response to therapy. It is concluded that this test as currently determined spectrophotometrically at this stage of disease and if employed alone is not sufficient to allow for total evaluation of the response of therapy. It is, however, helpful when used in correlation with the previously mentioned positive factors.

Acid Phosphatase↗
PubMed1976

Prostatic carcinoma. relationship between primary tumor, histologic grade, and response to chemotherapy.

This National Cooperative Study has randomly compared the usefulness of 5-fluorouracil (5-FU), cyclophosphamide (Cytoxan) and standard therapy in patients with advanced carcinoma of the prostate (Stage D). All patients studied were endocrine failures and were in progression. Favorable responses were seen with all three treatments regardless of histologic grade. Actual tumor regression occurred only in patients who received either 5-FU or cyclophosphamide. In patients with poorly differentiated or anaplastic tumors treated with cyclophosphamide, progression of disease was significantly less rapid than in patients treated with 5-FU or standard therapy. However, favorable responders could not always be identified in advance on the basis of histologic grade alone.

Carcinoma↗
PubMed1976

The continued evaluation of the effects of chemotherapy in patients with advanced carcinoma of the prostate.

The response and duration of survival were evaluated for patients with stage D relapsing prostatic cancer who were randomized to cyclophosphamide (cytoxan), 5-fluorouracil (5-FU) or standard therapy, or to subsequent chemotherapies. The chemotherapies on initial randomization were superior to the standard therapy in the number of responders and duration of response. Survival was longer for responders (stable or partial regression) on chemotherapy by comparison to responders (stable only) on standard therapy. The survival for patients receiving initial and crossover chemotherapy was significantly improved for patients who responded to therapy. Chemotherapy of advanced relapsing stage D prostatic cancer is more beneficially treated by specific chemotherapy as shown in this randomized study.

Carcinoma↗
PubMed1976

Non-invasive papillary carcinoma of the bladder associated with carcinoma in situ.

We evaluated 129 patients with low grade, low stage transitional cell carcinoma of the bladder with a minimum followup of 5 years. In addition to the phenomena recognized as indicators of a serious clinical problem (grade greater than I, rapid recurrence, multiple tumors and lamina propria invasion) the identification of carcinoma in situ and/or atypia in normal, incidentally resected mucosa adjacent to the tumor was found to be a positive predictor for subsequent muscle invasion. Ten of 12 patients with carcinoma in situ and 9 of 25 patients with atypia were among 39 who experienced invasion.

Adult↗