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Biomedical subjects

H T Ford

Publications and source records attributed to H T Ford.

At least 91 records · Page 5Linked to original sources
PubMed1980

Failure of intensive combination therapy (cyclophosphamide, adriamycin, 5-fluorouracil) to control adenocarcinoma or large-cell anaplastic carcinoma of lung.

Eleven patients with advanced adenocarcinoma of lung and six patients with large cell anaplastic carcinoma of lung were treated with combination chemotherapy using cyclophosphamide 1 g/m2 i.v., adriamycin 30 mg/m2 and 5-FU 500 mg/m2 i.v. on days 1 and 8, of a 28 day cycle. In neither group did any patient achieve a complete remission; 1 patient achieved a partial response in each group, and the rest showed no evidence of response. The duration of survival of the responding patients in each group was not significantly longer than those of the non-responders. Toxicity and side effects were considerable in all patients. This study demonstrates that these tumour types are refractory to this form of intensive combination chemotherapy. A literature review suggests that other forms of combination chemotherapy are usually equally ineffective.

Adenocarcinoma↗
PubMed1980

Physical test for distant metastases in patients with breast cancer.

Of 312 patients presenting with breast cancer to a single clinic, 297 were screened for metastases in skin and nodes, bone, marrow, liver and lungs, using standard clinical, radiological scanning and cytological techniques. Thirty-four patients were found to have overt metastatic disease using these tests. Metastases were demonstrable on chest X-ray in 6.1% of the entire group of patients, on the bone scan in 4.2%, liver scan in 1.5%, liver ultrasound in 1.2% and in the bone marrow in only a single patient; 3.8% had contralateral or supraclavicular lymph node metastases or skin metastases. Twenty-eight of these 34 patients (82%) with overt metastases would have been classed as metastatic had only chest X-ray and clinical examination been carried out.A survey was then carried out to determine when tests for bone and liver metastases became abnormal. Bone scan and skeletal survey results were reviewed in 58 patients, 22 of whom had developed skeletal metastases and all of whom had regular skeletal scintigraphy carried out. Sixteen of 20 (80%) scans carried out within six months of the development of skeletal deposits were abnormal compared with 4 of 19 (21%) scans at the same follow-up time in those who failed to develop metastases, but few patients showed definite evidence of bone metastases on scanning prior to radiological metastases. Fifty-one patients who were found to have liver metastases at post-mortem were reviewed and most showed progressively rising alkaline phosphatase before death but only 11 of 57 (19.2%) and 14 of 50 (28%) had positive liver scintiscans and liver ultrasound examinations respectively from 3-12 months before death.

Bone Neoplasms↗
PubMed1978

Clinical examination, xeromammography, and fine-needle aspiration cytology in diagnosis of breast tumours.

The diagnostic accuracy of clinical examination, xeromammography, and fine-needle aspiration cytology was compared with definitive histological findings in 255 breast lumps excised during one year. When suitable aspirates were obtained for cytological examination the diagnostic accuracy of aspiration cytology was higher than clinical examination or xeromammography. A diagnostic accuracy of 99% was achieved when all three screening tests were in agreement. As well as confirming a clinical diagnosis of malignancy, cytology is useful in identifying malignancy when clinical findings suggest that the tumour is benign. The availability of accurate cytology has affected patient management in many ways. Xeromammography did not enhance the diagnostic accuracy of clinical examination and aspiration cytology in patients presenting with a breast lump and, as a procedure with potential hazard, the benefit of routine xeromammography is questionable when an efficient cytological service is available.

Biopsy, Needle↗
PubMed1978

Aminoglutethimide in treatment of metastatic breast carcinoma.

42 patients with metastatic breast carcinoma were treated with aminoglutethimide, which inhibits adrenal steroid hormone synthesis. Treatment was stopped in 2 patients before response could be assessed; of the other 40, 15 (37.5%) had an objective response, 1 (2.5%) showed a response in bone but not in soft tissue, and 4 (10%) had complete or very great relief of metastatic bone pain but no radiological evidence of improvement. 19 (53%) of 36 patients with bone metastases responded to treatment (15 had X-ray evidence and 4 had pain relief), as did 5 (45%) of 11 patients with soft tissue metastases, 2 (25%) of 8 with malignant marrow infiltration, 1 (14%) of 7 with lung metastases, and none of 13 with liver metastases. Response was commonest in patients who had previously responded to other forms of endocrine therapy. Side-effects, usually mild and transient, occurred in a few patients; the most important were an initial period of somnolence in 9 patients and a rash in 5.

Administration, Oral↗
PubMed1978

Failure to detect intra-abdominal metastases from breast cancer: a case for staging laparotomy.

Two studies were performed to assess the accuracy of non-invasive methods in detecting intra-abdominal metastases from breast cancer. Firstly, the sites of spread detected at the time of first presentation with metastases were compared with the sites of spread shown at necropsy in the same patients. Although about two-thirds of the patients with bone and lung metastases at necropsy had had metastases detected at these sites when they first presented with metastases, only a third of the patients with liver metastases and none of those with other intra-abdominal metastases had had evidence of disease at first presentation with metastases. The second study confirmed a poor detection rate of liver and other intra-abdominal metastases in patients with breast cancer undergoing laparotomy and oophorectomy who were staged immediately before operation.Pre-mastectomy staging laparotomy should be considered in those patients with primary breast cancer who are most likely to have disseminated disease beyond the regional nodes. In the presence of occult gross metastases detected by staging laparotomy, mastectomy will not provide additional protection against loca recurrence of disease. Patients with occult gross metastases should also be excluded from studies on adjuvant chemotherapy (designed to treat micrometastases). Aggressive methods of staging are justified to protect the patient as far as possible against unnecessary mastectomy and to identify those patients who should be treated by therapeutic chemotherapy rather than adjuvant chemotherapy.

Abdominal Neoplasms↗
PubMed1978

Combination chemotherapy of metastatic breast cancer with vincristine adriamycin and prednisolone.

Fifty patients with metastatic breast cancer were treated with a combination of vincristine, Adriamycin and prednisolone (VAP) at four weekly intervals. Response rates of 78% for soft tissue disease, 66% for parenchymal lung disease, 67% for liver disease, and 64% for pleural effusions were seen. Only 26% of patients with bone metastases showed an objective response. These figures are as good as any previously reported for chemotherapy of breast cancer.

Aged↗
PubMed1978

The sympatomatic treatment of carcinoma of the bronchus using combination chemotherapy.

A study was made of chemotherapy for inoperable carcinoma of the bronchus. Only patients with symptoms directly due to the tumour or with evidence of rapid tumour growth were selected for treatment. Half the patients selected in this way responded and in these patients survival may have been prolonged. The regimen chosen caused the minimum of interference with the patient's life and, by relief of symptoms, appeared to offer an improvement in the quality of life.

Adult↗