Biomedical subjects

H Wilke

Publications and source records attributed to H Wilke.

147 records · Page 9Linked to original sources

PubMedDate not supplied

Phase II evaluation of 5-fluourouracil plus folinic acid and alpha 2b-interferon in metastatic colorectal cancer.

Biochemical modulation of 5-fluorouracil (5-FU) by folinic acid (FA) increases the response rate in patients with metastatic colorectal cancer compared to 5-FU alone. Phase II trials also demonstrated increased efficacy when interferon was added to 5-FU. In two consecutive trials, 76 patients were treated on days 1-5 with FA 200 mg/m2 plus interferon 5 x 10(6) U/m2 and 5-FU 350 mg/m2 as intravenous bolus injection (n = 33, regimen A) or 5-FU 500 mg/m2 as 2-hour infusion (n = 43, regimen B), repeated every 3 weeks with individual 5-FU dose escalation in steps of 50 (regimen A) or 100 mg/m2 (regimen B). In regimen A 5-FU dose reduction to 300 mg/m2 due to toxicity was necessary in 49% of the patients; in regimen B a 5-FU dose of 600 mg/m2 or above was tolerated by 70% of the patients. Dose-limiting toxicity was severe mucositis and/or diarrhea. Objective responses were observed in 5 of 33 patients (15%) in regimen A (3-28%, 95% confidence interval) and 7 of 41 patients (17%) in regimen B (5-29%, 95% confidence interval). Median time to progression was 4.7 and 4.8 months, and median survival 9.9 and 11.4 months for regimens A and B, respectively. Prolonged 5-FU administration over 2 h allows the administration of a higher 5-FU dose compared to bolus injection with no apparent improvement in antineoplastic efficacy. The addition of interferon to the combination of 5-FU plus FA in this dose and schedule does not seem to improve the response rate but appears to increase treatment toxicity.

Adult↗

PubMedDate not supplied

Curative management of adenocarcinoma of the oesophagus--pro multimodal approach.

The incidence rates of adenocarcinoma (AC) of the oesophagus were reported to increase rapidly in the Western Countries, especially within white males. Due to the late appearance of tumour specific symptomes, most of the carcinomas are diagnosed at advanced stages. Because of the majority of the patients presenting with lymph node metastases even in localized disease, the long term results with surgery alone are disappointing. Overall less than 35% can be cured and three year survival rates (3-YSR) rarely exceed 25% in patients with locally advanced tumours (T3/4N0-1M0). For these reasons multimodal approaches have been investigated recently. Preoperative chemoradiation seems to be most promising in improving the curative power of the treatment. Beside a couple of phase II studies, 2 phase III trials proved superiority of multimodal treatment compared with surgery alone in localized AC (1,2) by increasing 3-YSR from about 10% to 30%. These trials were critisized because of incomplete tumour staging and a possible stratification bias. However, recent phase II studies from the US and from our own group (3,4) confirmed the role of preoperative chemoradiation also in properly staged (including endoscopic ultrasound) locally advanced AC. Both trials showed complete resection rates of 90% and based on very high local tumour control rates of above 90% long term survival reached about 40% in these high risk patients. These impressive data were injured by perioperative mortality rates of 15%, which were obviously increased by the preoperative treatment. Thus, preoperative chemoradiotherapy is very likely to increase cure rates in patients with AC of the oesophagus. To prove this, well designed phase III trials are warranted.

Adenocarcinoma↗

PubMedDate not supplied

Advanced inoperable stomach cancer: a pilot study with the combination etoposide, adriamycin and cisplatin.

In a pilot study 16 patients with advanced inoperable stomach cancer were treated with Etoposide, Adriamycin, Cisplatin. The recommended dose for phase II studies was established and first therapy results are presented. Two of 16 patients responded with complete remissions and 8 with partial remissions. The recommended dose schedule for phase II studies is: Adriamycin 20 mg/m2 i.v. day 1 + 7; Cisplatin 40 mg/m2 i.v. day 2 + 8; Etoposide 120 mg/m2 i.v. day 4, 5, 6, every four weeks.

Aged↗