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Biomedical subjects

J Herson

Publications and source records attributed to J Herson.

At least 37 records · Page 2Linked to original sources
PubMed1982

Squamous cell carcinoma of the pyriform sinus.

This is a review of 418 patients with cancer of the pyriform sinus who had complete treatment at University of Texas M. D. Anderson Hospital, treated over a 28-year time span. Treatment modalities used included radiation therapy, surgery, and planned combined treatment, primarily in the form of surgery and postoperative radiation therapy. Superficial lesions, with no impairment of laryngeal motility, are suitable for irradiation therapy planned for cure. (The policies of treatment have changed throughout the years). Analysis is made comparing the results of the larger groups of patients treated by surgery only, or surgery followed by postoperative radiation therapy. There is a significant lower incidence of failure above the clavicle in the combined treatment group, and a better 5-year survival. Rate of recurrences and the specific sites of failure above the clavicles are discussed, as well as the means of preventing such. The causes of death between 2 and 5 years are presented.

Aged↗
PubMed1982

Cisplatin chemotherapy for disseminated endometrial cancer.

Twenty-six women with advanced or recurrent endometrial cancer were treated with cisplatin at a dose of 50, 70, or 100 mg/m2 every 4 weeks. An objective response was obtained in 11 of 26 patients (42%), with 10 partial responses and 1 complete response. The median duration of remission was 5 months, with a range of 2 to 11 months. The complete response lasted 8 months. Five patients had stable disease lasting an average of 5 months. One of 6 patients (16.6%) responded to cisplatin at a dose of 50 mg/m2, 4 of 7 (57%) responded to the dose of 70 mg/m2, and 6 of 13 (46%) responded to the dose of 100 mg/m2, but the differences were not statistically significant (P = .2). In 8 of 26 cases (31%) cisplatin was discontinued because of toxicity. Three patients developed a peripheral neuropathy, 1 patient refused further therapy because of vomiting, 2 patients had nephrotoxicity, and 2 others had both nephrotoxicity and neurotoxicity. The average total cumulative dose of cisplatin administered when renal deterioration and neuropathy occurred was approximately 500 mg/m2. Cisplatin is definitely active against endometrial cancer, but toxicity precludes its prolonged administration in high doses on an outpatient basis. By maintaining a forced diuresis, toxicity can probably be decreased, thereby permitting continued administration of cisplatin. The drug may also be more useful when used at a lower dose in combination with other active agents against endometrial cancer.

Aged↗
PubMed1981

Surgery for common epithelial tumors of the ovary.

The objectives of the initial surgical procedure in patients with common epithelial carcinomas of the ovary are determination of the intraabdominal extent of the cancer and the reduction of tumor masses to the smallest residuum before initiating further therapy. Since ovarian cancer is a disease of the entire abdominal cavity, biopsy of selected sites will often detect unsuspected involvement by microscopic foci of metastatic carcinoma. Tumor-reductive surgery resulting in a small tumor residuum before initiating chemotherapy is thought to improve the changes for inducing a complete response. The retroperitoneal operative approach enhances the surgeon's effort to remove tumor bulk. Between July 1, 1972, and September 1, 1978, 104 patients with FIGO Stage III or IV carcinomas of the ovary were treated with melphalan. The conditions of 38 patients were evaluated by second-look laparotomy. This analysis attempts to define tumor-reductive surgery and relates the outcome of the results of the operative procedure to patients treated with melphalan.

Adult↗
PubMed1981

A staging system for histiocytosis X: a Southwest Oncology Group Study.

Patients with generalized histiocytosis X may be divided into three prognostic groups based on age at the time of diagnosis and presence or absence of organ dysfunction. These variables are independent. Favorable response to initial chemotherapy was shown to be associated with improved survival and overall disease control.

Age Factors↗
PubMed1981

Survival after metastasis in osteosarcoma.

We analyzed survival patterns of 106 patients with metastatic osteosarcoma treated at the M. D. Anderson Hospital from 1954 to 1975. All were 20 years of age or less, had a confirmed diagnosis of medullary osteosarcoma (excluding mandibular and radiogenic osteosarcoma), and had developed evidence of metastasis at diagnosis or during treatment. Clinical characteristics evaluated statistically as possible prognostic factors in postmetastatic survival were: age at diagnosis, sex, race, site or primary, site of first metastasis, year of diagnosis, and time from diagnosis to metastasis. Two factors, year of diagnosis and time to metastasis, showed statistically significant association with postmetastastic survival. Those patients treated in 1971 or later (62) had significantly longer postmetastatic survival times than those (44) treated in 1970 or earlier (P = 0.002). Also, 14 patients who developed metastasis 1 year or more after diagnosis had significantly longer postmetastatic survival times than the 19 with metastasis at diagnosis (P = 0.002) or the 73 who developed metastasis during the 1st year after diagnosis (P = 0.005). Analysis also indicated a statistically significant interaction effect between the two factors (P = 0.093) that suggested the time to metastasis had a greater influence on postmetastatic survival time in those diagnosed in 1971 or later than in those diagnosed earlier.

Adolescent↗
PubMed1981

Single-agent cis-platinum therapy for advanced ovarian cancer.

From May 1976 to July 1978, 100 patients with untreated stage III or IV ovarian carcinoma were entered into a prospective randomized clinical trial comparing melphalan, cis-platinum, hexamethylmelamine and cyclophosphamide, and a combination of hexamethylmelamine, cyclophosphamide, and doxorubicin hydrochloride (Adriamycin). The 22 patients who received cis-platinum, 18 of whom ultimately received hexamethylmelamine and cyclophosphamide therapy, are analyzed, and surgical and chemotherapeutic treatments are described. Response was evaluated by either clinical or surgical methods. Eleven of the 22 patients (50%) responded to cis-platinum treatment. Survival times ranged from 2 to 24 months, with a median survival time of 21.2 months. Gastrointestinal, hematologic, renal, and neurologic toxicities are reported; peripheral neuropathy constituted the major toxicity. Methods of alleviating or preventing neurotoxicity are discussed. It is concluded that cis-platinum as a single agent possesses definite activity against ovarian cancer.

Cisplatin↗
PubMed1980

Favorable response to maintenance therapy of second or subsequent remissions in childhood acute lymphocytic leukemia.

Twenty-two children with acute lymphocytic leukemia (ALL) who had relapsed while on therapy and for whom remissions were successfully reinduced were maintained with a combination of methotrexate, daunomycin, 6-mercaptopurine, prednisone, and vincristine (Djerassi-methotrexate with BOMB). The median duration of remission was 35 weeks (range, five to 364+ weeks). Of 8 children (36%) did not relapse while receiving this therapy, 4 are off all therapy (durations of remissions, 40+, 97+, 132+, and 216+ weeks). Improved responses were found in children with platelet counts of greater than 10(5)/mm3 at the time of index relapse. Intrathecal chemotherapy seemed to greatly prolong the duration of remission for 16 children when compared to those children who did not receive IT therapy (45.5 vs. 24 weeks). No central nervous system relapses occurred. This maintenance regimen for children with previously relapsed ALL appears to be effective and worth additional clinical trials.

Adolescent↗
PubMed1980

Comparison of prednisolone, vincristine, methotrexate and 6-mercaptopurine vs. 6-mercaptopurine and prednisone maintenance therapy in childhood acute leukemia: a Southwest Oncology Group Study.

The study was designed to compare the relapse rate and toxicity of intermittent prednisone, oncovin (vincristine), methotrexate, and 6-mercaptopurine (POMP) vs. 6-mercaptopurine daily and a prednisone pulse every three months (PIP) for maintenance therapy in acute leukemia. Children with acute lymphoblastic, acute undifferentiated, or acute stem-cell leukemia were stratified on the basis of initial leukocyte count and age, then randomly assigned to POMP or PIP maintenance therapy. All patients received cranial irradiation and intrathecal chemotherapy. Of the 67 patients receiving POMP maintenance, 20(30%) remain in continuous remission. The median length of continuous remission achieved with POMP therapy was 49 weeks. Of 80 patients receiving PIP maintenance, 25(31%) remain in remission. The median length of continuous remission for PIP was 62 weeks. Of the possible prognostic factors evaluated, the only significant factor was the prognostic grouping base in age and initial leukocyte regimen was associated with a higher incidence of toxic reactions, frequently causing therapy interruption. The results for both regimens as studied are inferior to those for 6-mercaptopurine methotrexate maintenance regimens as reported by others.

Age Factors↗
PubMed1980

Radiotherapy (2500 rad) for testicular leukemia: local control and subsequent clinical events: a Southwest Oncology Group study.

The effectiveness of radiotherapy, 2500 rad over two weeks, in treating leukemic infiltrates of the testicles was studied in 38 boys who met the requirements for tissue conformation of testicular involvement and examination of the bone marrow. The study group was heterogeneous with respect to specific histology and prior therapy. Complete regression of testicular infiltrates was confirmed by repeated biopsy examinations of 32 of 33 patients undergoing the procedure. The single treatment failure occurred in a boy with acute myelogenous leukemia. In all other patients, local disease control following radiotherapy persisted throuthout the remainder of the clinical course. Three of 5 children, however, showed evidence of reseeding of the testicle as a part of the relapse process at post-mortem examination. Statistical analysis of data from the 35 patients with acute lymphocytic leukemia showed the subsequent course of the disease with respect to next relapse, involving either bone marrow (BM) or the central nervous system (CNS), to be dependent on the acute leukemia prognostic group, as determined by age and peripheral white blood cell count (WBC) at the time of diagnosis, and timing of extramedullary disease (EMD). Patients with poor prognosis at the time of diagnosis and EMD afterward had a 3.8 times greater risk of a subsequent BM or CNS relapse than did patients with good or average prognosis and no EMD at any time (P = 0.07). Of the candidate prognostic factors examined with repect to survival, only the number of prior BM relapses was of statistical significance (P = 0.044). Children with two or more prior BM relapses had the worst prognosis for survival from testicular relapse, with a death risk of 3.6 times greater per unit of time than that of children with no or one prior BM relapse. Protective BM and CNS rescue therapy was recommended for those otherwise in complete remission (CR) at the time of testicular relapse. The median times to next relapse for patients receiving both BM and CNS recue therapy and for patients given CNS recue only were 42+ and seven weeks, respectively ( P = 0.09). The type of rescue received did not appear to affect survival time following testicular CR.

Adolescent↗
PubMed1980

Adjuvant chemotherapy in nonmetastatic osteosarcoma: a Southwest Oncology Group Study.

This report updates experience with the CONPADRI-I, COMPADRI-II, and COMPADRI-III adjuvant chemotherapy programs for the treatment of nonmetastatic osteosarcoma. A total of 200 patients received one of the three regimens. The analysis of response to treatment is based on disease-free survival time (DFS time). The effect of treatment, age, sex, site of disease involvement, and race on DFS time were investigated. Cox's life-table regression analysis found only sex to have a significant effect on DFS time with males having 1.8 times the risk of recurrence or death per unit time as female patients (P = 0.004). An analysis of the 81 patients still alive and disease-free 18 months after the start of treatment shows significantly longer DFS time for CONPADRI-I than COMPADRI-II patients (P = 0.01). This trend is true for both male (P = 0.12) and female (P = 0.08) patients.

Adolescent↗
PubMed1980

Patient registration in a cooperative oncology group.

Patient registration in a cooperative oncology group refers to the process by which a patient diagnosed at a member institution of the group is entered into the groups records for a selected clinical trial and, where applicable, is issued a random treatment assignment. Patient registration in a cooperative oncology group should not be limited to the routine clerical activities of compiling lists of patients entered on studies and supplying random numbers for treatment assignments. After background material on cooperative oncology groups and statistical issues are presented, the objectives of patient registration are defined to include initiation of data collection, randomization of patients, quality control (enforcing protocol adherence, reduction of bias, suggestion of needed protocol amendments, and evaluation of institutional performance), and planning future clinical trials (providing estimates of patient accrual and providing advice on registration matters). Various administrative procedures found useful in fulfilling these objectives for both randomized and nonrandomized clinical trials that are neither single nor double blind are presented . Foremost among these are the creation of a centralized patient registration staff employing extended telephone registration and a monitoring of patient registration activities through a monthly report system.

Cancer Care Facilities↗