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Biomedical subjects

J Kühböck

Publications and source records attributed to J Kühböck.

At least 19 recordsLinked to original sources
PubMed1989

[Simultaneous radiation- and chemotherapy (methotrexate and bleomycin) of inoperable malignant oro-facial tumors].

The overall response rate is 65% with 17% CR (medium 56 months) and 49% PR (medium 5 months). The Kaplan-Meier survival plot shows no difference between the previously treated and untreated groups, whereas the kappa 2-analysis indicates a significant advantage for patient with complete response in the previously untreated group (p less than 0.03). Between the different tumor sites and the presence or absence of lymphnodes, there was no significant difference either in survival or in the distribution of the CR, PR and P. The group with bone destruction has a significant shorter median survival time of 9 months versus 15 months in patients with no bone-involvement (p less than 0.03).

Bleomycin↗
PubMed1988

Palliative and adjuvant chemotherapy of metastatic renal cancer.

Despite the prevalent scepticism regarding its value, chemotherapy for metastatic renal cell cancer was used in 45 patients, of whom 44 were nephrectomized, aged between 34 and 75 yr with a mean age of 57.3 yr. In 32 patients chemotherapy was used as palliative treatment because of the presence of their often multiple metastases or in 13 patients following surgical removal of metastases and/or histologically high-grade malignancy, as adjuvant treatment. Our treatment schedule consisted on day 1 of vinblastine 5 mg/m2 to a maximum of 10 mg provided intravenously in 1 or 2 to 3 week intervals X 6 and CCNU 130 mg/m2 orally each 6th week. This treatment schedule was supported by an intensive antiemetic regimen. Gastrointestinal side effects were well tolerated while 30% hematological depression necessitated extension of treatment intervals. The mean number of cycles was 2.5-3.7, respectively, with a maximum of 6. Palliative treatment resulted in 19% complete plus partial remission, 62% stabilization, and 19% progression, while adjuvant therapy proved to be superior with 10 of 13 patients in remission at 3-21 months, and 1 of 3 patients with metastatic recurrence in further remission for 20 months; two of three patients died. Palliative chemotherapy with CCNU-vinblastine acted successfully by blocking cancer progression, while adjuvant treatment together with surgical extirpation of metastases may have prolonged tumor-free remission.

Adult↗
PubMed1988

Survey of chemotherapy of metastatic renal cancer.

A critical survey is made of cytotoxic chemotherapy of metastatic renal cancer. On the basis of representative summaries, only a few substances such as vinblastine, CCNU, hydroxyurea, and ifosfamide seem to act with some degree of success, but no specific antirenal cancer agent has as yet become available. This outline should provide a more realistic view of the therapeutic possibilities and of the limits of cytostatic chemotherapy in the metastatic phase of renal cancer. It is postulated that chemotherapy should feature more prominently in future therapeutic strategies. Newer cytostatic substances, i.e., second-generation alkylating agents and anthracyclines as well as platinum analogues, may present an advance with regard to side effects and tolerance but are discouraging with regard to their therapeutic efficiency in metastatic renal cancer.

Antineoplastic Agents↗
PubMed1987

Prognostic value of tumor marker determinations in testicular cancer patients.

This report is based on the observation of 109 patients with testicular cancer over a period of 6 years. At the time of orchiectomy metastases were present in 54 patients. In 13 patients with an initially nonmetastatic disease, secondaries occurred later. The aim of this study was to evaluate the role of serum levels of human chorionic gonadotropin (beta-HCG) and alpha-fetoprotein (AFP) in the prognosis for achieving a complete remission. The importance of serial serum AFP and beta-HCG determinations for the early detection of tumor metastases was also evaluated. Remission rates were lowered significantly in patients with serum AFP levels above 500 micrograms/liter (8%, P less than 0.0005) and serum beta-HCG concentrations exceeding 5,000 U/liter (27%, P less than 0.05). For an early detection of metastases the best results (efficiency 0.92) were achieved with the combination of beta-HCG with AFP and X-ray examination of the chest.

Chorionic Gonadotropin↗
PubMed1987

[Primary metastasized hypernephroma: therapy and follow-up].

Out of 44 patients suffering from disseminated renal cell carcinoma 24/44 patients (group I) underwent nephrectomy, in 20/44 patients the primary tumor was not removed. In 12/44 patients chemotherapy was performed (7 patients group I, 5 patients group II). Comparison of the survival rate with and without chemotherapy revealed no significant difference in the two groups. Partial response was noted only in four patients with a mean duration of four months. These results can not give a final answer for the indication of chemotherapy in metastatic renal cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Immune thrombocytopenia in Hodgkin's disease].

Thrombocytopenic purpura of the idiopathic thrombocytopenic purpura (ITP) type is an unusual and poorly documented complication of Hodgkin's disease. In an eight year period, three patients out of 140 with Hodgkin's disease developed thrombocytopenia; two of them presented a clinical picture undistinguishable from classic ITP. In both platelet antibody could be demonstrated. The third patient developed thrombocytopenia during an acute exacerbation of the underlying disease. Successful therapy of thrombocytopenia was achieved by methylprednisolone alone in one case and by cyclophosphamide in combination with methylprednisolone in the other two cases. These case reports demonstrate again that thrombocytopenia in Hodgkin's disease take place in active phases as well as in periods of complete remission; in the latter thrombocytopenia may reflect a part of immunological imbalance closely related to the pathophysiological background of Hodgkin's disease.

Adult↗
PubMed1985

[Aminoglutethimide therapy in advanced breast cancer].

45 women (postmenopausal or after former oophorectomy) with metastatic breast cancer resistant to tamoxifen as well as to chemo- and radiotherapy were treated with aminoglutethimide (750 mg or 1000 mg resp. daily) and hydrocortisone (40 mg daily). Treatment resulted in 33% remissions (2 CR + 13 PR) and 53% stabilizations (24 patients) besides a non-responder rate of 13% (6 patients). Side effects (mainly central sedation, possibly exanthema, seldom anorexia, but no hematotoxicity) were observed in 13 patients (29%). Duration of remission lasted for 1 to 24 months (mean duration 10,5 months) while stabilization extended for 2 to 17 months (mean duration 7,7 months). Mechanism of action by enzymatic inhibition of the adrenal steroid hormone synthesis ("medical adrenalectomy") as well as by extra-adrenal diminution of estrogens is considered in detail. Aminoglutethimide provides effective treatment in patients with generalized metastatic breast cancer followed by best outcome in cases with osseous metastases. Clinical results are presented as an approach to successful therapy of advanced breast cancer and an endocrine alternative in tamoxifen resistance as well as a therapeutic possibility in cytotoxic induced pancytopenia.

Adult↗
PubMed1985

[Prognostic factors in the treatment of inoperable orofacial tumors with simultaneous radiotherapy and intra-arterial chemotherapy].

Between January 1973 and April 1982 66 evaluable patients with advanced inoperable orofacial tumours underwent intraarterial Bleomycin and Methotrexate with simultaneous radiotherapy in a prospective study. 32 patients had no previous treatment, 34 patients had initial surgery, radiotherapy and/or chemotherapy. 15 mg Bleomycin were administered through a catheter into the arteria externa carotis daily in the morning. 25 mg Methotrexate were given in the same way at night followed by 3 mg Calcium-Leucovorin i.m. every 8 hours. The cumulative dose was 300 mg Bleomycin and 500 mg Methotrexate. Four hours after the administration of Bleomycin the target volume was irradiated (single fraction 2 Gy, total dose 60 to 65 Gy). The overall response rate was 65% containing 17% complete and 48% partial remission. Destruction of the bone appeared to be the most important index at the start of the therapy. Further prognostic determinants as previous treatment, localisation of the primary tumours (maxilla and mandibula respectively oral cavity and oropharynx) and local regional lymphnode stage missed statistically significance in the survival time, may be due to a possible radiosensitizing effect of the simultaneous chemotherapy. Complete remission turned out to be the most important prognostic factor after the end of treatment. Patients responding with complete remission show a median disease free survival of 56+ months and a median survival time of 82 months. Acute reactions were reversible. Only in 14% of the patients the treatment could not be finished. Better results could be obtained by electron-affinic radiosensitizers and high LET radiation.

Antineoplastic Agents↗
PubMed1981

[Value of beta-HCG blood levels in patients with malignant tumors of the testis].

In 24 of 43 patients (56%) with malignant germ cell tumors of the testis, the serum was positive for HCG prior to ablation of the testis. We give a detailed account of the course of HCG levels in the serum of 7 patients with seminoma of the testis. Positive serum-HCG-findings 8 to 10 days after semi-castration and prior to retroperitoneal lymphadenectomy indicate tumor metastases. In two thirds of our patients, we observed a correlation between regression of metastases under chemotherapy and the pattern of serum-HCG-levels.

Adult↗
PubMed1981

The endocrinology of testicular germinal cell tumors.

Oestradiol (Oe2), testosterone (T), lutenizing hormone (LH), follicle stimulating hormone (FSH), beta-human chorionic gonadotrophin (beta-hCG) and alpha-1 foetoprotein (AFP) were measured in blood samples taken from 63 patients with testicular tumours. In patients without tumour recurrence (n=31) AFP, Oe2 and T were within the normal range, beta-hCG was negative, LH levels were marginally elevated and FSH concentrations were significantly elevated. In patients with tumor recurrence (n=32) Oe2 was significantly elevated, whereas the T levels varied considerably and were therefore statistically not different from the patients without tumour recurrence. The beta-hCG positive subgroup of the recurrence group, however, demonstrated significantly elevated T levels. T levels were highest in patients with 51 to 500 U beta-hCG/1. On hand T was normal or even low normal in beta-hCG negative -AFP positive patients. In all subgroups decreasing FSH levels and decreasing LH responses to LRH were among the earliest signs of tumour recurrence. The observations suggest that moderate hCG levels are able to stimulate testicular T production, whereas high levels no longer increase T serum concentrations. Increased conversion rates form steroid precursors to oestradiol seem to be a feature of beta-hCG positive as well as beta-hCG negative testicular tumours.

Choriocarcinoma↗
PubMed1981

[Localized poikiloderma vascularis atrophicans as an early manifestation of Hodgkin's disease of the nodular-sclerosing type].

A 33-year-old female patient is presented with a nine-year history of poikilodermatous, eventually ulcerative skin lesions on the right neck and shoulder. A work-up revealed Hodgkin's disease of the nodular sclerosing type with specific cutaneous infiltrations. Initial combination polychemotherapy followed by supradiaphramatic irradiation has resulted in complete clinical remission of the disease since 15 months.

Adult↗
PubMed1979

Concept of cytostatic therapy in advanced tumours of the head and neck.

In cases with inoperable tumours of the head and neck some benefit may still be derived from cytostatics and radiotherapy. One treatment concept is based on intraarterial infusion therapy (bleomycin, methotrexate), while the systemic intravenous application of cytostatic substances (bleomycin, cyclophosphamide) is considered as an alternative of the intra-arterial approach is ruled out. Of the 31 intra-arterially and the 30 intravenously treated patients (all except 2 had squamous cell carcinomas), 64,5% and 20%, respectively, went into remission. This documents the validity of our treatment concept.

Adult↗
PubMed1979

[Circulating immune complexes in patients with malignant diseases].

Circulating immune complexes were determined by a solid phase C1q assay in patients with divers malignancies. In Hodgkin's disease (n = 20), immune complexes were detected only in two patients during chemotherapy. Both patients succumbed shortly thereafter. In patients with testicular malignancies (n = 18), immune complexes were detected especially in patients without evidence of metastatic disease. Sequential investigations did not reveal prognostic insights. Summing up these data and the data obtained in additional patients with malignancies, it is interesting to note, that patients with carcinomas have a significant higher incidence of circulating immune complexes with malignancies of the lymphatic system. Our data, however, do not exclude presence of other than C1q binding immune complexes.

Hodgkin Disease↗
PubMed1979

[Oral 5-fluorouracil therapy in liver metastasis].

The therapeutic results of 5-FU given by oral application (15 mg/kg body weight x 10 days) in 11 patients with hepatic metastases (after colorectal and mammary carcinoma) are reported: objective response in 2 patients and subjective improvement in 4 patients contrasts to 3 patients without response and 2 patients with indefinite response to adjuvant chemotherapy. However, a long lasting complete remission in a female patient with important metastatic hepatic involvement following breast cancer must be emphasized.

Administration, Oral↗