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Biomedical subjects

J M Cruz

Publications and source records attributed to J M Cruz.

At least 73 records · Page 4Linked to original sources
PubMed1988

Megestrol acetate versus tamoxifen in advanced breast cancer: 5-year analysis--a phase III trial of the Piedmont Oncology Association.

One hundred thirty-eight patients with recurrent or metastatic breast cancer were randomized to receive megestrol acetate 40 mg orally four times daily or tamoxifen 10 mg orally twice a day. Upon treatment failure patients were crossed over to the alternate treatment. Eligibility required that either the estrogen receptor (ER) or progesterone receptor (PR) be positive or that both values be unknown, and that the patients be at least 2 years post-spontaneous menopause or over 50 years of age. Pretreatment characteristics including performance status (PS), disease-free interval (DFI), receptor status, and prior treatment were similar for both groups. Only three patients had previous hormonal therapy while one third had prior chemotherapy. Objective response was determined using strict International Union Against Cancer (UICC) criteria. Seventeen of 61 patients achieved complete response (CR) or partial response (PR) on megestrol (28%) while 20 of 64 patients achieved CR or PR on tamoxifen (31%). Responses of skin and bone lesions were similar for both agents; however, more patients with visceral disease responded to tamoxifen. Response did not correlate with the level of ER or PR but was correlated with age. Both unadjusted and adjusted analysis of time to progression and adjusted analysis (for pretreatment variables) of survival showed significant differences favoring tamoxifen. Six of 44 patients (14%) crossed from megestrol to tamoxifen achieved CR or PR while only two of 38 patients (5%) crossed from tamoxifen to megestrol achieved response. Only one of the original patients randomized to megestrol remains on study, while 12 patients still remain on tamoxifen. These data indicate similar response rates for megestrol and tamoxifen; however, time to progression and overall survival significantly favor tamoxifen when used as first-line therapy in this trial.

Adult↗
PubMed1986

Sequential hemibody irradiation integrated into a chemotherapy-local radiotherapy program for limited disease small cell lung cancer.

Twenty-four patients with limited disease small cell lung cancer (SCLC) were treated with sequential hemibody irradiation (SHB) integrated into a conventional chemotherapy-local radiotherapy (LRT) program. Among 23 evaluable patients, 12 (52%) attained a complete response (CR) and 8 (35%) attained a partial response for an overall major response rate of 87%. The median time since study entry is 29 months. Durations of response are 9.9 months for all patients and 16.5 months for patients who achieved a CR. The primary site was the predominant area of recurrence. The median survival is 13.2 months for all patients and 23.2 months for the 12 patients who attained a CR. Myelosuppression, especially thrombocytopenia, was the major toxicity. Acute radiation toxicities and subacute pneumonitis previously associated with hemibody radiotherapy were well controlled or prevented using the current dose, premedication, and shielding techniques. This integrated program of systemic therapies with SHB and combination chemotherapy plus LRT is feasible for limited disease SCLC; it may prolong survival in patients who attain a CR but compared to similar programs without hemibody irradiation, there was no improvement in overall response rate, response duration, or survival.

Adult↗
PubMed1985

Multiple hepatic adenomas after long-term therapy with testosterone enanthate. Review of the literature.

We report a case of multiple hepatic adenomas developed in a 32-year-old man with renal allograft after long-term therapy with testosterone enanthate. Histological assessment showed a benign hepatocellular adenoma, which has not regressed over a 6-month follow-up since androgen withdrawal. A review of primary hepatic tumors associated with androgenic-anabolic steroid therapy published in the English literature has been carried out, concentrating on the more relevant recent publications. No previous case of hepatic adenoma with possible relationship to the use of non-17-alpha alkylated compounds has been reported.

Adult↗
PubMed1985

Megestrol acetate v tamoxifen in advanced breast cancer: a phase III trial of the Piedmont Oncology Association (POA).

One hundred twenty-four patients with recurrent or metastatic breast cancer were randomized to receive megestrol acetate 40 mg orally, four times daily, or tamoxifen 10 mg orally twice daily. If therapy failed patients were crossed over to the alternate treatment. Eligibility required that either the estrogen or progesterone receptor be positive or that both values be unknown, and that patients be at least 2 years postspontaneous menopause or over 50 years of age. Pretreatment characteristics were similar for both groups. Three patients had had previous hormonal therapy while one third had had chemotherapy. Objective response for evaluable patients based on strict UICC criteria was 29% with megestrol acetate and 31% with tamoxifen. Responses in patients with bone and soft tissue disease were similar for both regimens; however, 7 of 19 (37%) patients with visceral disease responded to tamoxifen but none of 18 (0%) responded to megestrol acetate. Response did not correlate with amount of estrogen or progesterone receptor. Unadjusted analysis of time to progression and survival showed no significant differences between regimens. With adjustment for pretreatment characteristics, patients on tamoxifen had a statistically significant prolongation of both of these parameters. Crossover data show 3 of 24 patients responding to tamoxifen after failure on megestrol acetate and 1 of 24 responding to megestrol acetate after failure on tamoxifen. However, crossover data should be viewed cautiously, as patients who are currently responding to initial treatment are those who would be most likely to respond to crossover therapy.

Aged↗
PubMed1984

Detection of brain metastasis at diagnosis of small cell carcinoma of the lung.

As a part of the initial evaluation of previously untreated patients with small cell carcinoma of the lung, radionuclide and/or computerized tomographic (CT) scanning of the brain was performed. Evidence of metastatic brain disease was documented in 10 (9%) patients (9 by CT and 1 by radionuclide scanning). CT was abnormal in 2 patients who had no evidence of brain metastasis by radionuclide scan. The detection of brain metastasis resulted in upstaging of 6 neurologically asymptomatic patients who had no other extrathoracic disease. Evaluation of the brain with CT is recommended as part of the initial staging of patients with small cell carcinoma of the lung.

Brain Neoplasms↗
PubMed1984

Improved tolerance of vincristine by glutamic acid. A preliminary report.

In a murine model system, glutamic acid has demonstrated host protective properties during administration of vincristine (VCR). Subsequently, glutamic acid has been evaluated in patients receiving VCR during adjuvant chemotherapy for stage II carcinoma of the breast. The cumulative VCR dosage and toxicities incurred in 16 patients receiving glutamic acid have been compared to those observed in 88 patients who previously received VCR without glutamic acid in the same chemotherapy program. All patients received VCR 1.0 mg/m2 weekly for 6 weeks with dose modification for neurotoxicity. Treatment patients received glutamic acid 1.5 grams p.o. daily in three divided doses during the induction course. Of the 16 treatment patients, 9 (56%) received 100% ideal dosage of VCR during induction therapy whereas only 24 of 88 (27%) comparison patients attained this dosage level (p less than .025). Gastrointestinal and hematologic toxicities were similar in both groups. These preliminary results suggest the need for an expanded trial of this agent during administration of VCR.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Prospective evaluation of changes in computed cranial tomography in patients with small cell lung carcinoma treated with chemotherapy and prophylactic cranial irradiation.

Computed cranial tomographic scans were performed as part of the pretreatment evaluation and at six- to nine-month intervals posttreatment in 13 patients with small cell lung carcinoma. All patients received 3,000 rad of prophylactic cranial irradiation delivered over two weeks in ten treatment fractions in conjunction with multiagent chemotherapy. Posttreatment scans documented an extraordinarily high frequency of abnormalities including cerebral atrophy (100%), ventricular dilatation (70%), and decreased coefficient of absorption in the white matter (15%). Unexplained neurologic abnormalities developed in four of six patients living at least 15 months after institution of therapy. As the number of long-term survivors of this type of lung cancer increases, the need for prospective comprehensive neuropsychologic assessment to determine the clinical significance of these changes is needed.

Aged↗
PubMed1980

[Action of quinine sulphate on the incidence of muscle cramps during hemodialysis (author's transl)].

Muscle cramps are a complication occurring during hemodialysis or in the periods between dialysis in 26% of patients. Out of a group of 21 patients undergoing hemodialysis three times a week for terminal renal failure, eight patients (38%) were selected with and special tendency to develop muscular cramps. Quinine was chosen because of its action upon the neuromuscular end motor plate. A double-blind study was carried out for 16 weeks, divided in two periods of 8 weeks, administering in each one of them either quinine sulphate (300 mg capsule) or placebo at the beginning of hemodialysis. The frequency of muscle cramps was significantly reduced (p < 0.005) by quinine sulphate when compared to placebo. Before and during the study blood tests, liver function, ECG, and EMG were monitored, and ophthalmological and audiometric evaluations were performed. No secondary effects of the administration of quinine sulphate could be found.

Acute Kidney Injury↗
PubMed1979

The influence of several factors that intervene in hemodialysis on serum levels of triglycerides and free fatty acids.

The effect of the administration of heparin and glucose, in doses and sequence similar to those of hemodialysis, on serum free fatty acids and triglycerides, was studied in eight patients with chronic renal failure who had not undergone hemodialysis. The results are compared with the action exerted by hemodialysis on the same parameters. During hemodialysis, the values of triglycerides are not significantly different from those obtained at similar intervals after the administration of glucose and/or heparin, with the exception that the values obtained five hours after beginning hemodialysis are lower than those obtained five hours after the administration of glucose (P less than 0.005). The levels of free fatty acids obtained during hemodialysis are higher (P less than 0.005) than those found during the other tests. The possible origin of these high fatty acid values is discussed, and the possibility that they originate from the acetate in the dialysis liquid is suggested.

Fatty Acids, Nonesterified↗