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Biomedical subjects

J R Jacobs

Publications and source records attributed to J R Jacobs.

131 records · Page 8Linked to original sources
PubMedDate not supplied

Proto-chemotherapy in advanced head and neck cancer.

Induction (proto) chemotherapy consisting of 3 courses of cisplatin and 120-hour 5-fluorouracil infusion was administered to 88 patients who had locally advanced, previously untreated head and neck cancer. The majority (81%) of these patients were classified as stage IV, and 17% had second primary carcinomas of the upper aerodigestive tract. An overall response rate of 94% was observed, with a 54% incidence of complete clinical response. The toxicity of the chemotherapy was judged acceptable, and no life-threatening or fatal drug-related side effects occurred. Twenty-four percent of the patients failed to comply with recommended standard treatment. In patients achieving a complete clinical response, 47% refused recommended surgery. Any response less than a complete clinical response to induction chemotherapy was not associated with any survival advantage. We conclude that future research efforts should be directed toward the identification of chemotherapeutic regimins that maximize the incidence of complete clinical response. In addition, any large-scale chemotherapy trial in patients with resectable disease should avoid the use of an induction sequence to minimize compliance problems with standard treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

One stage carotid artery resection: reconstruction in radiated head and neck carcinoma.

PURPOSE: Management of the carotid artery involved with metastatic squamous cell carcinoma continues to be a topic of much discussion. Early reports, for the most part, focused on the sequel of ligation and the development of various tests to predict patient tolerance for the procedure. More recent alternatives have described resection reconstruction in multistage procedures. By using immediate reconstruction with autogenous arterial grafting, carotid artery resection can be accomplished in patients with radiation failure in a single stage. This technique can be used without the addition of myocutaneous flaps, controlled fistulas, or intracranial surgery advocated for usage with alternative techniques. PATIENTS AND METHODS: Immediate reconstruction after resection of the carotid artery with superficial femoral arterial graft is described. RESULTS: In a series of 18 high-risk patients with radiation failure, the artery was successfully resected and reconstructed in 1 stage without any neurologic or vascular complications. The technique has been associated with prolonged survival in selected patients. CONCLUSION: Carotid artery resection and immediate reconstruction can be performed in high-risk radiation failure patients with acceptable complications, and is associated with prolonged survival in selected cases.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Recurrent carcinoma of the larynx and the hypopharynx.

From a group of 765 patients treated primarily at Barnes Hospital (St Louis) for epidermoid carcinoma of the larynx and the hypopharynx, 199 cases of recurrent disease were identified. To define this group of recurrent carcinoma, the following study parameters were selected: initial site of lesion, initial pathologic condition, initial therapy, complications of therapy, site of recurrence, secondary treatment, and end results. Cause of death is detailed as a result of primary cancer (local, neck, distant, and mixed), complications of treatment, secondary cancer, or intercurrent disease. An attempt is made to correlate the data to understand this anomaly and its responses to therapy better.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Significance of alkaline phosphatase and chemotherapy for head and neck carcinoma.

As an adjunct to surgical treatment and radiation therapy, chemotherapy is becoming another major treatment for head and neck malignancies. While response rates have reached as high as 75% in some series, chemotherapy is time-consuming, expensive, and not without risk to the patient. If a subpopulation that would benefit from its use could be identified, this new modality could be applied on a more rational and selective basis. Recent work has suggested a prognostic role for serum alkaline phosphatase in carcinoma of the head and neck. In an attempt to verify this work, a study of 101 patients treated with an induction chemotherapy protocol for squamous cell carcinoma of the head and neck was undertaken. Alkaline phosphatase and other variables possibly related to alkaline phosphatase were studied in detail. We are unable to verify a prognostic role for alkaline phosphatase.

Alkaline Phosphatase↗