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Biomedical subjects

K Brunner

Publications and source records attributed to K Brunner.

At least 73 records · Page 4Linked to original sources
PubMed1980

A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease.

Five hundred and sixty-six patients with either Stage III or IV Hodgkin's disease were prospectively randomized to test whether CCNU and/or vinblastine are more effective than mechlorethamine and/or vincristine with procarbazine and prednisone. The combination of CCNU, vinblastine, procarbazine, and prednisone (CVPP) was shown to be a highly effective program with a complete response frequency of 69%. The use of CCNU as part of the induction program was also shown to be the most significant determinant of prolonged remissions (P = .025). Reduced vomiting and neurotoxicity, as well as the oral administration, were the chief advantages of the CVPP as compared with MOPP. These factors resulted in improved patient and physician compliance. The MVPP regimen was also shown to be a highly effective regimen with a complete response frequency of 73% in patients without prior exposure to chemotherapy. However, the induction regimens containing vinblastine were associated with a significantly higher frequency of fatal hematopoietic toxicities than the induction regimens containing vincristine (P = .05). This higher frequency was almost exclusively seen in the elderly or in patients previously treated with both chemotherapy and radiotherapy. At this time, the remission durations maintained by vinblastine with periodic reinforcement are longer when compared with vinblastine maintenance alone (P = .06), but there is no corresponding increase in survival.

Adult↗
PubMed1980

[Malignant melanoma: spontaneous course, therapy and prognosis].

The natural history, treatment and prognosis of malignant melanoma are reviewed. Stage, histologic level of invasion and clinical type are the most important prognostic factors. Surgical approach for treatment of the primary tumor, adjuvant therapy and treatment of advanced disease (chemotherapy, hormonal manipulation and immunotherapy) are discussed. 5-year survival rates are tabulated in relation to the most important prognostic factors.

Female↗
PubMed1980

[Kidney and urinary tract complications in tumor patients].

This review deals with renal and urinary tract complications in tumor patients. Neoplastic infiltration of the kidney and glomerular nephropathies in neoplastic diseases are discussed. Tumor obstruction of the urinary tract and renal disease due to tumor metabolites are important, potentially reversible complications. Radiation nephritis and drug-induced renal disease can often be avoided with the aid of precautionary measures. Urogenital infections in tumor patients are frequent and often due to atypical microorganisms. Guidelines for dosage modifications of antineoplastic agents in patients with renal insufficiency are summarized. Renal failure in tumor patients deserves a careful diagnostic and therapeutic approach. The potential renal and urinary tract toxicities of the different therapeutic modalities must be considered when planning therapy for cancer patients.

Alkylating Agents↗
PubMed1979

[Pregnancy following tumor therapy].

A report is presented on 9 patients who became pregnant and gave birth to 11 children after intensive or long-term tumor therapy. Eight patients had Hodgkin's disease and one patient metastatic choriocarcinoma. Two children had a birth defect probably related to the anticancer therapy: one child has hearing loss of the inner ear and one child a cleft lip and palate. Some general issues relating to pregnancy after tumor therapy are discussed.

Abnormalities, Drug-Induced↗
PubMed1979

A comparative study of a BCNU containing 4-drug program versus MOPP versus 3-drug combinations in advanced Hodgkin's disease: a cooperative study by the Cancer and Leukemia Group B.

A prospective randomized trial by CALGB examined the relative value of four chemotherapy regimens in 537 patients with stage III B and IV Hodgkin's disease. A new combination BOPP, derived by substitution of BCNU for nitrogen mustard in the MOPP regimen, was compared to MOPP and to two 3-drug regimens, derived by removing the procarbazine in BOPP (BOP) or removing the alkylating agent (OPP). The 4-drug programs gave significantly higher frequency of complete remissions (BOPP 67%, MOPP 63%) than the 3-drug regimens (BOP 40%, OPP 42%), and significantly longer duration of remission and survival. BOPP had a therapeutic activity equal to MOPP, and was accompanied by less toxicity. After 6 cycles of induction chemotherapy, responding patients, both CR and PR, were continued on maintenance chemotherapy for 3 years. No significant difference in relapse rate was demonstrated following maintenance treatment with either vinblastine, chlorambucil, or chlorambucil plus monthly vincristine + prednisone doses. Nor could a reinforcement phase late in the maintenance program be shown to influence the relapse rate. The median survival for all patients entered on the 4-drug programs was 5 years, while the median has not yet been reached at 6 years for those patients, who obtained CR.

Adult↗
PubMed1978

[Evaluation program for cancer patients].

The medical evaluation and requisite radiologic examinations for the cancer patient are presented. Adequate clinical staging is essential for determining prognosis, optimal therapeutic plan, and evaluation of therapy results. Newer radiologic methods allow more detailed evaluation and determination of disease stage.

Bronchial Neoplasms↗
PubMed1978

[Interdisciplinary treatment planning in cancer].

The prerequisites for and purpose of optimal interdisciplinary cooperation in cancer treatment planning are presented from the viewpoint of the medical oncologist, the surgeon and the therapeutic radiologists. Only with full appreciation of the therapeutic possibilities offered by each individual treatment modality and speciality can an optimal interdisciplinary treatment plan be devised. This maximum of cooperation and interdisciplinary teamwork is also the basis for further progress and improvement of therapeutic results.

Breast Neoplasms↗
PubMed1976

[Prognostic factors concerning the survival time of Hodgkin's disease stage III and IV, treated with cytostatic agents].

On the basis of a retrospective study of 79 well-documented cases of Hodgkin's disease it has been possible to determine the prognostic significance of several factors in regard to 3-year survival. All patients evaluated were in stage III or IV and receiving polychemotherapy. According to the survival curves, the following factors adversely affected the prognosis to a significant extent: clinical stage IV, the presence of systemic symptoms, male sex, and failure to receive maintenance therapy. Also, patients treated by polychemotherapy only on relapse following other prior treatment, had a somewhat worse prognosis, though in out patient material this was not statistically significant. Other criteria significantly affecting the probability of 3-year survival in a negative sense were: decreased activity index, anemia, lymphopenia, elevated alkaline phosphatase values, low serum albumin and high serum globulin values. Elevated sedimentation rate, leukocytosis and leukopenia had no statistically significant influence upon survival.

Adolescent↗
PubMed1975

Comparison of the combination of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and vincristine with two dose schedules of 5-(3,3-dimethyl-1-triazino) imidazole 4-carboxamide (DTIC) in the treatment of disseminated malignant melanoma.

One hundred twenty patients with inoperable metastatic malignant melanoma were randomly allocated to treatment with either a combination of BCNU 150 mg/m2 and vincristine 2 mg/m2 given every 30 days, or one of two regimens of DTIC: 300 mg/m2/day x 6 or 100 mg/m2/8 hours x 18 given every 30 days. Eight of the 51 (16%) patients who were originally treated with the BCNU and vincristine combination had 50% or more objective tumor regression, compared to 6 out of 25 (24%) patients treated with daily injections of DTIC, and 6 out of 21 (29%) patients treated with DTIC injections every 8 hours. The median duration of response to the BCNU and vincristine combination was 60 days, and the median duration of survival from initiation of treatment was 6.5 months in the responders and 3.3 months in the nonresponders. The median duration of response was 90 and 100 days for the daily and 8-hour regimens of DTIC respectively, andthe median duration of survival from commencement of treatment was 8.5 months for the responders and 3.5 months for the nonresponders. None of the 43 patients who failed to respond to the initial treatment program or whose disease progressed after initial improvement responded to the alternate treatment regimen.

Adult↗
PubMed1975

Reflectometry and micromorphology of polished, etched and repolished teeth.

Labial enamel surfaces of anterior teeth were polished, etched for thirty seconds with acid and then repolished by manual brushing with three different abrasive pastes for 10, 15, 15, 20, and 20 seconds respectively and finally for a 60-sec brushing with a dental engine. Before etching and following each paste treatment, the light reflection of the surfaces was measured with the scanning tooth surface reflectometer of GABATHULER. The reflectance values were compared with the microscopic tooth surface texture. Reflectometric findings were similar under in vitro and in vivo conditions. There were differences among the pastes in restoring maximum lustre of dull etched enamel, but not in polishing intact tooth surfaces.

Adult↗