Search PubMedSearch

Biomedical subjects

K M Rowland

Publications and source records attributed to K M Rowland.

6 recordsLinked to original sources

Continuous infusion of etoposide, bolus administration of cisplatin, and simultaneous radiation therapy in previously treated patients with small cell bronchogenic carcinoma.

Thirty-one patients with previously treated small cell bronchogenic carcinoma were treated with split-course radiation therapy and concurrent cisplatin and etoposide. Twenty-four patients (78%) had clinical partial or complete responses. Median survival from the time of salvage was 6.3 months. Fifty-eight percent of the patients failed on therapy initially in sites outside the radiation port. Hematologic toxicity was moderate. Concurrent cisplatin, etoposide, and split-course radiation therapy is feasible and active in the treatment of small cell bronchogenic carcinoma.

Antineoplastic Combined Chemotherapy Protocols

Phase II trial of therapy with etoposide, 5-fluorouracil by continuous infusion, cisplatin, and simultaneous split-course radiation in stage III non-small cell bronchogenic carcinoma.

Survival of patients who have clinical stage IIIM0 non-small cell bronchogenic carcinoma remains relatively short despite treatment with either surgery or radiation. Results from a phase II study of simultaneous continuous infusion of 5-fluorouracil, cisplatin, and split-course radiation with or without surgery indicate that median survival duration in patients treated with this combined modality approach may be better than the median survival for patients treated with radiation alone. Etoposide has been added to this regimen, and 32 stage IIIM0 non-small cell lung cancer patients have been treated with the 3-drug regimen resulting in a 73% clinical partial remission rate. No residual tumor was found in 6 of 12 patients who had pulmonary resection after 4 courses of chemotherapy and radiation. The sites of failure in 8 patients with recurrent disease are as follows: local only, 3; distant only, 4; and local and distant, 1. The major toxicities have been leukopenia, nausea, and vomiting. The median leukocyte nadir was 2,400/mm3. A leukocyte count less than 1,000/mm3 was observed in 2 patients (7%), 1 of whom died of progressive pneumonia. All patients experienced nausea, vomiting, and anorexia. Severe esophagitis, dermatitis, and pneumonitis were not observed. Survival analysis has not been done because median follow-up time (326 days) is relatively short.

Antineoplastic Combined Chemotherapy Protocols

Cisplatin and 5-FU infusion chemotherapy in advanced, recurrent cancer of the head and neck: an Eastern Cooperative Oncology Group Pilot Study.

Thirty-four patients with advanced, recurrent head and neck cancer were treated with cisplatin (100 mg/m2 on Day 1) and continuous-infusion 5-FU (1.0 g/m2/24 hours on Days 1-5) every 3-4 weeks. All but one patient had failed prior radiation therapy or surgery; 27 had failed both. Two patients were not evaluable for response because of death within the first 2 weeks from unrelated heart disease. Among 30 patients with squamous cell carcinoma, five achieved complete response (CR) (17%) and 13 achieved partial response (PR) (43%). Durations of response for patients with a CR and PR were 10.4 and 3.1 months, respectively. Median time to disease progression for all patients was 4.5 months and median survival was 9.1 months. Median survival times for all responders and for complete responders and partial responders were 12.5, 14.2, and 10 months, respectively. One additional patient with an adenocarcinoma failed to respond, while a second with an adenoid cystic carcinoma achieved a PR for 3.4 months. Toxicity was moderate: seven patients experienced Eastern Cooperative Oncology Group grade 3 mucositis, and 11 patients had grade 3-4 hematologic toxicity. There was one treatment-related death due to nephrotoxicity. This study supports other studies that show a relatively high degree of activity of cisplatin and continuous-infusion 5-FU in advanced head and neck cancer.

Adult

Current "corrected" calcium concept challenged.

There is wide individual variation in the number of millimoles of calcium bound per gram of albumin in the serum. Individual regression coefficients for serum calcium concentration on serum albumin concentration have been determined in 62 people (25 of our own patients and 37 reported by others). The 95 percentile range was 0-007-0-053 mmol/g, with a median value of 0-025 mmol/g. Accordingly, it is not valid to "correct" a person's measured serum total calcium concentration for variations in serum albumin concentration using an average regression coefficient. Rather, the individual's own regression coefficient must be used. A tourniquet test seems to be the simplest technique for determining this value. Even then, precise interpretation of an individual's corrected serum calcium concentration is possible only when an appropriate reference range for corrected serum calcium concentration has been established. Such an appropriate reference range must be determined from an adequate number of normal people using the individual's own correction factor in each case.

Adolescent