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Biomedical subjects

K W Brunner

Publications and source records attributed to K W Brunner.

At least 91 records · Page 5Linked to original sources
PubMed1982

Neurologic and cardiac toxicity following iv application of methotrexate.

The case of a 61-year-old female patient with metastatic breast cancer is reported. She developed neurologic symptoms and supraventricular extrasystoles when she received iv methotrexate. These symptoms were reproducible and were not found with other drugs. The cause for this event is not clear.

Bone Neoplasms↗
PubMed1982

An evaluation of tamoxifen dose escalation in advanced breast cancer.

We escalated the dose of tamoxifen (TAM) to 30 or 40 mg daily in 23 patients who had experienced remission or stable disease (NC) under prior treatment with TAM 20 mg daily. One patient, whose bone and soft tissue disease had previously been stabilized under TAM 20 mg daily for 13 months, showed a partial remission (PR) lasting for 6 months. In 14 patients (64%) the disease remained stable for a median duration of 6 months (1.5-18+ mos.). Subjective improvement was noted in nine patients (39%), including the patient with PR and another one with progressive disease (PD). We conclude that dose escalation has no relevant activity in patients failing prior treatment with conventional doses of TAM.

Adult↗
PubMed1981

[Nausea and vomiting during chemotherapy of malignant tumors].

Nausea and vomiting are frequent and unpleasant side effects of cancer chemotherapy. Current concepts of pathophysiology and clinical aspects of nausea and vomiting are reviewed. Individual and therapeutic factors are discussed which greatly modify the degree of vomiting. The commercially available antiemetics are tabulated and the individual classes of antiemetics are described. Finally, consideration is given to new approaches to the treatment of nausea and vomiting, including the search for new compounds and better use of currently available agents.

Antiemetics↗
PubMed1981

[Chemotherapy of non-small-cell bronchial cancer with a combination of Cis-diamminedichloroplatinum (II) and VP 16-213].

In a phase II study 40 patients with non-small-cell lung cancer were treated with 100 mg/m2 cis-diamminedichloroplatinum (II) (DDP) i.v. on day 1, combined with VP 16-213 (VP) in a dose of either 80 mg/m2 daily i.v. on days 1, 2 and 3 or 120 mg/m2 daily by mouth on days 3, 4, 5 and 6. The course was repeated every 3 weeks. In 30 evaluable patients, 10 partial remissions were recorded with a median duration of 3 months. Eleven patients had stable disease and 9 showed progression under treatment. Leukopenia was more pronounced with intravenous administration of VP than with oral VP (median leukocyte nadir 2400/mm3 and 3700/mm3 respectively). Two patients had thrombocytopenia under 50,000/mm3. All patients suffered from moderate to marked nausea and vomiting. All patients had alopecia. Nine patients had serum creatinine elevations over 1.4 mg/dl. Six patients with renal toxicity were treated in one institution with incorrectly applied forced diuresis during DDP administration. DDP and VP are an active regimen for remission induction in non-small-cell lung cancer. Due to cumulative and marked gastrointestinal intolerance this regimen cannot be given over prolonged periods of time.

Adenocarcinoma↗
PubMed1981

[Long-term tumor-free surviving patients with anaplastic small cell bronchial cancer].

Report on 12 patients with small cell lung cancer who achieved disease-free survival for over 24 months after initial therapy. All the cases were classified as limited disease. Median age was 62 years and median performance status 0. Only 2 patients had weight loss of more than 5% in the six months prior to the diagnosis. Four patients were treated by local therapy alone (surgery in 3, radiotherapy in 1). Eight patients received systemic treatment (chemotherapy in 4, chemotherapy plus radiotherapy in 4). Median duration of cytostatic treatment was 17 months, with 3 of 8 patients receiving chemotherapy for less than 6 months. Three patients relapsed 27, 34 and 54 months after initial treatment. Median survival is 52 + months. It is concluded that long term disease-free survival can be achieved in patients with limited disease small cell lung cancer, even where initial treatment is relatively short.

Adult↗
PubMed1981

[Results of, and indications for adjuvant chemotherapy in breast cancer].

As the observation times of current studies using adjuvant chemotherapy in the treatment of operable stage II breast cancer lengthen, the probability of significantly reducing the high risk of developing metastases associated with this stage of the disease is also increasing and should be reflected in improved cure rates. The theoretical basis, prerequisites and presently available results for adjuvant chemotherapy of breast cancer are discussed. Adjuvant combination chemotherapy provides better results than monochemotherapy with Alkeran. While earlier results suggested that adjuvant chemotherapy is especially effective in premenopausal women, newer studies and analyses indicate that appropriate dosage and consistent administration of chemotherapy are of decisive importance. Exact determination and documentation of the tumor stage, and especially the regional lymph node status, is the most important factor in determining the indication for adjuvant chemotherapy. Adjuvant chemotherapy is still best with many unsolved problems. These include the duration, necessary intensity based upon risk factors, and short- and long-term side effects.

Adult↗
PubMed1981

[Colorectal cancer. Progress and unsolved problems].

This review deals with colorectal carcinoma, the most frequent malignant tumor in western countries aside from skin cancer. Epidemiologic data confirm the crucial role of nutrition in the pathogenesis of these tumors. The pathology and natural history of colorectal cancers are reviewed. Screening programs have yielded encouraging first results. In recent years surgery of rectal cancer has been improved by the introduction of a new stapling device permitting more sphincter-saving operations. Pre- and postoperative radiotherapy as an adjuvant to surgery are important elements in the primary management of rectal carcinoma. Radiotherapy is often effective in palliating pain, bleeding, and mucous discharge. Chemotherapy of colorectal cancer is still unsatisfactory. The prospects for adjuvant chemotherapy are discussed. The often dismal outlook for patients with colorectal cancer will be more promising if etiological factors can be eliminated, early diagnosis improved and chemotherapy ameliorated.

Colonic Neoplasms↗
PubMed1981

Cis-dichlorodiammineplatinum (II) and VP 16-213 combination chemotherapy for non-small cell lung cancer.

Twenty-three patients with non-small cell lung cancer were treated with a combination of cis-dichlorodiammineplatinum (II) 100 mg/m2 IV on day 1 and VP 16-213 80 mg/m2 IV on days 1-3. Eighteen patients are evaluable for response. Seven partial remissions with a median duration of 3 months (range, 1-13+) have been observed. Three patients exhibit stable disease, and eight patients show tumor progression. Overall survival was 5+ months (range, 1-13+); 7.5 months (range, 3-13+) for responders and 3+ months (range, 1-9+) for non-responders. Hematologic toxicity was acceptable, but poor subjective tolerance (nausea, vomiting, loss of appetite) was the main factor limiting treatment duration.

Adenocarcinoma↗
PubMed1981

[Randomized phase II study with VP-16-213 (etoposide) in the treatment of advanced breast cancer].

Thirty patients with an advanced and previously heavily pretreated breast cancer were treated in a randomized phase II trial with the new podophyllotoxinderivative VP-16-213. The therapeutic result can be assessed in 28 cases. Half of these patients received the cytotoxic drug orally 150 mg/m2/day during 5 days once every 3 weeks. The other half were randomized to receive the drug i.v. 150 mg/m2 weekly. No clear-cut partial remission was detected among the treated patients. In 3 cases a tumor regression was observed, which only met the criteria for a minor regression. These data are consistent with the single agent activity reported in the literature, which encompass mostly heterogeneous series with a few patients. The antitumoractivity of VP-16-213 in the treatment of breast cancer seems to be moderate. However, this should not prevent its incorporation into future, suitable combination chemotherapies.

Administration, Oral↗
PubMed1981

Prognostic factors in metastatic breast cancer.

Modern polychemotherapy has decisively changed the spontaneous course and median survival in metastatic stages of breast cancer. The prognosis for patients with the rather unfavorable type of visceral metastatic spread is definitely better now than 10 years ago. The influence of modern polychemotherapy on the survival and course of cases with mainly osseous metastases, however, is more limited. It seems that, in contrast to hormonal therapy, modern polychemotherapy alters the course of more aggressive types of metastases with a poor prognosis into a more favorable form of disease.

Breast Neoplasms↗
PubMed1980

[Ovarian carcinoma: new prognostic and therapeutic viewpoints].

Some recently developed concepts concerning the management of ovarian cancer are discussed. Cytoreductive surgery to debulk the tumor to a minimum, even in those cases which were considered inoperable in the past, improves the chances for cure. Adjuvant radiotherapy or combination chemotherapy with new drugs have proved highly effective in inducing complete remission and potential cures in these patients. The definition and better understanding of prognostic criteria play a primary role in the selection of treatment. In designing the strategy for adequate treatment, the following points are of major importance: (1) exact definition of tumor spread as determined by accurate surgical staging; (2) histologic and cytologic grading; and (3) evaluation of response.

Alkylating Agents↗
PubMed1980

[Chemo-(hormonal)-therapy of advanced ovarian neoplasms in FIGO stages III and IV. Prospective SAKK-study 20/71].

From 1971 to 1974 89 patients with advanced ovarian cancer (FIGO-stage III-IV), admitted to seven centers of the Swiss Group for Clinical Cancer Research (SAKK), were randomly allocated to three different treatment schedules: cyclophosphamide (CYT) alone or CYT in combination with either medroxyprogesterone acetate (GEST) or 5-fluorouracil (FU). Results in 71 evaluable patients (according to standardized group criterial) were as follows: 1. The overall remission rate was 48% (34 out of 71 patients) with no clear-cut statistical difference between the three treatment schedules but a firm trend towards higher remission rate with CYT + FU (58% as compared to 42% with CYT alone). 2. The scheduled "second-look" operations were performed in only 5 of 34 patients clinically judged to respond to therapy (PR), and does not allow objective surgical monitoring of therapeutic effects intraabdominally. 3. The median remission duration varied from 3 months (CYT alone) to 6 months (CYT + FU or CYT + GEST), again with only marginal statistical differences. 4. With regard to survival from initiation of chemotherapy, no treatment regimen was superior to another. The median survival ranged from 6.6 months (CYT) to 10.3 months (CYT + GEST). Patients responding to chemo-(hormone) therapy (CR + PR + NC) showed a significant prolongation of survival as compared to those with initial disease progression: median survival in "responders" was 11 months and in "non-responders" 2.9 months. A small group of 8-10% of all treated patients has survived in documented tumor remission for 4 years and more. 5. Toxicity was moderate and consisted mainly of mild temporary hematologic depression, tolerable nausea and transient alopecia, with equal distribution in the three treatment regimens. Hemorrhagic cystitis due to CYT was observed only in 3 cases. 6. Progress in remission induction and duration, as well as survival in advanced ovarian cancer, seems to depend on the inclusion of new effective agents (such as adriamycin, hexamethylmelamine and cisplatinum) and, most probably, on significantly more intensive treatment.

Adenocarcinoma↗