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Biomedical subjects

L Balducci

Publications and source records attributed to L Balducci.

At least 109 records · Page 6Linked to original sources
PubMed1988

Surgery in small cell lung cancer.

Surgery in small cell lung cancer (SCLC) was abandoned in the late 1960s but is currently being cautiously reassessed, after the Armed Forces Asymptomatic Pulmonary Nodule Study demonstrated an unexpectedly prolonged 5-year survival (36%) with surgery. Subsequent prospective studies have reported five-year survival following resection in 22 to 83% of patients with Stage I disease and in 0 to 50% of patients with Stages II and III disease. Ten percent of patients with SCLC may be amenable to this approach. Additional patients may become candidates for resection following intensive combination chemotherapy. The optimal postoperative management remains unsettled. Combination chemotherapy and prophylactic cranial irradiation is recommended following complete resection. Postoperative thoracic irradiation may benefit patients with pathologically involved mediastinal nodes. Correlation of clinical response with our new understanding of the molecular biology of SCLC may further improve our approach to this disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Advanced Lewis lung carcinoma cured by tiazofurin as a system to study delayed hemopoietic effects of cancer.

Lewis lung carcinoma (LLC) induces a range of hemopoietic alterations in its murine host including progressive anemia, thrombocytopenia, splenomegaly, neutrophilia, and marrow and splenic myeloid hyperplasia. Concentrations of both pluripotent and committed marrow hemopoietic progenitors is increased and the cycling fraction of granulocyte-macrophage progenitors is accelerated. We have developed a way to study whether these hemopoietic effects become long-term consequences of cancer, using LLC-bearing mice with advanced tumor treated with the antineoplastic agent tiazofurin, 2-beta-D-ribofuranosyl-thiazole-4-carboxyamide, NSC 286193 (TZ). LLC mice were treated with a single dose of TZ either 150, 300, or 600 mg/kg, intraperitoneally on day 6 posttumor implant when lung metastases are present and all hemopoietic effects of the tumor are recognizable. Even a single dose of 150 mg/kg of TZ produced a significant survival advantage, and 600 mg/kg resulted in 30% of the animals remaining disease free during a 5-month follow-up. A 6-week treatment schedule was devised, administering TZ intraperitoneally, 600 mg/kg, weekly beginning on day 6. In this group, median survival was not reached after 9 months of follow-up. The only evidence of myelotoxicity produced by intermittent administration of TZ was a mild anemia which was fully reversible 2 weeks after discontinuance of the drug. No difference in white blood cell count, differential count, or platelet count was detected in tumor bearers and controls treated with TZ. Both pluripotent and committed marrow hemopoietic precursors remained unchanged in TZ-LLC, TZ-controls and untreated controls throughout treatment and 2 weeks thereafter. This study demonstrates that TZ-cured LLC mice are suitable to explore late hemopoietic effects of cancer.

Animals↗
PubMed1988

Extramammary Paget's disease: an annotated review.

The incidence, clinical features, histogenesis, and treatment of extramammary Paget's disease (EMPD) are reviewed. This unusual skin lesion is associated with an underlying adnexal neoplasm in about 50% of cases. Also, the incidence of distant organ malignancies of EMPD is higher than expected by chance. Even in the absence of a recognizable underlying cancer, EMPD may occasionally produce distant metastases, indicating the malignant potential of this condition. Histochemical, immunohistological, and lectin binding studies demonstrate that the cell of origin of EMPD is the exocrine cell of sweat glands. Although EMPD may arise from eccrine cells, derivation from apocrine cells appears more common. The treatment of the primary lesion, by wide margin excision, is fraught by a high recurrence rate. Chemosurgery may reduce local relapse of EMPD. The value of adjuvant radiation therapy is unestablished. Chemotherapy has induced remission in 2 cases of advanced EMPD and needs testing in clinical trials.

Diagnosis, Differential↗
PubMed1988

Sexual complications of cancer treatment.

The most common sexual dysfunctions in men are erectile impotence, retrograde ejaculation, infertility and loss of libido. Infertility is a function of the drugs and the dosage employed. Alkylating agents are likely to cause prolonged azoospermia. Sexual complications in women include stenosis and atrophy of the vagina, menstrual irregularities, early menopause and decreased libido.

Abnormalities, Drug-Induced↗
PubMed1987

Chemotherapy for advanced or recurrent gynecologic cancer.

Studies of chemotherapy in advanced or recurrent gynecologic cancer have focussed on ovarian, cervical, and endometrial carcinoma. For celomic epithelial carcinomas of the ovary, a large number of cytotoxic agents have been shown to be active. Dramatic improvement in frequency of response with lesser improvement in survival has been noted with the use of cisplatin-based combination chemotherapy as compared to single alkylating agents. More recent studies have evaluated alternative ways to employ cisplatin: higher dose schedules, intraperitoneal administration, and platinum compounds with a potentially better therapeutic index. None has yet been shown superior to a combination of relatively low-dose cisplatin plus an alkylating agent with or without doxorubicin. Cisplatin remains the best studied and most active single agent in patients with squamous cell carcinoma of the cervix. While a number of other agents have demonstrated moderate activity, no combination of drugs has as yet proved superior to single-agent cisplatin. In endometrial carcinoma, progestins and doxorubicin are the most active agents. Tamoxifen, cisplatin, and hexamethylmelamine appear to have moderate activity. No combination has yet been shown to be superior to single agents. Information on chemotherapy for less common gynecologic malignancies is largely anecdotal. Two observations are of note. Cisplatin-based combination chemotherapy is highly active against germ-cell neoplasms of the ovary. Cisplatin also has definite activity against mixed mesodermal sarcoma of the uterus.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Granular cell tumor. Clinical spectrum of the benign and malignant entity.

The clinical records of all patients with granular cell tumor seen at our institution over a 20-year period were reviewed. Three patients with malignant, and 37 with benign tumor, were identified. Eleven patients had multiple benign lesions. Three had a history of familial occurrence. Clinical and pathologic features and the management of this nebulous entity, in both its benign and malignant forms, are reviewed and discussed.

Adolescent↗
PubMed1987

Hepatic intra-arterial adriamycin in metastatic leiomyosarcoma: exploiting the steep dose-response curve.

We report a case of extensive leiomyosarcoma of the liver that failed on systemic Adriamycin. Hepatic intra-arterial chemotherapy with Adriamycin has resulted in a lasting clinical remission. This report illustrates the importance of the dose-response curve of drug to tumor in regional chemotherapy as with Adriamycin used in sarcoma, and the need to further explore such therapy in moderately chemosensitive tumors that are surgically unresectable for anatomic reasons.

Adult↗
PubMed1987

Evaluation of bone scan as a screening work-up in primary and local-regional recurrence of breast cancer.

To evaluate the use of radionuclide bone scan in staging patients with primary and local-regional recurrence of breast cancer, we reviewed the results in 265 patients with primary breast cancer who had the scan either preoperatively or within 6 weeks of surgery, and in 39 patients presenting with their first local-regional recurrence. All patients were clinically staged according to the revised 1983 criteria of the American Joint Committee for Cancer Staging and End-Results Reporting. None of the 92 with stage I and four of 95 patients with stage II had a positive scan. Eleven of 41 with stage IIIA and 13 of 37 with stage IIIB had a positive bone scan. In patients with their first local-regional recurrence, 12 of 39 had a positive scan. Follow-up scans were available in 61 patients with clinical stage I and II breast cancer who had adjuvant chemotherapy for pathological involvement of axillary node. There were six conversions observed in 61 scans obtained during the first year. Seven converted in follow-up scans in 47 patients in the second year. We conclude that although bone scans have a low positive yield in stage I and II breast cancer, their use in the preoperative setting and in the follow-up of patients with axillary node involvement detects early converters. Bone scans are justified in stage IIIA and IIIB breast cancer and in patients being evaluated for local-regional recurrence.

Adult↗
PubMed1987

Cancer chemotherapy in the elderly.

Although age may reduce the physiologic reserve of many systems, elderly patients with good performance status may receive chemotherapy without undue toxicity. Both survival and quality of life may be improved by treatment of responsive neoplasms, such as acute leukemia, multiple myeloma, small cell cancer of the lung, lymphomas and breast cancer. Age-related decrements in glomerular filtration rate and cardiac reserve suggest that doses of renally excreted drugs and cardiotoxic anthracyclines should be reduced in the elderly.

Aged↗
PubMed1986

Nutrition, cancer, and aging: an annotated review. II. Cancer cachexia and aging.

The interactions of cancer and malnutrition are discussed with the focus on aging. To establish whether the elderly are more likely to develop cancer cachexia and its complications, this review encompasses the pathogenesis of malnutrition in cancer; the age-related alterations of appetite, gastrointestinal function, energy expenditure, and protein turnover; the diagnosis of malnutrition; and the effectiveness of nutritional support in the elderly. Although metabolic and physiologic changes induced by cancer and age appear synergistic in causing cachexia, more frequent complications of malnutrition have not been observed in the geriatric cancer patients. This may be due to only a small proportion of the elderly with cancer being enrolled in clinical studies or to a reduced cachexia-inducing ability of tumors in these patients. A limited number of studies indicate nutritional replenishment is obtainable in malnourished elderly by hyperalimentation. As restoration of the lean body mass may be slower in older patients, early institution of nutritional support is recommended in malnourished elderly or elderly at risk for malnutrition during neoplastic treatment.

Aged↗
PubMed1986

Nutrition, cancer, and aging: an annotated review. I. Diet, carcinogenesis, and aging.

The interrelationships of diet and carcinogenesis are discussed with the focus on aging. To establish whether the elderly are more susceptible to dietary carcinogens and whether dietary prevention of cancer is a reasonable goal for this population, the mechanisms of chemical carcinogenesis, the age-related metabolic and physiologic changes, and the current cancer preventive dietary strategies are reviewed. Vulnerability to dietary carcinogens results from a combination of factors that may increase or decrease the occurrence of cancer in the elderly, and it is, therefore, a very individualized feature, unpredictable when based solely on a subject's age. Dietary prevention of cancer may be effective in advanced age, and the dietary guidelines of the National Academy of Sciences should be implemented in this population.

Aflatoxins↗
PubMed1986

Early hematopoietic events during tumor growth in mice.

Lewis lung carcinoma (LLC) of C57BL/6 mice, a transplantable tumor widely metastatic by 6-7 days post implant (PI), caused hematopoietic alterations such as progressive anemia (hemoglobin: day 1 PI, 11.0 g/dl; day 19 PI, 7.8 g/dl), neutrophilia (neutrophils: day 1 PI, 2 X 10(3)/microliter; day 19 PI, 22 X 10(3)/microliter), and marrow and splenic myeloid hyperplasia (marrow myeloid-to-erythroid ratio: day 1 PI, 1:1; day 7 PI, 3:1). Accompanying these changes were an increased concentration of marrow granulocyte-macrophage colony-forming units (culture) (GM-CFUC) (day 3 PI, LLC 185 +/- 27% of control; day 19 PI, LLC 265 +/- 10% of control) and accelerated cycling of these myeloid progenitors [day 3 PI, LLC 45.3 +/- 6.5% GM-CFUC in cycle vs. sham (media) injected 17.5 +/- 10.5%; day 7 PI, LLC 52.2 +/- 2.5% vs. sham (media) injected 29.8 +/- 9.8%; day 11 PI, LLC 56.2 +/- 4.4% vs. sham (media) injected 22.2 +/- 14%]. This study questioned whether enhanced hematopoiesis was a result of progressive tumor growth or whether the injection of tumor cells could evoke the response. By use of groups of C57BL/6 mice given an injection of live LLC cells, x-irradiated killed LLC cells, or media, the hematopoietic response to live LLC cells versus dead LLC cells could be dissected. A biphasic colony-stimulating activity (CSA) response in the sera of tumor bearers was found to account for the myelopoietic changes. The first wave of CSA from days 1 to 3 PI stimulated 168 +/- 3.7% more GM-CFUC than control sera and was likely released by dead cells of the tumor inoculum; the second wave from day 7 onward stimulated 220 +/- 7.6% more colonies and was a result of the enlarging tumor mass. Tumor growth was necessary for GM-CFUC proliferation, and the declining growth fraction at day 19 in LLC-bearing mice suggested that hematopoietic exhaustion was a consequence of tumor growth.

Animals↗