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Biomedical subjects

M Bains

Publications and source records attributed to M Bains.

51 records · Page 3Linked to original sources
PubMed1983

Clinical and pathological evaluation of response to chemotherapy in patients with esophageal carcinoma.

Pretreatment clinical staging, radiographic response to chemotherapy, and posttreatment pathological staging were assessed in 39 patients with epidermoid carcinoma of the esophagus. Thirty patients received combined modality therapy with cisplatin, vindesine, and bleomycin followed by surgery; nine patients were treated with the same chemotherapy with or without radiation therapy. Using barium esophagrams as the measure of response, radiographic objective regressions were quantitated and considered as complete (CR), partial (PR), and minor or no radiographic response. Sixty percent of patients had CR or PR. However, surgical or endoscopic restaging showed residual microscopic or macroscopic disease in nine patients, with complete radiographic regression. Downstaging of the primary tumor following chemotherapy (pretreatment clinical staging as compared to posttreatment pathological staging) was common. Chemotherapy-induced objective regressions in esophageal carcinoma can be achieved frequently and can be quantitated, using serial barium esophagrams. Complete radiographic regressions should be confirmed by repeat endoscopy or surgery. Downstaging of the primary tumor is commonly noted in responding patients, but it is too soon to determine whether or not this will effect their long-term prognosis.

Antineoplastic Agents↗
PubMed1982

Bronchogenic carcinoma with invasion of the spine. Treatment with combined surgery and perioperative brachytherapy.

A 64-year-old man with bronchogenic carcinoma was noted to have invasion of the chest wall and spine at time of diagnosis. Computed tomography and myelography demonstrated destruction of the vertebral body with epidural extension. After preoperative radiotherapy, resection of the involved lung, chest wall, and spine was accomplished. Afterloading catheters were placed for tumor-bed perioperative iridium 192 irradiation. The patient is free to disease two years after treatment. We describe the afterloading perioperative brachytherapy technique used and suggest this multidisciplinary approach for bronchogenic carcinoma invading the spine.

Brachytherapy↗
PubMed1982

Combination chemotherapy of esophageal carcinoma using cisplatin, vindesine, and bleomycin.

Sixty-one patients with epidermoid carcinoma of the esophagus have been treated with a three drug combination of cisplatin, vindesine, and bleomycin. Of 53 patients currently evaluable for response, 29 (55%) have had partial remissions: 7/16 with metastatic, and 22/37 with local-regional disease. The median duration of response in metastatic patients is eight months. Of 28 patients treated preoperatively, 23 (82%) had resectable disease. The major toxicities seen were nephrotoxicity and myelosuppression. Cisplatin, vindesine and bleomycin is an effective combination in the treatment of esophageal carcinoma. Effects on long-term survival cannot yet be evaluated.

Acute Kidney Injury↗
PubMed1982

Phase II study of methyl-GAG in the treatment of esophageal carcinoma.

Twenty-four patients with epidermoid carcinoma of the esophagus have been treated, in a phase II trial, with methyl-GAG using a weekly schedule. Eighteen patients had received prior chemotherapy with cisplatin-containing combinations. Of 23 evaluable patients, four (17%) had partial remissions, each lasting 2 months. All patients had received prior chemotherapy. Toxic effects were manageable and included mild nausea and vomiting, mucositis, and fatigue. Using this schedule, methyl-GAG had modest activity in esophageal cancer, with acceptable toxicity. Its role in combination chemotherapy remains to be defined.

Aged↗
PubMed1981

Combined chemotherapy and surgery in treatment of advanced germ-cell tumors.

Forty-eight selected patients with GCT who were suspected of having residual disease after two or three chemotherapy inductions underwent an attempt at resection of this residual tumor. In 37 patients all gross disease was resected: 11 had malignant tissue, eight adult teratoma, and 18 no residual neoplasm, and 9, 7 and 17, respectively, remain free of disease. Patients in whom complete resection was not possible generally did poorly. Elevated serum tumor markers following the completion of preoperative chemotherapy indicated residual malignant disease and poor probability for complete resection. Twenty-nine percent of patients with negative preoperative markers had malignancy at the time of surgery, but disease was resectable in most of these patients. The key for success is, first, the response to chemotherapy and, second, complete resection of residual disease. It is recommended that patients with initially bulky metastases (diameter greater than 5 cm) be first managed by chemotherapy, employing successive close inductions, and subsequently explored with intent to resect residual disease. When the resected specimen shows malignant elements, the patients should receive additional inductions, otherwise, maintenance chemotherapy is employed.

Antineoplastic Agents↗
PubMed1980

Palliative prosthetic intubation in gastric cancer.

Obstruction to swallowing from recurrent gastric cancer following total gastrectomy or when the tumor is initially unresectable presents a major surgical challenge. Resection of the recurrence or various bypass procedures are indicated, when technically feasible, unless widespread metastases are found. A useful palliative approach for obstructed patients with a limited prognosis is the use of a Celestin endoesophageal tube. This report describes the indications for and method of insertion in two typical clinical situations. Anchoring the tube to the anterior abdominal wall prevents proximal migration of the prosthesis, a complication which occurred six months later in a patient in whom this was not possible.

Adenocarcinoma↗
PubMed1980

Massive leiomyosarcoma of the chest wall in a young child.

An unusual instance of a very large primary leimyosarcoma of the chest wall is presented. It was asymptomatic but a swelling had been noted between the left clavicle and nipple by the parents. Chest x-ray showed a massive tumor with mediastinal involvement. Preliminary biopsy indicated a leiomyosarcoma. Wide an bloc excision of the chest wall was done, including much of the 1, 2, and 3 ribs and a piece of lung. The defect was closed with Marlex mesh and covered with a U-shaped flap of pectoralis major muscle and skin. There were 4000 rads of radiotherapy plus 15 mo of chemotherapy added. To date, she remains clinically well and apparently tumor-free.

Female↗
PubMed1979

Multipurpose central venous access using the cordis sheath introducer system.

A nonpyrogenic polyethylene sheath system with a hemostatic valve assembly and side port extension developed by the Cordis Corporation is now routinely used for central venous access in critically ill patients. It is inserted percutaneously via the subclavian or internal jugular vein and allows rapid and efficient catheterization for hemodynamic monitoring, infusion of multiple solutions simultaneously, and uniflow hemodialysis. This system represents a significant advance in catheter technology.

Catheterization↗
PubMed1978

cis-Dichlorodiammineplatinum(II) and bleomycin in the treatment of esophageal carcinomas.

Forty-seven patients with squamous cell carcinoma of the esophagus were treated with a combination of cis-dichlorodiammineplatinum (II) (cis-DDP) and bleomycin by infusion. cis-DDP at a dose of 3 mg/kg with mannitol and prehydration was given on Day 1. On Day 3, bleomycin was started as a 10--15-unit/m2 loading dose followed by a 10--15-unit/m2 24-hour infusion for 4--7 days. Three groups of patients were treated: group 1 (no clinical evidence of metastatic disease) included 25 patients, all with no prior therapy; group 2 (measurable metastatic disease) included 13 patients, eight previously treated with surgery and/or radiation; group 3 (known nonmeasurable metastatic disease) included nine patients, all previously treated with surgery and/or radiation and/or chemotherapy. A second course of therapy was given on Day 28 to groups 2 and 3, and as soon after surgery as possible in group 1. Nineteen percent of patients had complete or partial responses with another 44% having minor regressions. Toxic effects were mainly renal effects, alopecia, nausea and vomiting, and stomatitis. There were two drug-related deaths. The combination of cis-DDP and bleomycin is useful in the treatment of patients with squamous cell carcinoma of the esophagus.

Adult↗
PubMedDate not supplied

Vindesine in the treatment of esophageal carcinoma: a phase II study.

Vindesine, a new vinca alkaloid, has shown therapeutic activity in several human malignancies. A phase II study in 26 patients with squamous cell carcinoma of the esophagus was performed. Sixty percent of these patients had received prior chemotherapy. The starting dose was 3.0 mg/m2, which was escalated by 0.5 mg/m2 to a maximum of 4.5 mg/m2. Treatment was given once weekly for 7 weeks and every other week thereafter. Twenty-three patients were evaluable for response and toxicity. One complete remission (3 months), three partial remissions (5, 4, and 2+ months), and two minor responses (1.5 and 1 month) were seen. The major toxic effects were peripheral neuropathy, leukopenia, fever and myalgias, and alopecia. There was one drug-related death from leukopenia and sepsis. Vindesine has demonstrated therapeutic activity in esophageal carcinoma. Further studies with this agent are indicated.

Adult↗
PubMedDate not supplied

Cisplatin, vindesine, and bleomycin (DVB) combination chemotherapy for esophageal carcinoma.

Forty-six patients with epidermoid carcinoma of the esophagus have been treated with a three-drug combination of cisplatin, vindesine, and bleomycin. Of the 40 patients currently evaluable for response, 21 have had partial remissions (52%). At least four of these responses were almost complete, with only microscopic disease found on endoscopy or review of the resected specimen. Toxic effects have, in general, been manageable. The major toxic effects included nausea and vomiting, nephrotoxicity, and myelosuppression. There were two drug-related deaths: one due to renal failure and one due to sepsis. The three-drug combination appears to be substantially more effective than either the two-drug combination of cisplatin and bleomycin or vindesine alone. Effects on survival cannot yet be evaluated.

Adult↗