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Biomedical subjects

M Bernstein

Publications and source records attributed to M Bernstein.

280 records · Page 16Linked to original sources
PubMedDate not supplied

Phase I therapy trials in children with cancer.

PURPOSE: This study examined the response and toxicity rates of antineoplastic drugs evaluated in phase I clinical trials in children to identify trends in response and toxicity over time. PATIENTS AND METHODS: Full length, peer-reviewed articles describing the results of single agent phase I therapy trials in children younger than 21 years with cancer were reviewed. Tumor-specific response data and doses of drugs that resulted in objective responses were noted. Deaths that occurred on study caused by drug toxicity, progressive disease (PD), or complications of marrow aplasia were identified, along with drug doses that resulted in toxic death. Temporal trends in response rates, toxicity, and number of patients entered in trials were examined. RESULTS: A total of 1,606 patients with cancer were enrolled in 56 single-agent pediatric phase I therapy trials published between 1978 and 1996. Of these, 1,257 were evaluated for response by tumor type. The overall objective response rate was 7.9%. Response rates were highest for patients with neuroblastoma (17.7%) and acute myelogenous leukemia (11.6%). Patients with osteosarcoma and rhabdomyosarcoma had response rates of < 3%. Sixty percent of responses in patients with solid tumors occurred at 81 to 100% of the maximum tolerated dose (MTD), although 42% of responses in patients with leukemia occurred at > 100% of the MTD. Death on study was noted in 7.0% of all patients entered in trials. Only 0.7% of patients experienced a death related to drug toxicity. PD accounted for the death of 5.6% of study participants. A trend of increasing response rate despite smaller trial size was noted over the last 7 years of this period. CONCLUSION: Phase I trials in children with cancer represent a safe mechanism to determine the MTD, toxicity profile, and pharmacokinetics of new agents for use in children with cancer.

Adolescent↗
PubMedDate not supplied

Phase II trial of pyrazoloacridine in children with solid tumors: a Pediatric Oncology Group phase II study.

PURPOSE: Pyrazoloacridine (PZA), a rationally synthesized deoxyribonucleic acid (DNA) binding agent that preferentially inhibits ribonucleic acid rather than DNA synthesis, is active against hypoxic and noncycling tumor cells and has greater in vitro activity against a broad range of human solid tumor lines than against the L1210 murine leukemia line. The Pediatric Oncology Group conducted a phase II study to determine the activity of PZA administered as a 3-hour infusion. PATIENTS AND METHODS: The activity of PZA was evaluated in patients with a variety of childhood solid tumors including rhabdomyosarcoma, Ewing sarcoma/peripheral neuroectodermal tumor, neuroblastoma, osteogenic sarcoma, Wilms tumor, or other solid tumors (excluding brain tumors). In addition to a standard three-stage design to test the drug's activity in each tumor type, a global stopping rule was used such that if no complete or partial responses (CR or PR) occurred in the first 35 patients (pooled across all strata except "other"), the study would be closed. RESULTS: A total of 47 patients were entered into the study. Myelosuppression was the primary toxicity. Severe nonhematologic toxicity was uncommon. Only one patient exhibited grade 3 neurologic toxicity (anxiety). No CRs or PRs were observed. CONCLUSION: Use of the global stopping criterion permitted early identification of lack of activity of PZA against childhood solid tumors.

Acridines↗
PubMedDate not supplied

A critical appraisal of the role of brachytherapy for pediatric brain tumors.

While brachytherapy is increasingly being utilized in adult patients with brain tumors, there has been very little experience with this approach in pediatric patients. This report reviews the current published experience with brachytherapy for brain tumors in children. Intracavitary irradiation with radioactive colloid is quite effective in controlling cystic craniopharyngiomas and represents an alternative approach to this subgroup of patients with craniopharyngiomas. There has been a substantial experience with the use of permanent interstitial implants in cases of low-grade astrocytoma in Europe, but its value is difficult to judge because of the variable natural history of these slow-growing neoplasms. Very few high-grade astrocytomas have been treated with brachytherapy in children, but children with localized recurrences after conventional therapy should be considered for this approach.

Astrocytoma↗
PubMedDate not supplied

Cerebral amyloid angiopathy presenting as a mass lesion.

A rare clinical presentation of cerebral amyloid angiopathy is reported. Our patient presented with the clinical and radiological signs of a right frontal mass lesion suggesting a brain tumor, and a biopsy provided the diagnosis of cerebral amyloid angiopathy. A brief review of the pathology and clinical features of cerebral amyloid angiopathy is presented.

Amyloidosis↗
PubMedDate not supplied

Development of an inductive, non-invasive RF applicator for studying hyperthermia in a rat brain tumour model.

A non-invasive inductive RF applicator has been designed specially for local heating of 6 mm diameter tumours growing in the brains of F344 rats (144-148 MHz). It is shown that an inductive applicator is the choice for this particular case. The power deposition pattern is analysed by modelling the applicator with a three-dimensional array of magnetic dipoles. The total hyperthermia system is briefly described and results of phantom and in vivo experimental measurements are presented. These confirm the theoretical analysis.

Animals↗
PubMedDate not supplied

Radiotherapy for brain tumors.

Improved techniques of radiotherapy have led to marked improvement in the results of radiotherapy for certain brain tumors, such as medulloblastoma and pineal germinoma, but results for malignant astrocytoma, the most common brain tumor, have been modest. This article reviews results of radiotherapy for brain tumors in adult patients over the last decade and comments on the new approaches being studied.

Brachytherapy↗
PubMedDate not supplied

Elective neurosurgical office consultations: how well are patients informed?

A prospective study was performed on elective neurosurgical office referrals to one neurosurgeon at the Toronto Hospital from September 1988 to May 1996. Patient level of information was tested using the chisquare test on the study population of 2,017 patients grouped according to the type of referring doctor and regional category of diagnosis. There was a statistically significant difference in the degree of knowledge of referred patients according to the type of referring doctor (p < 0.008). In addition there was statistical significance found in the difference in degree of knowledge among patients referred with the various regional categories of disease (p < 0.008). Patients referred by family physicians are not as informed as to the nature of their neurosurgical referral as those referred by neurologists and other specialists. Furthermore, patients with an intracranial diagnosis had a greater level of knowledge about their referral than those patients referred for spinal, peripheral nerve or other diagnoses.

Health Knowledge, Attitudes, Practice↗