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Biomedical subjects

M Brada

Publications and source records attributed to M Brada.

140 records · Page 8Linked to original sources
PubMed1987

Radiotherapy for lacrimal gland tumours.

Forty-two patients with lacrimal gland tumours were treated with radiotherapy at the Royal Marsden Hospital between 1950 and 1982. Thirty-three patients with malignant tumours had a median cause-specific survival of 10.4 years. The tumour control following radiotherapy was related to histology, extent of initial surgery, and radiotherapy dose. Those patients with adenocarcinoma, undifferentiated carcinoma and malignant mixed tumour, who had complete surgical excision and adjuvant radiotherapy all remained disease-free; after incomplete excision, radical radiotherapy achieved local control in only one of 13. In contrast, in patients with adenoid cystic carcinoma 7 or 13 (54%) with residual local disease remain disease-free after radical radiotherapy. The complication rate of radiotherapy was low; 79% of patients who remained disease-free with an intact eye retained good vision.

Adenocarcinoma↗
PubMed1987

Circulating lymphoma cells in patients with B & T non-Hodgkin's lymphoma detected by immunoglobulin and T-cell receptor gene rearrangement.

We studied peripheral blood mononuclear cells from 50 patients with active B- and T-cell non-Hodgkin's lymphoma by DNA hybridisation. Nineteen patients (38%) had circulating clones of cells detected by immunoglobulin gene rearrangement (17 patients) or T-cell receptor gene rearrangement (2 patients) with JH and J beta 2 probes. Lymphoma tissue and peripheral blood were studied simultaneously in 22 patients, 9 of which had a circulating clone of cells in peripheral blood. In 7 patients the gene rearrangement in lymphoma tissue and peripheral blood mononuclear cells was identical. However, in 2 patients both heavy chain and light chain gene rearrangements were different in tissue and peripheral blood. The incidence of peripheral blood involvement was commonest in advanced CSIII & IV disease (54%) compared to CSI & II disease (18%) (P less than 0.05), and in low grade (45%) compared to intermediate and high grade lymphoma (31%) (difference not statistically significant). Only 4 patients had definite lymphoma cells seen on peripheral blood smear. The presence of circulating lymphoma cells correlated with conventional assessment of bone marrow involvement although circulating clones were detected in 30% (12/40) of patients with apparently normal bone marrow.

B-Lymphocytes↗
PubMed1987

Surveillance following orchidectomy for stage I testicular cancer.

Surveillance following orchidectomy was introduced in the management of Stage I testicular nonseminoma in 1979 and Stage I seminoma in 1983. Of 132 nonseminoma patients followed for 12-84 months (median 43 months) the relapse rate is 27%. Relapses were diagnosed 2-44 months after orchidectomy with 90% of relapses appearing within the first year. Of the 132 patients, 131 are alive and disease-free. The pattern of relapse was as follows: 47% of relapses occurred in abdominal nodes, 13% in abdominal nodes and lung, 17% in the lung and 23% with elevated serum markers as the only evidence of disease; 26% of relapsing patients had normal serum AFP and hCG levels. The prognostic significance of thirteen clinical histopathological and biochemical factors has been analysed by multiple regression analysis. Histology and lymphatic invasion within the primary tumour are significant independent prognostic factors. A total of thirty-six patients had scrotal interference prior to removal of the primary tumour. This was not a contra-indication to surveillance. None has developed scrotal recurrence and the overall relapse rate (11%) is comparable to that observed in the surveillance series as a whole. Fifty-two patients with Stage I seminoma have been observed from 12-41 months after orchidectomy. Seven (13%) have relapsed and six of the seven relapses have been confined to retroperitoneal lymph nodes. Preliminary data suggests that pre-orchidectomy elevation of serum hCG is not a significant prognostic factor.

Carcinoma in Situ↗
PubMed1987

Treatment of favorable-prognosis nonseminomatous testicular germ cell tumors with etoposide, cisplatin, and reduced dose of bleomycin.

We have explored a dose reduction of bleomycin in combination with etoposide and cisplatin in the treatment of a good-prognosis subgroup of patients with nonseminomatous germ cell tumors. Twenty-two patients were treated with etoposide, cisplatin, and low-dose bleomycin. All patients achieved complete remission, but four relapsed. Three patients achieved long-term remission after salvage therapy. The disease-free survival rate of 82% (18 of 22 patients) at a median follow-up of 24 months (range, 17-33) was significantly worse compared to the 99% disease-free survival rate in 91 patients receiving full-dose bleomycin, etoposide, and cisplatin. These results are similar to a previously reported 82% disease-free survival rate of 17 patients treated with etoposide and cisplatin alone. The combined results of the 82% disease-free survival rate in the total group of 39 patients treated with etoposide and cisplatin and etoposide, cisplatin, and low-dose bleomycin suggest that the reduced bleomycin regimens in their present schedule constitute inadequate therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Clinical presentation as a predictor of laparotomy findings in supradiaphragmatic stage I and II Hodgkin's disease.

Clinical presenting features, sex and histology have been correlated with laparotomy findings in 225 patients with clinical Stage I and II supradiaphragmatic Hodgkin's disease seen at The Royal Marsden Hospital between 1970 and 1979. Age, sex, and in Stage I disease, size and position of involved nodes were independent predictors of positive laparotomy. On the basis of these observations low risk (less than 15% positive laparotomy), high risk (greater than 50%) and intermediate risk categories can be defined. The observations form the basis of a policy employing laparotomy on a selective basis.

Adult↗
PubMed1985

cis-Diammine-1, 1-cyclobutane dicarboxylate platinum II (carboplatin) in the treatment of testicular germ-cell tumours: a preliminary report.

Between 1982 and 1985 47 patients with metastatic testicular germ-cell tumours were treated with carboplatin alone or combined with bleomycin and etoposide and/or vinblastine. Of 14 untreated seminoma patients 13 (93%) are free from active disease at 7-38 months (median 12 months). Twenty patients with untreated advanced non-seminomatous testicular germ-cell tumours have been entered into a study of carboplatin, etoposide and bleomycin (CEB) as first-line treatment. Preliminary data show that of 15 men observed for 6-12 months (mean 7.5 months) 11 are disease-free. Toxicity with the single agent and combination has been mild. Of 12 patients receiving carboplatin alone or in combination for relapse after cisplatin chemotherapy 10 showed no response, one a transient complete response and one a partial response consolidated with radiotherapy. On the basis of these preliminary observations it is concluded that carboplatin is an active drug in testicular germ-cell tumours and that cross resistance with cisplatin may be a significant problem.

Antineoplastic Agents↗
PubMed1983

Ceftazidime compared to tobramycin and ticarcillin in immunocompromised haematological patients.

Tobramycin and ticarcillin has been compared to ceftazidime in a clinical study on immunocompromised patients with febrile episodes. In the tobramycin and ticarcillin group (A) 70 febrile episodes occurred (10 being unassessable) in 43 patients of which 16 (23%) were bacteriologically positive. Forty-three episodes occurred during neutropenia. In the ceftazidime group (B) 54 febrile episodes (6 being unassessable) were treated in 34 patients. Eleven (20%) were bacteriologically positive and 30 episodes occurred during neutropenia. Clinical cure in group A occurred in 39 episodes, 65% of assessable cases. Cures in group B numbered 27 out of 54 episodes (56% of assessable cases). Clinical failure among evaluable cases, that is no decrease in fever in three days, was 22% in group A and 31% in group B. These results, within the limitation of the study, suggest that ceftazidime given alone at a dosage of 1 g tds is not significantly worse than tobramycin 120 mg tds plus ticarcillin 2 g tds.

Bacterial Infections↗
PubMed1980

The effect of methylprednisolone sodium succinate on erythrocyte and haemoglobin function.

1. As it has been suggested that the beneficial effect of methylprednisolone in shock is due to its effect on erythraocyte oxygen affinity, we studied its effect on incubated erythrocytes and on haemoglobin solution. 2. Incubation of fresh whole blood anticoagulated with acid/citrate/dextrose with methylprednisolone (7 mmol/l) produced a significant decrease in oxygen affinity, which was not seen with lower concentrations of methylprednisolone. When either acid/citrate/dextrose blood stored for 10 days or fresh heparinized blood was used, no significant increase in the partial pressure of oxygen at 50% haemoglobin saturation (P50) was demonstrated even with methylprednisolone at 7 mmol/l. At the highest concentration achieved in plasma with standard therapeutic doses (56 mumol/l) there was no increase in P50 under all the conditions studied. 3. Methylprednisolone reduced the oxygen affinity of haemoglobin in solution. The reduction in oxygen affinity was less than that produced by 2,3-diphosphoglycerate and more than that of either sodium succinate or sodium chloride. 4. From the results of this study we conclude that the effect observed in whole cells is probably due to a direct effect of methylprednisolone on haemoglobin. To produce a significant decrease of oxygen affinity of while blood in vitro requires a plasma concentration of methylprednisolone above that obtained in plasma in vivo, with the currently used therapeutic doses.

Cells, Cultured↗
PubMedDate not supplied

The management of early-stage aggressive non-Hodgkin's lymphoma.

Sixty-one patients with stage I or II non-Hodgkin's lymphoma of aggressive histological subtype were treated at the Royal Marsden Hospital between 1972 and 1984. The overall 5-year survival probability was 69 per cent (60 per cent continuously relapse-free). The 5-year survival probability was 80 per cent for stage I disease and 55 per cent in stage II (p = 0.05). Survival was significantly higher in non-bulky than bulky presentations (85 per cent versus 44 per cent at 5 years, p = 0.003). There was no significant 2-year survival difference between those treated initially with chemotherapy and those treated with radiotherapy alone (65 per cent versus 83 per cent), however chemotherapy had been employed predominantly in patients with adverse presentations. The 2-year survival in 41 patients treated initially with doxorubicin-containing chemotherapy combinations was 76 per cent. Combined modality treatments should be considered especially in patients with stage II or bulky disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Severe lung toxicity with a weekly low dose chemotherapy regimen in patients with non-Hodgkin's lymphoma.

Nineteen patients in poor prognostic subgroups of aggressive non-Hodgkin's lymphoma (NHL) were treated with weekly chemotherapy consisting of low dose mitoxantrone and cyclophosphamide alternating with bleomycin and vincristine together with continuous oral prednisolone. Six patients developed pneumonitis which was severe in five patients. This occurred at total bleomycin doses of less than 50 U/m2 and cyclophosphamide less than 1875 mg/m2. The 31 per cent incidence of pneumonitis following low dose bleomycin suggests an increased susceptibility to drug-induced pulmonary damage in non-Hodgkin's lymphoma.

Aged↗