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Biomedical subjects

M F Spittle

Publications and source records attributed to M F Spittle.

At least 73 records · Page 4Linked to original sources
PubMed1987

A randomized, prospective, comparative, multicentre trial of a single combination versus alternating combinations of antitumour drugs in advanced breast cancer.

A prospective, multicentre trial was conducted in 262 patients with advanced breast cancer randomized to receive every 3 weeks either: (i) a single five-drug combination of adriamycin (50 mg), vincristine (1.5 mg) and 5-fluorouracil (750 mg) given intravenously; with methotrexate (50 mg) intramuscularly and chlorambucil (10 mg) orally all at time zero, followed by three further doses of chlorambucil (10 mg) at 6-h intervals, or (ii) one course of two alternating three-drug combinations consisting of regimen A--vincristine (1.5 mg), adriamycin (70 mg) and methotrexate (50 mg) and regimen B--5-fluorouracil (750 mg) and vindesine (5 mg) intravenously with cyclophosphamide (50 mg) orally at time zero, followed by three further doses of cyclophosphamide (50 mg) at 6-h intervals. Results show that overall response rates to chemotherapy were comparable in the two arms of this study being 63% (83 of 131 patients) for the single combination and 64% (84 of 131 patients) for the alternating combinations. Response rates according to menopausal status indicate no significant difference for the two arms of this study. However overall, combining all patients treated with either the single or the alternating combinations, post-menopausal patients had a significantly lower response rate (57%) compared with pre-menopausal patients (76%), P less than 0.05. Overall serious side-effects were minimal and were similar in both treatment groups. Response durations and overall survival data, which are essentially similar for the two treatment groups, proved disappointing with a median response duration of only approx. 6 months and overall median survival only slightly in excess of 1 year. Alternative treatment approaches are needed to maintain the remissions initially achieved in metastatic breast cancer.

Adult↗
PubMed1986

The treatment of carcinoma of the cervix and poor-risk endometrial carcinoma using the Cathetron at the Middlesex Hospital: experience since 1979.

This study reports on 5 years experience of the treatment of carcinoma of the cervix and poor-risk carcinoma of the body of the uterus using a combination of external beam radiotherapy and high-dose-rate intracavitary 60Co-brachytherapy using the Cathetron since 1979 at the Middlesex Hospital, London. Despite a reduction in external beam dose of 20% since 1979, survival rates for both diseases remain unchanged and also compare favourably with those of other centres; they are 70.02% for carcinoma of the cervix of all stages except Ia, and 81.17% for 'poor-risk' carcinoma of body of uterus of all stages. The complication rates were acceptable. Analysis of the results of treatment by stage of disease in those patients with carcinoma of the cervix revealed that, except for Stage I cases, the results were comparable with those reported in the literature. The reason for the poor results in Stage I was found to be due to the high proportion of patients of 35 years of age and under with Stage I disease who fared significantly worse than older patients.

Age Factors↗
PubMed1986

Immunologic differentiation of the Sézary syndrome due to cutaneous T-cell lymphoma and chronic actinic dermatitis.

Peripheral blood mononuclear cells from two well-defined groups of patients with the Sézary syndrome have been studied employing indirect immunofluorescent and indirect immunogold techniques in light and electron microscopy, using monoclonal antibodies against T-cell subpopulations. Four patients had chronic actinic dermatitis (CAD) of the actinic reticuloid variant, with erythroderma. Eight patients had cutaneous T-cell lymphoma. All patients showed the clinical features of the Sézary syndrome, including erythroderma, palmoplantar hyperkeratosis, and peripheral lymphadenopathy, and in all patients significant numbers (0.5-30.5 X 10(9) cells/liter) of circulating mononuclear cells were observed with Sézary cell morphology on light-microscopic examination of blood films. Major differences were observed in the circulating T-cell subpopulations in the two groups. In the erythrodermic CAD patients, there was a moderately elevated T-cell count (1.6 +/- 0.6 X 10(9) cells/liter; normal, 1.0 +/- 0.3 X 10(9) cells/liter) of which the majority of the cells was suppressor T cells (OKT8+) giving a very low helper:suppressor T-cell ratio of 0.1:1-0.36:1 (normal, 1.7:1-3.5:1). In cutaneous T-cell lymphoma, there was also an elevation of the T-cell count (9.5 +/- 12.9 X 10(9) cells/liter), but in these patients the predominant cell was the helper T cell (OKT4+) with a high helper:suppressor T-cell ratio of 3.7:1-98:1.

Antibodies, Monoclonal↗
PubMed1986

Combination chemotherapy of squamous cell carcinoma of the bronchus with cisplatinum and bleomycin followed by radiotherapy: results of a pilot study.

Thirteen patients were entered into an uncontrolled pilot study to investigate the response to, and toxicity of, a combination of cisplatinum (20 mg/m2) and bleomycin (6 mg/m2) infused daily for 5 days and repeated every 21 days up to a maximum of 4 cycles, in the treatment of squamous cell carcinoma of the bronchus. This regimen was subsequently followed by a split course of local irradiation. All patients have been followed to death. Six patients showed a partial response to chemotherapy while 7 showed no response or progressive disease. The median survival was 5 months. The median survival of the responders was 15 months and that of the nonresponders 3 months. Two patients developed the syndrome of inappropriate antidiuretic hormone secretion from which one died. The longest survivor, who died 26 months after the commencement of chemotherapy, had severe mediastinal and pulmonary fibrosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Adjuvant chemotherapy in the treatment of breast cancer: results of a multicentre study.

248 patients with locally radically treated early breast cancer (196 node-positive) were randomized post-operatively between 6 courses of a 'CMF like' chemotherapy and no further treatment. Results (with a minimum of 5 years follow-up on every patient) favour chemotherapy with a significant increase in the median time to recurrence from 31 to 50 months for all patients (P = 0.04) and from 26 to 49 months for node-positive patients (P = 0.023). No significant effect on survival is seen although there is a trend towards longer survival in the treated group. The regimen used was relatively non-toxic when compared to the traditional CMF with 34% of patients experiencing mild nausea and vomiting immediately post-injection and only 11% complaining of more severe nausea and vomiting. Because of this lower toxicity the treatment was found to be amenable to administration in both regional hospitals and specialized centres.

Adult↗
PubMed1984

Embryonal rhabdomyosarcoma of the hand. A case of mediastinal relapse 103 months after treatment.

A 9-year-old boy was seen to have embryonal rhabdomyosarcoma of his right hand. He was treated with surgery, radiotherapy and adjuvant combination chemotherapy and remained free of disease for 103 months. He then developed signs of upper respiratory tract obstruction and a mass in the superior mediastinum was found. Histopathological and immunohistochemical studies confirmed metastatic embryonal rhabdomyosarcoma. This very unusual, long, relapse-free interval is discussed.

Child↗
PubMed1982

Electron beam therapy for difficult cutaneous basal and squamous cell carcinoma.

Electron beam therapy was used to treat twenty-nine patients with squamous or basal cell carcinomas considered unsuitable for surgery or conventional superficial X-ray therapy. Primary control failed in two patients at 2 and 5 years. Good cosmetic and functional results occurred in all patients treated. The advantages of this therapy in the management of cutaneous tumours which are difficult to treat are discussed.

Basal Cell Carcinoma↗
PubMed1980

A comparison of different treatment regimes on the visual appearance and mechanical properties of mouse skin.

Four different regimes of radiotherapy employed in the treatment of basal cell epitheliomas were compared in order to assess their effect on the visual appearance and mechanical properties of skin. Three groups of mice received exposures identical to those given in the radiotherapy treatments; three months after completion of the radiation the visual and mechanical properties of the skin and its appendages were examined. The skin scarring, coat condition, greying of hair, skin, thickness, load at rupture, extension at rupture, mechanical stress at rupture and stiffness were used as cirteria for comparing the four treatments. The treatment regime which caused the least damage to normal skin was identified.

Animals↗
PubMed1979

Mycosis fungoides: electron beam therapy in England.

Since 1962, total-skin electron-beam therapy has been available in London, England, for the treatment of patients with mycosis fungoides and skin lymphomas. The 6-mev linear accelerator produces a pencil beam of electrons at 7 mev, which are scattered through a brass scatterer and decelerated by either of two carbon decelerators or a copper decelerator to produce a beam of effective energy of 2.5, 3, or 3.5 mev; these beams have an 80% isodose distribution at 5.5, 8, and 11.5 mm, respectively. The patient receives 200 rads to the anterior, posterior, and right and left lateral fields, for a total dose of between 1600 and 2600 ras in ten treatments over 5--7 weeks. Complete clearing of the disease can be predicted in all patients except those with the most advanced tumors. However, the duration of remission after electron-beam therapy is approximately 18 months and we are presently investigating the combination of psoralens and ultraviolet light therapy as maintenance treatment following lower-dose electron-beam therapy.

Humans↗
PubMed1977

Mycosis fungoides. Electron beam therapy.

The most effective treatment of late mycosis fungoides is total skin electron beam therapy. The beam at the Hammersmith Hospital in London has been adapted to treat these patients. Patients with advanced disease who have failed more conservative methods of treatment are irradiated. The electron beam is modified by the use of carbon and copper scatterers to produce an 80 percent depth dose at 5.5, 8 and 11.5 millimeters below the skin surface. The dose achieved in most patients is between 1500 rads and 2600 rads given in 10 to 13 treatments over 5-7 weeks. Recently the higher dose range has been employed and lithium flouride studies have shown that giving these doses from each of 4 fields, the dose achieved on the skin is approximately twice the given dose. The management of patients and the effects of treatment are discussed.

Electrons↗
PubMed1975

Comparison of 5-day, 1-day, and 2-day cyclical combination chemotherapy in advanced breast cancer.

The results of 5-day cyclical combined chemotherapy for advanced breast cancer were compared in two trials with the less demanding 1-day and 2-day regimens. At all stages, except at 3 months, 5-day treatment was significantly more successful in providing regression and remission of tumours than the 1-day regimen. However, although the differences are not statistically significant, data from the second trial indicated that the 2-day regimen tended to be more effective than the 5-day regimen. The lower 95% confidence limit for the success of the 2-day treatment was 56.2% at 3 months.

Antineoplastic Agents↗