Search PubMed⌕ Search

Biomedical subjects

M L Samuels

Publications and source records attributed to M L Samuels.

At least 55 records · Page 3Linked to original sources
PubMed1982

The management of brain metastases in germ cell tumors.

Twelve patients, with brain metastases from germ cell tumors were treated with combined whole brain irradiation and systemic chemotherapy. Two prognostic categories were identified. Patients with single brain metastases had a mean survival of 29.9 months, while patients with multiple brain lesions had a mean survival of 13.7 months. Four of the six patients with single brain lesions remain alive at 13, 14, 35 and 41 months following the clinical diagnosis of brain metastasis. The improved survival among patients with single lesions can be attributed to the sensitivity to chemotherapy of their tumors. Meningeal carcinomatosis, a previously unreported complication of metastatic germ cell tumor, developed in two patients who were initially treated for single brain metastasis. Both patients developed a clinical picture suggesting meningeal invasion by tumor and both had cytologic evidence in the cerebrospinal fluid of malignant cells.

Adult↗
PubMed1982

Serum lactate dehydrogenase isoenzyme 1 in patients with advanced testicular cancer.

Abnormal levels of serum lactic dehydrogenase-1 (LD-1) activity have been observed in 81% (34/42) of patients with stage III germ cell malignancy of the testis. The criteria for evaluation the electrophoretic isoenzyme patterns of these patients were, as follows: For criterion 1 elevations the LD-1 value in absolute units was greater than 52.0 U/I with the LD-1/Total LD ratio greater than 37.2%. Criterion 2 elevations had absolute values of LD-1 less than 52.0 U/I, but the LD-1/Total LD ratio was greater than 37.2%. For criterion 3 elevations of LD-1, the absolute value was greater than 52 U/I and the LD-1/Total LD ratio was less than 37.2% activity with the LD-5/LD-1 ratio less than 0.5; or when the LD-5/LD-1 ratio was greater than 0.5 but the LD-1 is equal to or greater than the LD-2. The frequency of LD-1 elevation correlated well with the extent of the disease (stage II-B-1 and 2, 50%; stage III-B-3, 86%; stage III-B-4, 91%; stage III-B-5, 93%). LD-1 elevation occurred in groups I, II, IV and V histopathologic cell types (Dixon and Moore Classification) and there did not appear to be any correlation between the histologic cell type and the frequency of elevation of LD-1. Interpretation of LD-1 activity only on the basis of its relative ratio to the total LD value (criterion 1 and 2) identified a total of 28 patients (67%). A criterion 3 elevation was demonstrated in 6 (14%) additional patients. All patients with persistent elevations or recurrent elevations of LD-1 have shown progressive or recurrent disease and patients with no clinical evidence of disease have demonstrated normal LD-1 values. In those patients with elevated LD-1 activity, serial measurements of serum. LD-1 isoenzyme reflect the response of the patient to therapy.

Choriocarcinoma↗
PubMed1982

Management of pelvic complications of malignant urothelial tumors with combined intra-arterial and iv chemotherapy.

Twenty-nine patients with local-regional pelvic recurrences of malignant urothelial tumors were treated with combined intra-arterial and iv chemotherapy. 5-FU (1 g/m2) was infused daily for 5 days via bilateral percutaneously placed hypogastric catheters. Doxorubicin (25 mg/m2) was infused iv on Days 1 and 2 and mitomycin (5 mg/m2) was infused iv on Days 3 and 4 of each course. Seventeen patients (58%) demonstrated an objective decrease in the size of the pelvic mass. All four patients with one of the adenocarcinoma variants of malignant urothelial tumors responded to therapy, while the three patients with squamous transformation of a transitional cell carcinoma failed to respond. The median survival of the responding patients was significantly longer (52 weeks) than that of nonresponding patients (28 weeks) (P = 0.002). Patients with initial low-volume pelvic disease demonstrated durable control of local residual tumors, with four of six patients having negative repeat cystoscopic examinations.

Adenocarcinoma↗
PubMed1982

Doxorubicin, mitomycin, and 5-FU (DMF) in the treatment of hormone-resistant stage D prostate cancer: a preliminary report.

Fifteen patients with advanced stage D hormone-resistant prostate cancer were treated with the combination of doxorubicin, mitomycin, and 5-FU. Nine patients (60%) had objective responses, with a mean duration of 27.9 weeks. No responding patient had relapsed. Although three patients developed a culture-negative leukopenic fever, no deaths from chemotherapy occurred. Preliminary results with doxorubicin, mitomycin, and 5-FU indicate that this is a very effective chemotherapy regimen, resulting in a high objective response rate in metastatic prostate cancer.

Adenocarcinoma↗
PubMed1981

Chemotherapy of carcinoma of renal pelvis: preliminary report.

Seven patients with metastatic and/or recurrent transitional cell carcinoma of the renal pelvis treated with systemic chemotherapy are evaluated. The median age of the patients was fifty-five; 6 were men, 6 of the tumors were histologic grade III and Stage C at the time of nephroureterectomy. Most of the patients presented with a large recurrent mass at the original site of surgery in addition to bone and/or pulmonary metastases. Four patients were treated with CISCA combination chemotherapy (cis-platinum, cyclophosphamide, and doxorubicin), and responded with 1 partial remission, 1 less than partial remission, and 2 symptomatic improvement. Two patients were treated with FAM combination chemotherapy (5-fluorouracil, doxorubicin, and mitomycin C) and demonstrated an objective response. One patient had a less than partial remission (30 per cent) and the second patient a partial remission. The seventh patient was treated with alternating courses of CISCA and FAM and thus far has received 8 courses and is in complete remission. The median survival time of the 7 patients is seven months (range four to fourteen months). Transitional cell carcinoma of the renal pelvis is responsive to chemotherapy; therefore, trials are indicated.

Aged↗
PubMed1980

High-dose combination chemotherapy with autologous bone marrow transplantation in adult solid tumors.

In order to determine whether high-dose combination chemotherapy was active in chemotherapy resistant patients, 19 patients, (9 with small cell bronchogenic carcinoma, 6 with embryonal cell carcinoma, 2 with diffuse histiocytic lymphoma, 1 with Hodgkin's disease and 1 with chondrosarcoma), 18 of whom had had extensive prior chemotherapy and failed, received 23 courses of high-dose chemotherapy with autologous bone marrow infusion (ABMT). Three patients received four courses of cytoxan (2-6 g/m2) and VP-16 (500-600 mg/m2) and 16 patients received 19 courses of cytoxan and VP-16 in these doses plus BCNU (300 mg/m2). Activity was observed in 6 of 8 evaluable small cell bronchogenic carcinoma patients (1 complete response (CR), 4 partial responses (PR), 1 less than PR), in 6 embryonal cell carcinoma patients (3 CR, 2 PR, 1 less than PR), in both patients with diffuse histiocytic lymphoma (1 CR, 1 less than PR), in the patient with Hodgkin's disease (1 PR); and in the patient with chondrosarcoma (stable). Only 2 patients who had received prior cytoxan and VP-16 extensively showed resistance to these programs. The median response duration was 11 weeks (range = 4-55 + weeks). Major toxicity consisted of bacterial infections. Two patients died from treatment related causes. Neutrophils recovered to levels of greater than or equal to 1.5 x 10(9)/liter by days 20-42 (median, day 27) and platelets to levels of greater than 100 x 10(9)/liter by days 21-56 (median, day 32) without any delayed BCNU toxicity. High-dose combination chemotherapy with ABMT causes acceptable toxicity and high response rates of relatively short duration in tumors refractory to conventional chemotherapy.

Adult↗
PubMed1980

Mixed mesodermal tumors of urinary bladder: prognosis and management.

Three cases of mixed mesodermal tumors of the urinary bladder characterized by the simultaneous occurrence of malignant epithelial and mesenchymal elements in the same tumor are reported. Integrated therapy consisting of preoperative radiotherapy followed by radical cystectomy is recommended. Chemotherapy is best withheld until the nature of any metastatic disease has been confirmed histologically in order that the appropriate drugs can be administered.

Aged↗
PubMed1980

Adjuvant therapy of testis cancer: the role of vinblastine and bleomycin.

We studied 37 patients with testis cancer who received adjuvant chemotherapy with vinblastine and bleomycin. These patients included 5 with stage III disease who were down staged by a surgical procedure and 32 with stage II disease. Of the 32 patients 26 had stage IIB tumors, showing gross nodal disease. There have been 4 deaths, 2 of disease and 2 as a result of therapy. The remaining patients are free of disease and the estimated 5-year survival is 85 per cent.

Adolescent↗
PubMed1980

Ewing sarcoma: its course and treatment in 50 adult patients.

34 patients were treated for Ewing sarcoma with primary presentation. There were 10 females and 24 males with average age of 21 years (range 16-36 years). These patients received radiotherapy (greater than 5,000 R) to the primary site and combination chemotherapy with vincristine, cyclo-hosphamide, doxorubicin and actinomycin D. Of 19 patients with primary presentation in an extremity, 12 remain alive at 29 months without clinical evidence of tumor (63%); 2 patients are alive with relapse. All 10 patients with primary presentation in the pelvis died despite vigorous treatment. 3 patients are alive out of 5 patients with primary presentation in chest or abdominal wall or axilla but only 1 patient remained tumor-free. Of the entire group of 34 patients, 12 remained tumor-free at 27 months (35%). 2 relapsed patients were rendered surgically tumor-free and receive further treatment. 20 patients died or are receiving treatment for advancing disease. 16 patients were treated for locally recurrent (1 patient) or metastatic (15 patients) Ewing sarcoma. There were 6 females and 10 males (average age 24.7 years). These patients received palliative radiotherapy and combination chemotherapy with vincristine, cyclophosphamide, doxorubicin, actinomycin D and dacarbazine. At 36 months, 3 patients are alive tumor-free and 1 patient is alive with stable disease. 12 patients died, 2 after temporarily achieving complete remission.

Abdominal Neoplasms↗
PubMed1979

Management and results of localized Ewing's sarcoma.

Seventy-six patients with localized Ewing's sarcoma who received primary treatment at M.D. Anderson Hospital from 1948 through December 1975 were reviewed. Patients have been divided into four groups according to the different treatment regimens they received: Group I, moderate dose radiotherapy alone; Group II, high dose radiotherapy alone; Group III, radiotherapy plus vincristine and cytoxan; and Group IV, radiotherapy plus vincristine, Adriamycin, cytoxan and actinomycin. The problem of local recurrence appears to be solved with combined chemotherapy and radiation therapy with only one of 36 patients having a recurrence at the primary site in Groups III and IV. Multimodal therapy is the preferred treatment to obtain control of the primary lesion by radiation therapy while preserving good function. However, the major cause of failure remains distant metastases, 19 of 36 (53%) in Groups III and IV. In addition, 4 of 10 patients who have survived over 5 years have developed osteogenic sarcoma.

Antineoplastic Agents↗
PubMed1978

Chemoimmunotherapy of small cell bronchogenic carcinoma.

Thirty-one patients with small cell bronchogenic carcinoma were treated with a regimen of cyclophosphamide, Adriamycin and vincristine. Radiotherapy was given to patients with limited disease. Nonspecific immunotherapy consisting of BCG scarification was administered after each chemotherapy course. The results of treatment for this group were compared with those for a group of 45 patients treated similarly but with no immunotherapy. Therapeutic results, expressed in length of survival and rate of response, were similar. Myelosuppression was not modified by the addition of BCG scarification. This study showed no benefit from the use of such nonspecific immunotherapy.

Adult↗
PubMed1977

Combination chemotherapy and radiation therapy for small cell carcinoma.

A three-drug combination of the chemotherapeutic agents cyclophosphamide, vincristine sulfate, and doxorubicin hydrochloride was given to 45 patients with small cell bronchogenic carcinoma. In addition, patients with limited disease received radiation therapy to the primary tumor. The complete response rate was 44%, with a median survival of 50 weeks. The partial response rate was 29%, with a median survival of 35 weeks. Patients who did not respond to therapy showed a median survival of only 12 weeks. Twenty percent of the patients had their first recurrence in the brain, and the median survival from the time of disease recurrence was ten weeks. Bone marrow metastasis was encountered in 24% of the patient population, but this did not adversely affect survival.

Brain Neoplasms↗
PubMed1977

Survival with inoperable lung cancer: an integration of prognostic variables based on simple clinical criteria.

The objectives are to identify and integrate through regression analysis those fundamental clinical variables predicting survival of patients with inoperable lung cancer managed in a modern setting. Median survival time from first treatment in 129 patients with limited disease and 187 patients with extensive disease was 36 and 14 weeks, respectively. Within the proposed survival model for limited disease, weight loss was the major prognosticator followed by symptom status, supraclavicular metastases, and age. Within extensive disease, symptom status and age were dominant variables followed by weight loss and metastases to liver, opposite hemithorax, brain, and bone. Survival by cell type was similar within the limited and extensive disease groups. The data identify the essential factors which must be controlled or accounted for in studies analyzing survival as a dependent variable.

Age Factors↗
PubMed1977

Treatment of multiple superficial tumors of bladder with intravesical bleomycin.

Twenty-six patients with superficial Stage O or A transitional cell carcinoma of the urinary bladder, whose lesions were not amenable to transurethral resection, received bleomycin sulfate intravesically at weekly intervals for eight treatments. Five different drug regimens were tried, and the optimal concentration appeared to be 60 units dissolved in 30 cc. of sterile water. Serum determinations failed to reveal any significant absorption. There was a 27% complete response rate in patients with small tumor burdens. An additional 9% had partial responses which allowed the tumors to be readily managed transurethrally. However, no patients with extensive superficial tumor showed complete response to therapy. Although belomycin used intravesically is active against transitional cell carcinoma, the current cost of the drug precludes its routine use and restricts it to situations in which other agents are contraindicated.

Adult↗
PubMed1977

Complexity of branching dendritic trees: dependence on number of trees per cell and effects of branch loss during sectioning.

We have investigated whether the complexity of dendritic trees is correlated with the number of primary dendrites per neuron (trees per cell). In estimating the average number of branches of centrifugal orders 1-5 per tree we used statistical methods to compensate for loss of parts of trees during sectioning. Limitations of these methods are discussed. Neurons from four populations, stained by the Golgi-Cox method, were examined: stellate cells from layer IV, area 17 of visual cortex, in normal and dark-reared cats; the pyramidal cells from layer V, somatosensory cortex, in two strains of rats. In all four groups of neurons the average number of branches of higher orders (3, 4, 5) per tree tended to be smaller in neurons bearing more trees. Thus all trees from a population of neurons should not be assumed to be equivalent. The decreasin high-order branches per tree tended to offset the increase in number of trees per cell. In three of the four groups these opposed tendencies maintained the average number of high-order branches per neuron nearly independent of the number of trees per cell. Natural selection may have favoured near-constancy in the number of high-order branches to reduce dispersion among neurons of one type in functional input-output rleations.

Animals↗
PubMed1977

Random censoring and dendritic trees.

The motivating problem is the estimation of the branching parameters of dendritic trees when some of the branches are cut. A primary element of this problem is the estimation of a bivariate discrete distribution when, because of partial censoring, some of the observations are incomplete. (This is similar to the problem of a multinomial cross-classification with supplemental partially cross-classified data.) Tests for randomness of censoring and estimators of parameters under random censoring are derived. The results on random censoring are applied in the dendritic tree context to obtain estimators for certain branching and cutting parameters. The testing and estimation procedures are applied to a set of dendritic tree data.

Dendrites↗
PubMed1976

Large-dose bleomycin therapy and pulmonary toxicity. A possible role of prior radiotherapy.

Bleomycin sulfate pulmonary toxicity was encountered in nine of 101 patients receiving high-dose therapy for widespread testicular cancer. The pulmonary presentation was separable into two categories: (1) an early or minimal from with dyspnea on exertion, minimal roentgenographic findings, and normal arterial partial pressure of oxygen at rest and (2) a severe form, with prominent roentgenographic findings and hypoxemia at rest. All five patients with the severe form died, while the remaining four patients with the minimal presentation recovered. Prior thoracic radiotherapy appeared to predispose to bleomycin pulmonary toxicity, as this complication developed in five of 12 patients receiving prior chest radiotherapy vs four of 89 not receiving radiotherapy (p less than .001). The fatality rate of 5% with high-dose bleomycin therapy is acceptable in view of the 75% response rate and substantially improved survival achieved with bleomycin combination chemotherapy in metastatic testicular cancer.

Adolescent↗