Biomedical subjects
Publications and source records attributed to M Posner.
Multimodality therapy has not reproducibly improved the survival of patients with gastric adenocarcinoma. This is largely because the staging of disease has been imprecise and because the current regimens have only limited efficacy against advanced disease. Until staging is improved and active regimens are found, it will be difficult to identify synergism between surgery and other treatment modalities.
Carcinoma of the pancreas has an especially grim prognosis. Only 1-3% of patients survive for 5 years. Radical pancreaticoduodenectomy, especially for minimal disease, is currently the only chance for cure. While radiation therapy does not improve overall survival, it may improve local control following radical resection and decrease pain in locally advanced cancers. Although chemotherapy has led to significant improvements in survival in patients with locally advanced disease, the overall effect is small. When surgery, radiotherapy, and chemotherapy are administered to localized carcinomas in randomized, prospective trials, survival is significantly lengthened. Similar trials in locally advanced, unresectable pancreatic cancer also confirm the concept of synergistic interaction between therapies. Thus, pancreas carcinoma is one neoplasm where multimodality therapy has had a demonstrable, although small effect.
Explore the source record for details and available documents.
Twenty-nine of 32 patients with advanced squamous cell carcinoma of the head and neck were treated with two courses of an intensive chemotherapy regimen consisting of cisplatin, bleomycin, and methotrexate (PBM). The frequency of toxic effects (in 29 evaluable patients) associated with this regimen was low. Serious neutropenia occurred in 17% and thrombocytopenia in 10% of the courses. Nausea (50%) and severe vomiting (6%) were easily managed. All 26 (100%) evaluable patients with squamous cell carcinoma had significant reduction (less than 50%) of measurable tumor. Complete regression was noted in seven patients (27%). Fifteen patients were treated with PBM prior to receiving radiation therapy or surgery as definitive treatment for their disease. Antitumor response in these patients was rapid, occurring within 3 weeks from the initiation of chemotherapy. Maximal antitumor effect was achieved by Week 6 of induction chemotherapy. No patient showed tumor regrowth prior to the institution of radiation therapy or surgery. Twelve patients with recurrent disease following previous radiotherapy and/or surgery also received PBM chemotherapy. In our study, previous radiotherapy or surgery did not diminish the antitumor effect of PBM, but toxicity was more severe.