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Biomedical subjects

M Westerhausen

Publications and source records attributed to M Westerhausen.

At least 37 records · Page 2Linked to original sources
PubMed1986

Prospective randomized trial concerning hyper- and normoprolactinemia and the use of bromoergocryptine in patients with metastatic breast cancer.

This prospective trial was designed to help in selecting therapy for patients with elevated and normal plasma prolactin. Ninety-two patients entered this trial, of whom 86 were evaluable for final analysis. Hyperprolactinemic patients (n = 31) were randomized to receive VAC/FMC chemotherapy with or without bromoergocryptine. Normoprolactinemic patients with 'low risk' metastatic disease (disease-free interval greater than 30 months, ER/PR positive or unknown) were treated with medroxyprogesterone acetate or VAC/FMC chemotherapy. Normoprolactinemic 'high risk' patients (n = 42) (disease-free interval less than 30 months, EP/PR negative) received VAC/FMC chemotherapy with or without medroxyprogesterone acetate (MAP). The results show that bromoergocryptine does not improve response rate, duration of response and survival. Median survival of patients with elevated basal plasma prolactin (greater than 15 ng/ml) is reduced to 9 months compared to patients with normal basal plasma prolactin (17 months, log-rank p = 0.005). Unexpectedly, TRH stimulation proved inappropriate to separate normo- and hyperprolactinemic patients in terms of survival. Normoprolactinemic 'low risks' (tamoxifen failures) were observed to qualify for further hormone therapy (median survival 21+ months). Normoprolactinemic 'high risks' showed median survival of about 12 months with no apparent benefit for those receiving MAP, additionally. The results suggest that basal hyperprolactinemia, disease free interval, ER/PR receptor status, and liver metastasis are important prognostic variables. Endocrine and cytotoxic chemotherapy should be selected according to these risk factors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Aclarubicin (aclacinomycin A) in the treatment of relapsing acute leukaemias.

Forty patients with relapsing acute leukaemias were treated with aclacinomycin A (aclarubicin, ACM), 25 mg/m2 i.v. daily for 7 days. Twenty-nine patients with acute myeloid (AML) and five with acute lymphoblastic (ALL) leukaemia were evaluable. The overall response rate was 29.5%. Eight complete (CR) and one partial (PR) remissions were achieved in AML (31%). A high CR rate was induced in patients treated at first relapse without prior reinduction (6/12 patients). A small proportion of leukaemias resistant to daunorubicin or doxorubicin responded to ACM (3/17 patients). Median remission duration was 5.5 months (range: 2-9 months). The most common toxic effects were nausea, vomiting, stomatitis and diarrhoea. Acute cardiotoxic effects were documented in three patients. Congestive cardiomyopathy was not observed despite prior treatment with anthracyclines. We conclude that the present dose scheduling of ACM is effective in the treatment of relapsing AML and that it should be introduced in combined chemotherapy in phase III trials to compare its activity to that of daunorubicin or doxorubicin.

Aclarubicin↗
PubMed1984

[3 multicenter phase II studies of the treatment of small cell bronchogenic carcinoma (incl. AIO studies BI + BII)].

Between March 1979 und January 1983 122 patients with small-cell carcinoma of the lung were treated with different polychemotherapy regimen. 33 patients received VP-16-213 (etoposid), ifosfamide and vindesine (VPIV). 37 patients were treated with adriamycin, cisplatin and vincristine (APO). A third 3-drug combination, cyclophosphamide, methotrexate and CCNU (CMCC), was given to the remaining 52 patients alternating with the two other regimen. Response rates varied between 61% for the APO regimen and 85% for the VPIV regimen. The median survival was 10 months for patients treated with VPIV or APO and 12 months for patients treated with alternating drug combinations. This difference was not statistically significant. The rate of long-term survivors (longer than 2 years after diagnosis) was 9.9%. Side effects were seen more frequently in the group treated with APO.

Adolescent↗
PubMed1984

[Phase II study of the water-soluble nitrosourea compound ACNU in advanced colorectal carcinomas].

In a phase-II study 46 patients with advanced colorectal cancer were treated with the new nitrosourea ACNU [1-(2-chloroethyl)-1-nitroso-3 (4-amino-2-methyl-5-pyrimidinyl)methyl-3-nitrosourea]. From 43 evaluable patients, 86% presented distant metastases and 14% an unresectable primary tumour or a recurrent tumour. 24 patients presented a colon and 19 a rectal cancer. Prior anticancer drug treatment was given to 34 patients (79%), 11 (26%) were pretreated with a nitrosourea. ACNU was administered every 4-6 weeks as a single intravenous push injection of 100 mg/m2. Most patients received 2-3 courses. From 43 evaluable patients, one patient achieved a complete and 3 a partial remission (CR + PR 9%). 5 patients reached a minimal regression (tumour regression of less than 50%) and 5 a no change for at least 2 months. The median duration (time from beginning of ACNU therapy until tumour progression) of the 14 responders was 132 days. The median survival time was significantly longer for responders in comparison to patients with progressive disease (9.8 versus 4.1 months). The dose limiting toxicity was delayed bone marrow suppression predominantly in the form of thrombocytopenia. 22/42 patients (52%) presented a thrombocytopenia of under 50.000/mm3 with a nadir after 27 days. Leucocytopenia under 2.000/mm3 were observed in 22/40 patients (30%). A fall of haemoglobin of more than 2 g/dl was seen in 71%. Nausea or vomiting over 1-2 days were found in 59% of the treatment courses. Other drug related side effects were not encountered. ACNU has a similar activity in colorectal cancer as BCNU and CCNU.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1983

[Etretinate (Ro 10-9359, Tigason) and CCNU (1-(2-chloroethyl)-3-cyclohexyl-l-nitrosourea) and bleomycin versus CCNU and bleomycin in the treatment of advanced squamous cell carcinoma of the bronchus (Working group on Internal Medicine Oncology Study BS1/78)].

Forty-six evaluable patients with advanced squamous cell carcinoma of the lung were treated in a randomized fashion with either etretinate, CCNU and bleomycin in combination (ECB) or with CCNU and bleomycin (CB). There were no complete and no partial responses. Minor responses occurred in 5 patients (24%) with ECB and in 3 patients (12%) with CB independently of histological grade. No change was observed in 9 patients (43%) with ECB and in 13 patients (52%) with CB. There was no survival difference between the two groups. Reversible side-effects of skin and mucous membranes were more frequent under ECB. The antitumor efficacy of CB is marginal and could not be improved by the addition of the vitamin-A-derivative etretinate.

Adult↗
PubMed1983

[2d interim evaluation of a chemotherapy study on patients with squamous cell carcinomas of the head-neck area. A comparison of 2 therapy regimens: cis-diamminedichloroplatinum (II) and bleomycin versus methotrexate and vindesine].

52 patients with epidermoid cancer of the head and neck region were either treated with cis-DDP and bleomycin (arm A) or with methotrexate and vindesine (arm B). In case of resistance patients were further treated with the alternative regimen (A leads to B or B leads to A). Treatment results are superior in arm A. Complete and partial remission were in A: 54%, in B: 31%, after crossover 46% and 0%, respectively. Status of pretreatment (operation and/or radiotherapy) is of minor importance for arm A than for the "soft" treatment of arm B. Preliminary analysis of survival and remission duration shows no significant difference in regard to A or B and status of pretreatment. However, those patients resistant to B and further treated with A have an increase of median survival from 3 to 9 months (p = 0.02). With primary chemotherapy inoperable tumors can be made operable with curative intention.

Adult↗
PubMed1983

[Therapeutic results in advanced ovarian cancer].

From 1977 to 1981 39 patients with advanced ovarian carcinoma (stage III, IV, and relapses) were treated at the department of oncology. From 1977 to 1979 we followed to a great extent the ECOG protocol (EST 2875) which means combination chemotherapy by alternating cycles. Since 1980 we used for treatment the PAC I regimen. There was no obvious difference between the therapeutic results of regimen 1 (MTX/Thio followed by 5FU/CTX) and regimen 2 (MTX/Thio followed by VCR/ADM/5FU/CTX). The greatest complete remission rate (confirmed by a second-look laparotomy) was obtained by regimen 3 (PAC I). In 8 cases PAC I was used as a second line treatment. Only 3 partial remissions were seen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

[Alternative treatment with carmustine, vindesine and tamoxifen in previously cytostaticly (VAC, FMC) treated patients with metastatic breast cancer].

Looking for an alternative treatment for patients with advanced breast carcinoma resistant to the common treatment regimens, vindesine, carmustine (BCNU) and tamoxifen were used for further treatment. 27 patients were admitted to a two-step-treatment-schedule including a step I with tamoxifen alone and a step II with vindesine, carmustine and tamoxifen. Within the step I with tamoxifen 7 of 14 patients (50%) and within the consecutive step II with vindesine, carmustine and tamoxifen 4 of 20 patients (20%) responded to this regimen. The mean duration of the response was + 7.4 and + 9.0 months, respectively. The results suggest that effective palliation is still possible in some patients suffering from progressive disease after therapy with vincristine + adriamycin + cyclophosphamide and 5-fluorouracil + methotrexate + cyclophosphamide.

Adult↗
PubMed1982

[Clinical aspects of monoclonal gammopathies in diseases of the lympho-plasmacytic cell system].

Paraproteinemias can be subdivided in 1. obligatory paraproteinemias (myeloma, macroglobulinemia, heavy chain diseases); 2. accompanying paraproteinemias (Non-Hodgkin's lymphomas, myeloproliferative diseases, immune deficiency diseases, autoimmune diseases, transitory paraproteinemias after infection, paraproteinemias in association with nonlymphatic neoplasms); 3. benign paraproteinemias: a) with symptoms (primary amyloidosis, chronic cold agglutinin disease, paraproteinemias with further autoantibody function, monoclonal cryoglobulinemia); b) asymptomatic forms. Myeloma is the most common type of obligatory paraproteinemias. Characteristic findings are: Paraproteinemia and/or paraproteinuria in 98%, increase of plasma cells in the bone marrow in 84%, alterations in the roentgenograms of the skeleton in 79%. Clinical staging is of importance for the prognosis (amount of paraproteins, Hb level, renal disease, hypercalcemia, lytic lesions of bone). Neurologic complications, hemostasis dysfunction, cryopathies may be other symptoms. The terminal phase of the disease is determined by plasma cell proliferation, immune deficiency and renal disease or myelomonocytic leukemia. As to Non-Hodgkin's lymphomas the accompanying paraproteinemia is to be found in immunocytomas and in CLL. At last it has to be mentioned that B-cell disorders will influence the T-cell populations and vice versa.

Antibodies, Monoclonal↗
PubMed1981

Comparison of ftorafur with 5-fluorouracil in combination chemotherapy of advanced gastrointestinal carcinoma.

The aim of the study was to compare the combination 5-FU-carmustine with ftorafur-carmustine in the treatment of advanced gastrointestinal cancer. To this end, a prospective, multicenter, randomized trial was initiated. Part I of this trial showed that similar response rates can be obtained with 5-FU-carmustine and ftorafur-carmustine in 109 patients (32.7% versus 26.3%). However, median survival was better in patients treated with 5-FU-carmustine (307 days versus 163 days). Part II of the trial revealed that neither a higher dosage of ftorafur (2 g/m2/day X 5 days) nor the addition of vincristine to both regimens changed the previously obtained results significantly. Again, median survival was found to be better in patients treated with 5-FU combination chemotherapy (304 days versus 144 days). Both the 5-FU and the ftorafur combination were tolerated reasonably well. The results suggest that combination chemotherapy including 5-FU is superior to ftorafur at the applied dosages in terms of survival.

Adult↗
PubMed1981

Immunological changes following posttraumatic splenectomy.

In 31 splenectomized individuals blood lymphocytes and serum immunoglobulins were examined 1-11 years after splenectomy. The results demonstrate: 1. Increase of the surface immunoglobulin bearing lymphocytes. 2. Reduction of the E-rosette forming lymphocytes, especially in a combined test assay. 3. Reduction of serum IgM. A surface-restoring effect of the RES of the spleen is discussed as a reason for the diminished E-rosette formation in splenectomized individuals.

Adolescent↗
PubMed1980

[Treatment of severe febrile neutropenia (author's transl)].

Random allocation of 22 patients with benign and malignant diseases with neutrophil counts of up to 1 X 10(9)/l blood and probably infection-caused fever of more than 38 degrees C to intravenous treatment with one of the following antibiotic combinations was performed: carbenicillin (6 g/m(2) . 6 h) plus sisomicin (45 g/m2 . 6 h) or mezlocillin (3 g/m2 . 6 h) plus sisomicin (45 g/m2 . 6 h). Both combinations were tolerated equally well. Patients became afebrile in 16 out of 23 treatment periods. Seven out of 11 patients responded to carbenicillin - sisomicin, and 9 out of 12 to mezlocillin - sisomicin. Mezlocillin thus leads to equal success of treatment in febrile neutropenia as the double dose of carbenicillin when both antibiotics are combined with the same aminoglycoside.

Agranulocytosis↗