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Biomedical subjects

O Alfthan

Publications and source records attributed to O Alfthan.

At least 37 records · Page 2Linked to original sources
PubMed1991

Hormone-resistant metastatic prostate cancer. Comparisons between estramustine phosphate and low-dose epirubicin treatments.

We compared the effect and toxicity of estramustine phosphate and weekly low-dose epirubicin in a prospective randomized trial in 41 patients with metastatic prostate cancer refractory to hormonal manipulation. No significant difference between treatment modalities was seen. Palliation was reached in over 60% of patients. The median survival was 15 months in both groups. Toxicity was mild. Further, we investigated the effect of epirubicin after the failure of preceding estramustine phosphate therapy in additional 20 patients. Pain relief was achieved in 50% of these patients. The median survival was 10 months. Toxicity was acceptable.

Aged↗
PubMed1990

Efficacy of orchiectomy versus high dose polyoestradiol phosphate (160 mg) in relieving infravesical obstruction in patients with prostatic cancer.

Post voiding residual urine volume (78 patients) and maximum urinary flow rate (59 patients) were measured in prostatic cancer patients treated by orchiectomy or oestrogen (polyoestradiol phosphate 160 mg i.m. monthly) to compare the effects of these endocrine treatments on bladder outlet obstruction caused by prostatic carcinoma. The relieving effect of orchiectomy seemed to be more apparent than that of high dose oestrogen during the first six months of therapy.

Aged↗
PubMed1990

Comparison of primary orchiectomy and polyoestradiol phosphate in the treatment of advanced prostatic cancer. Finnprostate Group.

The primary clinical efficacy of orchiectomy and polyoestradiol phosphate (PEP) 160 mg/month i.m. was evaluated by progression and cancer mortality rates in a Finnish multicentre study comprising 200 prostatic cancer patients. After the minimum follow-up time of 2 years there was a significant difference between the groups--orchiectomy delayed progression of the disease more effectively. The follow-up time is rather short for prostatic cancer, but on the basis of this preliminary study the dose of PEP seems to be insufficient in the treatment of advanced prostatic cancer.

Aged↗
PubMed1990

The effect of parenteral estrogen versus orchiectomy on blood coagulation and fibrinolysis in prostatic cancer patients.

The effects of parenterally given polyestradiol phosphate (80 or 160 mg i.m. monthly) and bilateral subcapsular orchiectomy on blood coagulation and fibrinolytic parameters were compared in 11 patients with prostatic carcinoma. Estrogen therapy lowered antithrombin III, plasminogen and plasminogen activator inhibitor activities, whereas these parameters remained unchanged in orchiectomized patients. There were no significant changes in platelet count, fibrinogen, factor VII, protein C and alpha 2-antiplasmin in either group. Estrogen had unfavorable effects on hemostatic laboratory parameters in the direction of a hypercoagulable state. However, no thromboembolic complications were encountered.

Aged↗
PubMed1990

Effects of orchiectomy and polyestradiol phosphate therapy on serum lipoprotein lipids and glucose tolerance in prostatic cancer patients.

In 17 prostatic cancer patients, changes in the plasma lipoprotein pattern, including high density lipoprotein (HDL) subfractions, and in glucose tolerance were compared after 6 months on parenteral polyestradiol phosphate (PEP; Estradurin, 80 or 160 mg/month) with the respective changes in orchiectomized patients. In the estrogen group there was no change in the total serum cholesterol level, whereas in the orchiectomy group an increase of 10% was observed. Estrogen therapy resulted in a significant increase of serum HDL (11%) and HDL2 cholesterol (26%) levels; in the orchiectomy group these fractions remained unchanged. Estrogen therapy induced a significant decrease in total serum triglycerides (24%) and in low density lipoprotein triglycerides (27%); in the orchiectomy group reverse changes were observed. PEP treatment caused changes in the serum lipoprotein pattern, which apparently decreases the risk of atherosclerosis.

Aged↗
PubMed1990

Evaluation of principles in intravesical chemo- and immunotherapy for superficial bladder cancer.

There is still much controversy about the diagnostics and therapy of carcinoma in situ (TIS/CIS) of the bladder. Reliance on cytological possibilities in the primary diagnosis and grading varies in separate centres. Hence, the small series published hitherto are often incomparable due to different start points and end points of trials. We regard cytology as the key examination in TIS. Complete response (CR) and progressive disease (PD) are end points which can be defined by histology/cytology and the timer factor. Our philosophy concerning the evaluation of therapy-principles in superficial bladder cancer is mainly based on our own experience. The efficacy of MMC and of BCG was equally modest in the Finnbladder I study: the CRs 38% and 40%; the PDs 8% and 20%, respectively. The interim of the ongoing Finnbladder II study are more promising after 6 months follow-up: the CR with MMC 67% and with alternating therapy with MMC and BCG 80%; there were no progressions so far. The primary grade of TIS has been a significant prognostic factor for instillation therapy in our earlier series of 62 pts since 1976. There were no progressions of grade I but 19% of grade II and 13% of grade III. A wide consensus of concepts dominates as to the superficial bladder cancer (Ta-T1). The recurrence rate (RR) and the recurrence index (RI/m) as the end points of prophylactic trials are capable of indicating the recurrence-preventive efficacy of different instillations, allow the use of a patient as his own control, and are suitable for statistical evaluation (table I).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗
PubMed1988

Pretreatment plasma levels of testosterone and sex hormone binding globulin binding capacity in relation to clinical staging and survival in prostatic cancer patients.

Pretreatment plasma concentrations of total testosterone (T), sex hormone binding globulin binding capacity (SHBG). T/SHBG ratio, and free testosterone (fT) were measured in 123 patients with prostatic cancer categorized into groups according to the UICC classification. The patients were randomized to orchiectomy or estrogen therapy and the mean follow-up time was 48 months. The mean plasma levels of T were higher in patients without metastases and with intracapsular cancer, but the differences were not statistically significant. The calculated ratio of T/SHBG was noticed to be significantly higher (p less than 0.05) in the M0 category. The prognostic significance of pretreatment T and, more impressively, T/SHBG ratio and fT was confirmed. Low pretreatment values indicated poorer prognosis. This study supports the view that there are differences in the pretreatment T and fT levels in prostatic cancer patients in relation to the stage of tumor and that these hormone assays could be used as prognostic factors.

Aged↗
PubMed1988

Aminoglutethimide for advanced prostatic cancer resistant to conventional hormonal therapy.

Aminoglutethimide (AG) and hydrocortisone (HC) were given to 20 patients with advanced prostatic cancer resistant to conventional hormonal therapy. Most patients had painful bone metastases and were heavily pretreated. 12 of 16 patients required narcotic analgetics. 8 of 20 were bedridden. AG + HC produced relief of bone pain in 12 patients (75%) and only 4 required narcotics after treatment. The performance status improved in 8 of 20 patients (40%). However, the number of bone metastases seen in bone scans decreased in only 4 patients (22%). The level of serum alkaline phosphatase decreased in 11 of 18 patients and that of acid phosphatase in 8 of 16 patients. The reduction of bone pain lasted approximately 4 months (range 1-15 months). The median lifespan between the start of AG treatment and death was 8 months (range 2-22 months). There was no difference in survival between responders and nonresponders. 3 patients had skin rash, 1 lethargy and 1 thrombocytopenia.

Aged↗
PubMed1988

Intracavernous self-injection for erectile failure.

Thirty-three patients with erectile failure were taught to self-inject papaverine intracavernosally. The dose was from 15 to 80 mg. Phentolamine was added if 80 mg was not sufficient. The patients kept a diary on the effects of the regimen, and also filled out a questionnaire after a follow-up of 4-16 months. The results showed that 55% were satisfied with the method. However, technical difficulties were common. Sexual stimulation turned out to be very important resulting in varying erections on consecutive occasions with the same papaverine dose. Prolonged erection occurred once in 5 patients and was easily handled conservatively in all. Fibrous plaques developed in 2 patients. Twelve patients (36%) stopped the injections for various reasons. When failure occurred the disappointment was usually severe. Thus, the selection of patients for self-injection is important.

Adult↗
PubMed1988

Comparison of endocrine and radiation therapy in locally advanced prostatic cancer.

151 patients with locally advanced prostatic cancer (T3-4 M0), representing 38% of the 404 cancer patients in a Finnish multicenter study, were randomly assigned to one of three treatment arms: orchiectomy, estrogens or radiotherapy. During the 4-year follow-up period there were no significant differences in the progression rates (appearance of metastases in bone scan) between the therapy groups. The frequency of thromboembolic and other cardiovascular complications was highest in the estrogen group (13/50 patients). In the radiotherapy group, 19 of 45 patients had bowel or bladder complications. On the other hand, orchiectomy has few, if any, complications. The high risk of complications associated with estrogens and radiotherapy has to be taken into consideration in the selection of treatment.

Adenocarcinoma↗
PubMed1988

Orchiectomy, estrogen therapy and radiotherapy in locally advanced (T3-4 M0) prostatic cancer.

In this randomized trial 151 patients with locally advanced prostatic carcinoma (T3-4 M0) were treated with orchiectomy, estrogens or radiotherapy. In comparison of these therapy modalities attention was paid to the progression free survival and to the complications associated with these therapies. There was no significant difference in the progression free survival during the four-year follow-up period. The frequency of cardiovascular complications was highest in the estrogen group, where 13 of 50 patients had 19 complications. In the radiotherapy group 19 of 45 patients had bowel or bladder complications.

Adenocarcinoma↗
PubMed1988

Pretreatment hormone levels in prostatic cancer.

Pretreatment plasma concentrations of total testosterone, prolactin, and total estradiol-17 beta (E2) were measured in 123 prostatic cancer patients who were categorized into groups according to the UICC classification. Patients with intracapsular tumour without metastases had significantly higher (p less than 0.05) pretreatment total estradiol levels than those with more advanced disease. The patients were treated either by orchiectomy or estrogens. The mean follow-up time was 48 months. Higher pretreatment estradiol and testosterone levels were associated with better survival. Prolactin assays seemed to be of no value in this respect.

Aged↗