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Biomedical subjects

R Joss

Publications and source records attributed to R Joss.

At least 73 records · Page 4Linked to original sources

[Nausea and vomiting during chemotherapy of malignant tumors].

Nausea and vomiting are frequent and unpleasant side effects of cancer chemotherapy. Current concepts of pathophysiology and clinical aspects of nausea and vomiting are reviewed. Individual and therapeutic factors are discussed which greatly modify the degree of vomiting. The commercially available antiemetics are tabulated and the individual classes of antiemetics are described. Finally, consideration is given to new approaches to the treatment of nausea and vomiting, including the search for new compounds and better use of currently available agents.

Antiemetics↗

[Chemotherapy of non-small-cell bronchial cancer with a combination of Cis-diamminedichloroplatinum (II) and VP 16-213].

In a phase II study 40 patients with non-small-cell lung cancer were treated with 100 mg/m2 cis-diamminedichloroplatinum (II) (DDP) i.v. on day 1, combined with VP 16-213 (VP) in a dose of either 80 mg/m2 daily i.v. on days 1, 2 and 3 or 120 mg/m2 daily by mouth on days 3, 4, 5 and 6. The course was repeated every 3 weeks. In 30 evaluable patients, 10 partial remissions were recorded with a median duration of 3 months. Eleven patients had stable disease and 9 showed progression under treatment. Leukopenia was more pronounced with intravenous administration of VP than with oral VP (median leukocyte nadir 2400/mm3 and 3700/mm3 respectively). Two patients had thrombocytopenia under 50,000/mm3. All patients suffered from moderate to marked nausea and vomiting. All patients had alopecia. Nine patients had serum creatinine elevations over 1.4 mg/dl. Six patients with renal toxicity were treated in one institution with incorrectly applied forced diuresis during DDP administration. DDP and VP are an active regimen for remission induction in non-small-cell lung cancer. Due to cumulative and marked gastrointestinal intolerance this regimen cannot be given over prolonged periods of time.

Adenocarcinoma↗

[Long-term tumor-free surviving patients with anaplastic small cell bronchial cancer].

Report on 12 patients with small cell lung cancer who achieved disease-free survival for over 24 months after initial therapy. All the cases were classified as limited disease. Median age was 62 years and median performance status 0. Only 2 patients had weight loss of more than 5% in the six months prior to the diagnosis. Four patients were treated by local therapy alone (surgery in 3, radiotherapy in 1). Eight patients received systemic treatment (chemotherapy in 4, chemotherapy plus radiotherapy in 4). Median duration of cytostatic treatment was 17 months, with 3 of 8 patients receiving chemotherapy for less than 6 months. Three patients relapsed 27, 34 and 54 months after initial treatment. Median survival is 52 + months. It is concluded that long term disease-free survival can be achieved in patients with limited disease small cell lung cancer, even where initial treatment is relatively short.

Adult↗

[Results of, and indications for adjuvant chemotherapy in breast cancer].

As the observation times of current studies using adjuvant chemotherapy in the treatment of operable stage II breast cancer lengthen, the probability of significantly reducing the high risk of developing metastases associated with this stage of the disease is also increasing and should be reflected in improved cure rates. The theoretical basis, prerequisites and presently available results for adjuvant chemotherapy of breast cancer are discussed. Adjuvant combination chemotherapy provides better results than monochemotherapy with Alkeran. While earlier results suggested that adjuvant chemotherapy is especially effective in premenopausal women, newer studies and analyses indicate that appropriate dosage and consistent administration of chemotherapy are of decisive importance. Exact determination and documentation of the tumor stage, and especially the regional lymph node status, is the most important factor in determining the indication for adjuvant chemotherapy. Adjuvant chemotherapy is still best with many unsolved problems. These include the duration, necessary intensity based upon risk factors, and short- and long-term side effects.

Adult↗

[Colorectal cancer. Progress and unsolved problems].

This review deals with colorectal carcinoma, the most frequent malignant tumor in western countries aside from skin cancer. Epidemiologic data confirm the crucial role of nutrition in the pathogenesis of these tumors. The pathology and natural history of colorectal cancers are reviewed. Screening programs have yielded encouraging first results. In recent years surgery of rectal cancer has been improved by the introduction of a new stapling device permitting more sphincter-saving operations. Pre- and postoperative radiotherapy as an adjuvant to surgery are important elements in the primary management of rectal carcinoma. Radiotherapy is often effective in palliating pain, bleeding, and mucous discharge. Chemotherapy of colorectal cancer is still unsatisfactory. The prospects for adjuvant chemotherapy are discussed. The often dismal outlook for patients with colorectal cancer will be more promising if etiological factors can be eliminated, early diagnosis improved and chemotherapy ameliorated.

Colonic Neoplasms↗

[Treatment and prognosis of superior vena caval syndrome in small-cell anaplastic carcinoma of the lung (author's transl)].

One hundred and forty nine consecutive patients with small-cell anaplastic carcinoma of the lung were studied retrospectively. 19 patients (13%) presented with superior vena caval obstruction, 11 further patients (7%) developed this complication during the course of their disease. 16 patients presenting with superior vena caval syndrome were treated with chemotherapy alone and 13 patients responded. Due to suboptimal chemotherapy for current standards 7 of the 13 successfully treated patients (54%) relapsed after a median of 4.5 months. 3 patients were effectively retreated with another chemotherapy combination, 4 patients with radiation therapy. Superior vena caval obstruction is a frequent complication of small-cell anaplastic carcinoma of the lung. It can be treated effectively with combination chemotherapy.

Antineoplastic Agents↗

[Central nervous system metastases in small cell lung cancer].

Forty of 156 patients (26%) with small cell lung cancer developed central nervous system metastases (CNS metastases) in the course of the disease. CNS metastases were found in 8 patients at the time of the initial diagnosis and 32 patients had subsequent CNS involvement. CNS metastases were usually concurrent with disease progression at other sites and became more frequent as survival increased. With a median survival of 6 months in 1973 19% of patients developed CNS metastases as compared to 35% in 1978, when median survival had increased to 9.5 months. The value of prophylactic cranial irradiation is discussed.

Brain Neoplasms↗

[Ovarian carcinoma: new prognostic and therapeutic viewpoints].

Some recently developed concepts concerning the management of ovarian cancer are discussed. Cytoreductive surgery to debulk the tumor to a minimum, even in those cases which were considered inoperable in the past, improves the chances for cure. Adjuvant radiotherapy or combination chemotherapy with new drugs have proved highly effective in inducing complete remission and potential cures in these patients. The definition and better understanding of prognostic criteria play a primary role in the selection of treatment. In designing the strategy for adequate treatment, the following points are of major importance: (1) exact definition of tumor spread as determined by accurate surgical staging; (2) histologic and cytologic grading; and (3) evaluation of response.

Alkylating Agents↗