Search PubMed⌕ Search

Biomedical subjects

R M Fox

Publications and source records attributed to R M Fox.

At least 109 records · Page 6Linked to original sources
PubMed1985

Cisplatin, vinblastine, and bleomycin in inoperable non-small cell lung cancer.

Forty two patients with inoperable non-small cell lung cancer were entered into a phase II study of the combination chemotherapy regimen PVB (cisplatin 60 mg/m2 by intravenous infusion over two hours on day 1, vinblastine 4 mg/m2 by intravenous bolus on days 1 and 2, and bleomycin 15 mg intramuscularly on days 1, 8, and 15), repeated at three weekly intervals. Twelve of 40 evaluable patients (30%) achieved partial responses; there were no complete responses. The median duration of response was 16 weeks (range greater than 8-73 weeks). The median survival of responding patients calculated from entry to the study until death (40 weeks) was superior to that of patients failing to respond (15 weeks). Treatment was accompanied by signs of moderate toxicity, particularly myelosuppression, nausea and vomiting, alopecia, and neuropathy. One patient died from a neutropenic infection. PVB is a moderately toxic regimen for non-small cell lung cancer and appears similar in efficacy and toxicity to high dose cisplatin and vindesine.

Adenocarcinoma↗
PubMed1985

Randomized trial of combination chemotherapy in hormone-resistant metastatic prostate carcinoma.

A prospective randomized study was conducted in 51 patients with stage D hormone-resistant prostatic carcinoma, comparing a combination of doxorubicin and lomustine (DC) with cyclophosphamide and 5-FU (CF). Patients were assessed objectively (employing National Prostate Cancer Project criteria) and subjectively (using a numerical scoring scheme). Each regimen was well tolerated with acceptable levels of myelosuppression. The objective partial response rate was 57% for DC and 8% for CF. Objective stabilization occurred, respectively, in 14% and 44% of the patients. Similarly, DC demonstrated a significantly superior subjective response rate (partial plus complete) of 82%, compared to 48% for CF. Patients with poor initial performance status or liver involvement had significantly lower response rates and reduced survival. Overall, there was no significant difference in survival between the two arms, reflecting the similarity between DC and CF in total objective response rate (partial response plus stable disease). DC provided superior palliation and was well tolerated by an essentially geriatric population.

Aged↗
PubMed1984

High-resolution proton nuclear magnetic resonance analysis of metastatic cancer cells.

High-resolution proton nuclear magnetic resonance (NMR) studies of intact cancer cells revealed differences between cells with the capacity to metastasize and those that produce locally invasive tumors. The NMR resonances that characterize the metastatic cells were associated with an increased ratio of cholesterol to phospholipid and an increased amount of plasma membrane-bound cholesterol ester. High-resolution NMR spectroscopy could therefore be used to assess the metastatic potential of primary tumors.

Animals↗
PubMed1984

Treatment of advanced squamous-cell carcinoma of the head and neck with a combination of cisplatin, vinblastine, and bleomycin.

Fifty patients with advanced, measurable, squamous-cell cancers of the head and neck received treatment with a combination of cisplatin, vinblastine, and bleomycin (PVB). The tumours in 25 patients (50%) responded to treatment (partially in 17 and completely in eight). The median duration of response was 18 weeks, and that of survival was 31 weeks. Toxicity was moderately severe; myelotoxicity occurred in 13 patients, and nausea and vomiting in 22 patients.

Adolescent↗
PubMed1984

Relation between electrocardiographic and scintigraphic location of myocardial ischemia during exercise in one-vessel coronary artery disease.

The purpose of this study was to determine the usefulness of exercise electrocardiography in predicting the site of myocardial ischemia. Fifty-two patients were studied who had angiographically documented 1-vessel coronary artery disease (CAD) and exercise-induced reversible thallium-201 perfusion defects. The patients were divided into 2 groups: group I (28 patients) had left anterior descending CAD and group II (24 patients) had left circumflex or right CAD. There were no significant differences between the 2 groups in severity of coronary stenosis, heart rate and systolic blood pressure during exercise. The size of the perfusion defect was larger in group I than II (28 +/- 12% vs 19 +/- 10%, p less than 0.02). There was no significant difference between the 2 groups in the frequency of ST depression in the anterior, inferior or lateral electrocardiographic leads. ST depression occurred in 16 patients (57%) in group I and 11 patients (46%) in group II (difference not significant). The sensitivity of the exercise electrocardiogram was 52% using 12 leads, 50% using 3 leads (V3, V5 and aVF) and 50% using V5 alone (difference not significant). Thus, the site of ST depression during exercise is not a good predictor of the site of exercise-induced perfusion defect or anatomic site of CAD. The use of 12 leads does not improve the sensitivity of exercise electrocardiography in patients with CAD.

Adult↗
PubMed1984

Combination therapy with methotrexate and 5-fluorouracil: a prospective randomized clinical trial of order of administration.

Because of biochemical and tissue culture evidence casting doubt on the physiologic relevance of reported synergy afforded by sequential administration of methotrexate (MTX) followed by 5-fluorouracil (5-FU), a randomized controlled clinical trial was conducted in 108 patients with advanced cancer, including 70 with squamous cell carcinoma (SCC) of the head and neck, nine with SCC of other primary sites, 24 with colorectal, and five with gastric adenocarcinomas. Patients were randomized to receive weekly therapy consisting of MTX followed one hour later by 5-FU, or 5-FU followed one hour later by MTX. There was a trend to higher tumor response rates in patients treated with MTX before 5-FU (45% v 33% overall; 65% v 39% in patients with previously untreated head and neck cancer), but these differences were not significant, either by chi-square test or by multivariate stepwise logistic regression. The trend in survival favoring the reverse sequence of 5-FU before MTX was not significant in univariate analyses. Stepwise multivariate Cox model analysis showed that Eastern Cooperative Oncology Group performance status at study entry was the major prognostic factor for survival (P less than 0.001), but among the 70 patients with head and neck cancer, the sequence of drug administration was the only other significant prognostic factor for survival, and favored the sequence of 5-FU followed by MTX (P less than 0.025).

Adenocarcinoma↗
PubMed1984

Relative sensitivity of human T cell subsets to deoxyadenosine toxicity.

In the presence of adenosine deaminase (ADA) inhibitors, human T cells are highly sensitive to the cytotoxic action of deoxyadenosine (dAdo). On this basis, patients with T cell malignancies have been treated with the ADA inhibitor, deoxycoformycin. It is not known, however, whether T suppressor/cytotoxic (Leu 2a+) and T helper/inducer (Leu 3a+) subsets have different sensitivities to dAdo toxicity. In the present study, peripheral blood T (E+) cells from normal volunteers were incubated with dAdo in the presence of the ADA inhibitor, EHNA, and the proportion of viable Leu 2a+ and Leu 3a+ cells compared after 1, 2 and 3 days. Leu 2a+ T cells were found to be significantly more sensitive than Leu 3a+ cells as evidenced by an increase in the Leu 3a+/Leu 2a+ ratio from 1.9 to 3.0 over 3 days. This finding was confirmed by comparing the cytotoxic action of dAdo on separated Leu 2a+ and Leu 3a+ T cells. The action of dAdo on T helper and T suppressor cell function in antibody responses by human blood lymphocytes was also tested. As Leu 2a+ T cells were more sensitive to the cytotoxic action of dAdo than Leu 3a+ T cells, it was thought that a dose of dAdo plus EHNA could be chosen which would abrogate suppression but leave T helper cell function intact. We were, however, unable to obtain this result indicating that the biochemical mechanism by which T helper and suppressor cells are functionally inhibited is different to that resulting in cell death, and is unable to discriminate between them.

Antibodies, Viral↗
PubMed1984

Analytical DNA flow cytometric analysis of deoxyadenosine toxicity in cultured human leukemic lymphoblasts.

Human T leukemic lymphocytes are highly susceptible to growth inhibition by dAdo. We have investigated this phenomenon using analytical DNA flow cytometry. By using (a) bromodeoxyuridine quenching of Hoechst 33342 fluorescence and (b) the drug ICRF-159, a selective G2 - M-blocking agent, we show that dAdo causes a G1 block in cultured T leukemic cells and that cells in the S phase exposed to dAdo are able to complete that S phase, pass through G2 + M, and return to the G1 phase. Centrifugal elutriation was used to enrich cells for various phases of the cell cycles. dAdo caused elevation of the dATP pool to a similar extent in G1, S, and G2 - M-enriched cell fractions, but did not cause a fall in the dCTP pool. These findings indicate that dAdo induces a G1 block via elevation of dATP pools, apparently independently of inhibition of ribonucleotide reductase.

Benzimidazoles↗
PubMed1983

Surgery in patients with advanced germ cell malignancy following a clinical partial response to chemotherapy.

Twenty-one patients with metastatic germ cell tumors achieved only partial clinical tumor regression following chemotherapy, and underwent surgical biopsy or resection of the residual tumor deposits. Sixteen (76%) are at present clinically disease-free after a median 30 + months (range 17-50 months) from the time of surgery, and five (24%) died after 9-29 months. Adverse prognostic signs were the finding of persistent cancer at histopathological examination of the resected tumor masses, and the presence of elevated serum tumor markers at the time of surgery. Postchemotherapy surgery in this setting provides tissue for the prognostically important histopathological examination on which a decision regarding further chemotherapy may be based. In addition, it provides tumor bulk reduction in the cases of differentiated teratoma and persistent cancer.

Adolescent↗
PubMed1983

On the receiving end--II. Linear analogue self-assessment (LASA) in evaluation of aspects of the quality of life of cancer patients receiving therapy.

Linear analogue self-assessment (LASA) scales were used to measure general well-being and specific factors (mood, pain, nausea and vomiting, appetite, breathlessness, physical activity) in patients receiving therapy for malignant melanoma, small cell bronchogenic carcinoma (SCBC) or ovarian cancer. Among the patients with SCBC and melanoma, high correlations were observed between LASA scores for general well-being, mood and appetite. There was a significant relationship between performance status and LASA scores for general well-being, pain and appetite. Among patients with ovarian cancer, there was a significant association between performance status and LASA scores for general well-being, breathlessness and physical activity. Objective response category was related to change in LASA scores for pain. Changes in LASA scores during treatment reflected increased morbidity during radiotherapy in patients also receiving chemotherapy for SCBC. The LASA technique provides a convenient method for the assessment of quality of life in patients receiving cancer therapy, and potentially allows comparison of patient perception of treatment-related morbidities.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

On the receiving end--patient perception of the side-effects of cancer chemotherapy.

We conducted a survey to identify and rank side-effects perceived by 99 patients receiving cancer chemotherapy. Non-physical side-effects constituted 54% of the 15 most severe symptoms, and included the thought of coming for treatment, the length of time taken by treatment and having to have a needle. Major physical side-effects were vomiting, nausea and hair loss. Differences in ranking of severity of side-effects were evident when patient groups were divided by sex, age, marital status and domestic situation, as well as by diagnosis, treatment and response. Evaluation of patient perception of the severity of side-effects is an aid to striking the cost benefit balance when deciding whether to use cancer chemotherapy.

Adolescent↗
PubMed1983

Lorazepam as an adjunct to antiemetic therapy with haloperidol in patients receiving cytotoxic chemotherapy.

Twenty-seven consecutive patients were treated with 3 mg oral lorazepam and 2.5 mg intravenous haloperidol in an effort to improve patient tolerance of cytotoxic chemotherapy and decrease nausea and vomiting. Antiemetic efficacy and side-effects were assessed using a patient questionnaire. Vomiting either did not occur, or was considered to be of only moderate intensity in 22 patients (81%) and usually ceased within 24 hours of commencing chemotherapy. Similarly, nausea was either absent or of only moderate severity, lasting less than 48 hours in the majority of patients. Eight of 11 patients who had received similar previous cytotoxic treatment with antiemetic agents but not lorazepam considered that lorazepam and haloperidol had considerably improved their tolerance of chemotherapy. The side-effects of haloperidol and lorazepam were mild and well tolerated.

Anti-Anxiety Agents↗
PubMed1983

Terminal incorporation of 2'-deoxyadenosine into polyadenylate segments of polyadenylated RNA in G1-phase-arrested human T-lymphoblasts.

In the presence of the adenosine deaminase inhibitor erythro-9-[3(2-hydroxynonyl)]adenine microM concentrations of 2'-deoxyadenosine (dAdo) are toxic to nondividing human lymphoid cells and induce G1-phase arrest in T-leukemic lymphoblasts, effects which appear to be independent of ribonucleotide reductase inhibition by accumulated 2'-deoxyadenosine 5'-triphosphate. We sought to determine if 2'-deoxyadenosine 5'-triphosphate had effects similar to those of other cytotoxic adenosine analogues which are incorporated into polyadenylated RNA [poly(A)+ RNA]. In the presence of erythro-9-[3-(2-hydroxynonyl)]adenine, 8-14C]dAdo, at minimal cytostatic concentrations, was incorporated into the polyadenylate segments of cytoplasmic poly(A)+ RNA in the human T-leukemic lymphoblast line CCRF-CEM, and 70% of incorporated dAdo was in the 3'-terminal position. No DAdo was found in enzyme hydrolysates of nonpolyadenylated regions of poly(A)+ RNA or of poly(A)-RNA. Enzymic hydrolysis of polyadenylated segments from labeled poly(A)+ RNA yielded adenosine:dAdo ratios of approximately 55:1.

Adenine↗