Search PubMed⌕ Search

Biomedical subjects

R Rosso

Publications and source records attributed to R Rosso.

At least 361 records · Page 20Linked to original sources

Cisplatin, methotrexate, and 5-fluorouracil combination chemotherapy for advanced ovarian cancer.

A combination chemotherapy including cisplatin, 25 mg/m2 on Days 1,8; methotrexate, 30 mg/m2 on Day 1; and 5-fluorouracil, 600 mg/m2 on Day 1 has been evaluated in 28 previously untreated and 10 pretreated patients with advanced ovarian cancer after debulking surgery when feasible. The pathological response rates (complete + partial responses) were 69.2 and 50% in untreated and pretreated patients, respectively. Overall 24-month survival and progression-free survival (PFS) are 19.2 and 10.9%, respectively. A significant difference in survival and PFS is evident between patients with less and more than 2 cm residual disease and between responders (CR + PR) versus nonresponders. No renal toxicity was induced and no cycles had to be delayed because of hemathologic toxicity.

Adenocarcinoma↗

Phase II study with high-dose N5-10-methyltetrahydrofolate and 5-fluorouracil in advanced colorectal cancer.

Thirty-eight patients with advanced colorectal adenocarcinoma were treated with the following regimen: N5-10-methyltetrahydrofolate (MTHF) (200 mg/m2/day) and 5-fluorouracil (5-FU) (375 mg/m2/day) given concomitantly, consecutively for 5 days, every 4 weeks, in order to evaluate the potential advantage derived from the biochemical enhancement of cytotoxic activity of 5-FU by high-dose reduced folates. Of 33 evaluable patients (six of whom had received prior 5-FU chemotherapy) three untreated patients achieved a partial response (9.1%) lasting 84, 281 and 401 days; 24 patients (72.7%) had stable disease lasting a median of 150 days (range 60-304 days). The overall toxicity was acceptable: two patients had severe cardiac symptoms. Pharmacokinetics and biochemical studies seem necessary to determine the optimal dosage and timing of 5-FU and folates.

Adenocarcinoma↗

Antitumoral activity of human fibroblast interferon administered intranodularly.

Human fibroblast interferon was given intranodularly to 14 patients with cutaneous metastases from breast cancer and malignant melanoma; 1,000,000 units/cm3 of tumor tissue was administered daily for 8-10 days. 13 patients were evaluated. Complete response was achieved in 1 of 7 breast carcinoma nodules and in 2 of 6 melanoma nodules; partial response was achieved in 1 of 7 breast carcinoma and in 3 of 6 melanoma nodules. The overall objective response was therefore 7 of 13 (53.8%) metastatic nodules. Pathological complete response was confirmed in 2 of 3 complete clinical responses. Necrosis, lymphocytic infiltration and fibrosis were observed in all the specimens pathologically examined. In spite of a clear antitumoral activity, this approach does not appear to have clinical significance due to its extremely localized effect.

Adult↗

Kaposi's sarcoma and HTLV-III infection. Virus-like particles in skin lesions: experimental observations.

Skin biopsies from a subject affected by KS and AIDS were examined by means of EM. Samples were obtained both in correspondence of a typical nodule, and from an apparently normal area. The disease process had started at least 8 mo. before, and the patient showed a reduced number of OKT4 cells, with an inversion of the normal T4/T8 ratio. Besides that, high titre antibodies versus HTLV-III were present, whereas antibodies versus CMV and EBV were not demonstrable. Light and electron microscopy demonstrated the typical picture of KS, with marked proliferation of undifferentiated endothelial and spindle-like cells within a network of collagen fibers. Neoformed capillaries very rarely showed an organization comparable to small vessel of normal dermis. Retro-virus-like particles recalling the ones described in lymph-nodes of subjects affected by AIDS by Armstrong et al. (1984) were observed in the skin tissue obtained in correspondence of the Kaposi lesion; the same were either isolated or gathered in small groups within cytoplasmic vescicles. Similar particles were not evidenced in the tissue obtained from normal skin. The interpretation of morphological aspects requests of course a great caution. However the observation seems to be noteworthy, specially if one considers the demonstrated association between retro-virus of HTLV-III group and AIDS, and that its unusual frequency as well as the malignancy in an immunodepressed host are as yet poorly understood.

Acquired Immunodeficiency Syndrome↗

High dose cisplatin after failure of polychemotherapy containing cisplatin in ovarian cancer. Preliminary results.

A substantial percentage of patients with advanced ovarian cancer will progress or relapse after platinum-based front therapies and will require salvage chemotherapy. In order to evaluate feasibility and effectiveness of high dose platinum (HD-CDDP) nine patients with ovarian cancer were treated with HD-CDDP while progressing after conventional doses of the same drug. Cisplatin 40 mg/M2 d. 1----5 q. 28 days, was administered with forced chloruresis for a total of fifteen cycles. Preliminary results show a promising 44.4% response rate with acceptable toxicity: only one patient had to discontinue treatment because of severe combined toxicity including infection, mucositis, shaking tremors, ototoxicity and palmar hyperkeratosis.

Adult↗

Phase I-II trial with cisplatin and 5-FU in recurrent head and neck cancer: an effective outpatient schedule.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of cisplatin (20 mg/m2) and 5-FU (400-200 mg/m2) by iv push on Days 1-5 every 21 days. All patients but two had relapsed disease. Twenty-seven patients were evaluable for response: there were four complete responses and 12 partial responses (objective response rate, 59.2%). The response rate falls to 53.3% if it is calculated on the total number of patients entered. Twenty-seven patients were evaluable for toxicity: myelosuppression occurred in ten patients (37%), while renal toxicity, nausea and vomiting, and stomatitis were quite rare and moderate. These results look encouraging and suggest the need for further studies.

Adult↗

Chemotherapy following estrogen-induced expansion of the growth fraction of human breast cancer.

We have evaluated the feasibility of a cytokinetically oriented regimen based on the induction of cell recruitment by diethylstilbestrol (DES) in locally advanced human breast cancer. Tumor proliferative activity was evaluated by the thymidine labeling index and the primer-dependent alpha-DNA polymerase labeling index, which gives an in vitro estimation of the growth fraction. Sixteen previously untreated patients received DES (1 mg daily for 3 days) followed by FAC [5-fluorouracil (600 mg/m2): Adriamycin (50 mg/m2): Cytoxan (600 mg/m2)] i.v. on day 4 every 21 days. Radical surgery was delayed to allow for three DES-FAC regimens in responsive patients. Proliferative activity on tumor biopsies was evaluated immediately before and after treatment with DES, 24 h after chemotherapy and, in nine patients, at the time of radical surgery. DES was able to induce a significant increase in thymidine labeling index in 8 of 16 patients, while the primer-dependent alpha-DNA polymerase labeling index was significantly increased in 13 of 16 tumors, independently of their estrogen receptor content. Subsequently administered chemotherapy induced an early decrease in tumor proliferation. In the nine patients submitted to surgery after three DES plus FAC courses, the average thymidine labeling index and primer-dependent alpha-DNA polymerase labeling index were 27.8 and 73% of the pretreatment values. Our preliminary results provide the rationale for the design of new therapeutic schemes in which antitumor drugs are given at the time of estrogen-induced tumor cell recruitment. Further extended studies are required to establish whether induction of tumor cell recruitment will actually translate into appreciable improvement of the clinical response to chemotherapy.

Adult↗

Low-dose cisplatin and etoposide in advanced non-small cell lung carcinoma.

Twenty-seven consecutive patients with locally advanced or metastatic non-small cell lung carcinoma were treated with low-dose cisplatin and etoposide. Out of 25 evaluable patients, 8% had a partial response, 56% had stable disease and 36% had disease progression. The overall median survival was 4 months. The survival of the two responding patients was 5 and 6.5 months. The patients showing stable disease or progression had a median survival of 6 and 3 months, respectively. Toxicity including myelosuppression, nephrotoxicity and gastrointestinal side effects was generally mild. In this trial the combination of low-dose cisplatin and etoposide did not yield the same positive results observed by other authors. The different selection of patients and criteria of response evaluation could represent the main reason for this disagreement in results.

Aged↗

Phase II study of ifosfamide combined with Mesna uroprotection in advanced non-small-cell lung carcinoma and other solid tumors.

Thirty six patients with advanced solid tumors (24 lung: 3 oat-cell, 14 squamous, 7 adenocarcinomas, 3 soft tissue sarcomas, 6 breast carcinomas; 1 seminoma; 2 ovarian adenocarcinomas) entered a phase II study of high-dose ifosfamide (IF) administered in combination with the uroprotective agent sodium 2-mercapto-ethane-sulfonate (Mesna). Fourteen patients had prior treatment; most patients with lung cancer (22/24) were previously untreated; all had measurable disease. The patients median age was 59 (range 31-74). IF was given at 1.8 g/m2 days 1-5 q 4 weeks. Mesna was given after each IF injection at 0, 4 and 8 h randomly, either i.v. (0.36 g/m2) or orally (0.72 g/m2). Twenty-four patients had greater than or equal to 3 courses of therapy, 9 had 2 courses, and 3 had only 1 course; 129 courses were evaluated for toxicity. Mesna was given orally (17 patients, 57 courses) or i.v. (19 patients, 72 courses). The following side-effect were observed: no gross hematuria, microhematuria (14 courses), transitory mild proteinuria (34 courses), leukopenia grade I-II ECOG (26 courses), anemia grade I ECOG (31 courses), 1 case of pancytopenia, alopecia (31 patients), nausea (moderate, 33 courses; severe, 6 courses), vomiting (moderate, 17 courses; severe, 1 course). Five patients showed a partial response (1 oat-cell carcinoma, 2 with squamous lung cancer, 1 with ovarian carcinoma, 1 with breast carcinoma), 14 showed a minor response (2 patients with oat-cell carcinoma, 2 with lung adenocarcinoma, 5 with squamous lung cancer, 1 with seminoma, 1 with sarcoma, 1 with ovarian carcinoma), and 14 showed progression of disease (7 patients with squamous cell lung cancer, 4 with lung adenocarcinoma, 1 with sarcoma, 2 with breast carcinoma). Considering partial plus minor responses, ifosfamide produced some degree of tumor reduction (PR + MR) in 12/23 (52.1%) lung cancer patients. The data reported support the conclusions that Mesna can prevent high-dose IF bladder toxicity, that IF is active in advanced solid tumors, including lung cancer, and that the IF + Mesna combination is a generally safe treatment procedure.

Adult↗

Ineffectiveness of 5-fluorouracil and cis-platin as second-line chemotherapy in head and neck cancer.

Seventeen patients with heavily pretreated head and neck squamous cell carcinoma were submitted to a combination of 5-fluorouracil, 500 mg/m2 on days 1-4, and cis-platin, 50 mg/m2 on day 5, repeated every 21 days. Before administration of 5-fluorouracil, N5,N10-methyltetrahydrofolate, 200 mg/m2 i.v., was given. Only 1 partial response and 4 stable disease were observed, and the median survival of the entire group was 5 months. Although all patients had been heavily pretreated and a considerable percentage (6/17, 35.2%) of these showed resistance to first-line therapy, this combination seems to be ineffective as second-line therapy in head and neck cancer.

Adult↗

Timed sequential chemotherapy following drug-induced kinetic recruitment in refractory ovarian cancer.

Kinetic recruitment of cancer cells can seldom be monitored in human solid tumors. Repeated tumor sampling in ascitic ovarian cancer has been exploited to study tumor cell kinetic recruitment following treatment with the alkylating agent iphosphamide (IFX). The treatment schedule of the study was designed to administer the antimetabolic agents MTX-5FU at the time of the recruitment peak. Kinetic studies by the labelling index (LI) assay could be performed during and after the IFX treatment in four out of eight patients because of sampling difficulties. Experimental results showed that the IFX effectiveness reduced the proliferating cells, followed by cell kinetic recruitment from the resting pool. The antimetabolic treatment in concomitance with the proliferative peak (day 12) has been reduced with respect to the original schedule due to the heavy leukopenia occurring to the patients. It is likely that the reduced drug dosage might have contributed to the poor clinical response. However, the recruited cells exhibited an increased in vitro chemosensitivity to adriamycin in comparison to tumor cells studied before the IFX treatment.

Adult↗

Eosinophilic ulcers of the tongue.

A case of eosinophilic ulcer of the tongue is presented. Although the entity is rarely described, the distinctive histopathologic pattern featuring the remarkable presence of eosinophils in the superficial corium and in between muscle bundles, together with the benign clinical course, make a diagnosis possible.

Adolescent↗

Combined radiotherapy and CMF-B cytotoxic regimen in stage III-IV head and neck squamous cell carcinoma.

Twenty patients with stage III-IV squamous cell carcinoma of the head and neck were treated with the combination of a multidrug cytotoxic regimen CMF-B (cyclophosphamide, methotrexate, 5-fluorouracil, bleomycin) and radical radiotherapy. All the patients were evaluable: 7 (35%) achieved clinical complete response (CR), 10 (50%) partial response (PR) and 3 (15%) stable disease (SD). The median survival of the whole group is 14 months (range 3-26+); 21+ months for complete responders (range 4+-22+). Hematologic and gastrointestinal toxicity was moderate, 9 patients (45%) developed mucositis but only one needed total parenteral nutrition. It is concluded that the combination of CMF-B regimen and radiotherapy is effective and well tolerated in these patients and needs to be evaluated in further controlled studies.

Adult↗

Immunofluorescence and enzyme histochemistry on consecutive sections from glycol-methacrylate-embedded bone marrow, lymph node and kidney specimens.

We describe an immunohistochemical technique adapted to tissues embedded in glycol-methacrylate (GMA). 1-micron-thick GMA sections from kidney, lymph node and bone marrow biopsies were trypsinized and then incubated with F(ab)2 antisera. GMA sections presented some distinct advantages with respect to compared paraffin and cryostatic sections: (1) reduction of background fluorescence, (2) higher resolution of morphologic details, (3) possibility of studying undecalcified bone marrow specimens and (4) possibility of coupling histochemistry with immunofluorescence on consecutive sections. Moreover, in a case of lymphoplasmacytoid lymphoma specific immunostaining for membrane IgM was obtained on GMA sections.

Acid Phosphatase↗

Anti-ulcer drugs and hypergastrinism: utilization in surgery.

The peptic ulcer disease associated with hypergastrinemia is very often a challenging problem of diagnosis and therapy. In absolute surgical emergency (haemorrhagic and perforative complications), the utilization of the most recently discovered anti-ulcer drugs appears to be extremely helpful; the prevention of incumbent complications can be accomplished, in fact, during the post-operative treatment and the "free time" so obtained can be used for an adequate differential diagnosis (gastrinoma-induced Zollinger-Ellison syndrome: antrum retained, G cells of the antrum hyperplastic, apud-tumours with hypersecretion). The "anti-H2 and anti-muscarinic" drugs (often in association) give the surgeon the possibility of an accurate diagnosis and the choice of the best surgical procedure (tumorectomy, DCP, gastrectomy). Even in elective surgery the prevention with anti-H2 drugs permits greater "safety margins" and an optimal follow-up study. The results of the surgical experience in the General Surgical Clinic of Pisa (18 cases of Z.E.'s) confirm the validity of the associated anti-ulcer therapy.

Cimetidine↗

Low-dose metoclopramide versus methylprednisolone in controlling chemotherapy induced nausea and vomiting.

Ninety outpatients with histologically confirmed malignancy receiving chemotherapy entered a randomized crossover trial to assess the antiemetic efficacy of low-dose metoclopramide versus methylprednisolone. Treatment consisted of either metoclorpramide (MCP) 60 mg or methylprednisolone (MPN) 375 mg administered in 3 equal doses just prior to chemotherapy and 6 and 12 hours after treatment. Patients receiving MPN had significantly less nausea (p less than 0.001) and fewer episodes of vomiting (p less than 0.0003) than patients receiving MCP. MPN also proved to be the more effective agent in cross-over trials. Both MPN and MCP were well tolerated. No important side effects were observed. MPN is a safe, effective, antiemetic treatment suitable for use in the outpatient.

Adult↗

Mitomycin C and 5-fluorouracil as second choice treatment in advanced breast cancer patients.

Twenty-six patients with advanced breast cancer, (12 previously treated with adriamycin-containing regimens, 14 not exposed to adriamycin because of poor cardiac performance), were treated with combination chemotherapy including mitomycin C plus 5-fluorouracil. Objective response was seen in 7/66 patients (26.9%) with a statistically higher response rate in patients with fewer than 2 metastatic sites. Because of mild toxicity this regimen can be safely used as second-line chemotherapy for heavily pretreated patients and as first-line treatment in patients with poor cardiac performance.

Adult↗