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Biomedical subjects

R Rosso

Publications and source records attributed to R Rosso.

At least 415 records · Page 23Linked to original sources
PubMedDate not supplied

Analysis of time to response to chemotherapy in 316 metastatic breast cancer patients.

Chemotherapy is a major tool for metastatic breast cancer treatment. In this study, a series of 316 patients have been analyzed to evaluate the time needed to reach tumor response by means of combination chemotherapy. Twenty-five percent of patients responded within 3 months and virtually all responses occurred within 7.5 months. The time curves of response (any) and best response are superimposable. A subset analysis has shown that the following pretreatment characteristics predict a significantly longer time to response: prior exposure to adjuvant chemotherapy, nodal positivity at diagnosis, no previous endocrine treatment and osseous metastases.

Age Factors↗
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[Description of a case of acute neurological toxicity after DTIC-adriamycin-vincristine therapy (author's transl)].

A case of acute neurological toxicity was observed in a patient with a retroperitoneal fibromyxosarcoma treated with DTIC (NSC-45382), Adriamycin and Vincristine. The neurological symptoms started one hour after drug administration and rapidly declined with symptomatic therapy: no EEG and scintigraphic changes were detectable. The case is discussed in relation to central nervous system complications reported by other authors, following administration of DTIC and Adriamycin.

Brain Diseases↗
PubMedDate not supplied

[Antitumoral activity of calusterone in advanced mammary carcinoma (author's transl)].

Thirty-one post-menopausal patients with advanced mammary carcinoma were treated with calusterone (7-beta, 17-alpha-dimethyl-testosterone), 200 mg daily per os for at least three months. Twenty-seven patients were avaluable. Eight patients (29%) had an objective response; two patients had a complete remission maintained for more than eighteen months by repeated three-month courses of therapy. In eight patients (29%), calusterone produced no objective response, without disease progression. The main side effects have been hirsutism, acne and gastro-intestinal distress; no libido modification was observed. Increased BSP retention was observed in one third of patients.

Acne Vulgaris↗
PubMedDate not supplied

Hematologic parameters during treatment with high-dose medroxyprogesterone acetate.

Blood clotting, platelet aggregation, complete blood count and lipid profile were evaluated in 12 postmenopausal patients with advanced breast cancer. Patients under treatment with high-dose MPA were considered not at risk for thomboembolic disease and were given MPA orally, 800 mg/day, for at least 3 months. Laboratory investigations were performed prior to treatment with MPA then once weekly during the first month and every 2 weeks during the following months. PTT, TEG, antithrombin III and platelet adhesiveness underwent statistically significant changes, tending towards hypercoagulability, although, on the average, they did not exceed the upper normal range. The authors conclude that a clinically relevant thrombotic activity cannot be attributed to MPA at the administered oral doses in the absence of additional risk factors.

Blood Cell Count↗
PubMedDate not supplied

A randomized trial of chemotherapy with or without estrogenic recruitment in locally advanced breast cancer. North-West Oncology Group (GONO) Study, Italy.

The present phase III trial was carried out to verify whether a kinetic recruitment induced by low doses of diethylstilbestrol (DES) could increase the killing efficacy of chemotherapy in patients with locally advanced breast cancer. One-hundred and seventeen untreated patients with locally advanced breast cancer (stage IIIA/IIIB) were randomized to receive 3 courses of primary chemotherapy consisting of cyclophosphamide (600 mg/m2 i.v.), doxorubicin (50 mg/m2 i.v.) and fluorouracil (600 mg/m2 i.v.) (CAF) on day 1, or DES-CAF (DES, 1 mg orally days 1-3, CAF on day 4). The courses were repeated every 3 weeks. The patients who achieved an objective response were submitted to mastectomy followed by 3 courses of CAF alternated with 3 courses of CMF (cyclophosphamide, 600 mg/m2 i.v.; methotrexate, 40 mg/m2 i.v.; fluorouracil, 600 mg/m2 i.v.), with or without DES. The two treatment arms were well balanced in terms of clinical and pathologic features. There was no significant difference in response rates to induction chemotherapy between the two treatment arms (objective response rate, 63.3% for CAF and 56.1% for DES-CAF). Median overall survival was 49 and 47 months and median progression-free survival was 24 and 21 months for CAF and DES-CAF patients, respectively. Toxicity was not significantly different in the two groups, with the exception of leukopenia: DES chemotherapy was significantly more myelotoxic than the standard treatment, which resulted in a significant reduction in the actual dose intensity. In spite of the attractive experimental evidence, we conclude that so far there is no clinical advantage in the combination of estrogen and chemotherapy. Further research is needed to investigate different schedules of chemotherapy and hormones, or to test the possibility of combining various mitogens.

Antineoplastic Agents, Hormonal↗
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[Epoietin alfa in lung cancer].

There is a high frequency of hematopoietic abnormalities in patients with neoplastic disorders, anemia being one of the most common and important, especially in lung cancer patients undergoing chemotherapy. A number of factors are able to affect the incidence and severity of chemotherapy-induced anemia: the type of chemotherapy, chemotherapy dose-intensity, chemotherapy duration, prior treatment, baseline Hb value and entity of Hb decrease during chemotherapy. An impaired erythroid marrow response to erythropoietin (EPO) and reduced EPO levels in response to anemia may contribute to the development of this form of anemia in lung cancer patients. Recombinant human EPO has been successfully used in the treatment of anemia. EPO increases the red cells mass and eliminates by approximately 50% the need for blood transfusions in patients with chronic anemia of cancer. EPO is also effective in the prevention of anemia of cancer patients. Besides increasing the levels of hemoglobin, EPO is also able to significantly improve the quality of life and performance status of anemic patients with cancer. EPO is well tolerated and the only drawbacks are represented by its cost and the need for a prolonged parenteral treatment. The use of EPO can be optimized by taking into consideration some predicting factors, by modulating the dose and by using iron support. In patients with lung cancer, the objective of EPO treatment may vary from palliation to survival improvement according to stage, type of antineoplastic treatment and prognosis. To take maximum advantage from its efficacy, EPO treatment in lung cancer patients needs to be individualized by identifying for each patient the risk of severe anemia and the objective of treatment.

Anemia↗
PubMedDate not supplied

The role of vindesine and lonidamine in the treatment of elderly patients with advanced non-small cell lung cancer: a phase III randomized FONICAP trial. Italian Lung Cancer Task Force.

AIMS: To evaluate the efficacy and treatment compliance in elderly patients with advanced non-small cell lung cancer (NSCLC) of two chemotherapeutic agents with mild toxicity, 153 previously untreated patients aged over 70 years were randomized to receive lonidamine (450 mg daily p.o. until progression), vindesine (3 mg/m2/daily i.v. weekly for 4 weeks and then every 2 weeks until progression), the combination of the two drugs at the same dose and schedule, or supportive therapy only in a four-arm factorial randomized trial. METHODS: 126 patients were included in the final analysis. Their median age was 75 years. Forty percent had stage IV disease and 60% stage III. Most patients were males (85%) and the majority had squamous histology (68%). RESULTS: Among 104 patients evaluable for response there were only 3 PRs (1/30 in the lonidamine arm and 2/33 in the lonidamine + vindesine arm). Overall, 8.7% and 9.5% of the patients, respectively, progressed or died early, before response evaluation; another 9.4% refused treatment continuation because of poor compliance with the study protocol. Eighty-five patients were fully evaluable for toxicity, which was generally mild. Leukopenia grade 1-3 was found in less than 30% of patients treated with vindesine or vindesine + lonidamine. The most common complaints associated with lonidamine treatment were myalgia (70% of patients), fatigue (55% and 83% of patients treated with lonidamine or lonidamine + vindesine, respectively) and testicular pain in nearly 40% of cases. The overall median survival was 170 days, with no significant impact on survival of either lonidamine or vindesine. CONCLUSIONS: The low response rate and survival together with the poor treatment compliance, even in the presence of mild toxicity, do not support the usefulness of these "gentle" chemotherapies in elderly NSCLC patients. The standard management of advanced NSCLC in elderly patients remains to be defined. Specifically designed studies to address this issue are warranted.

Aged↗
PubMedDate not supplied

Rhabdomyosarcoma with primary osteolytic lesions simulating non-Hodgkin's lymphoma.

We report the case of an 8-year-old child presenting with the pathological fracture of two vertebral bodies due to bone lytic lesions. Physical and instrumental examinations did not show any further evidence of disease. However, bone marrow aspirate showed an infiltrate of poorly differentiated cells. When the child was transferred to the Department of Pediatrics, lymphoblastic leukemia was suspected. Although the morphology of the bone marrow biopsy could have suggested a lymphoblastic lymphoma, further immunochemical and immunological studies together with the study of tissue surface antigens resulted in a diagnosis of embryonal rhabdomyosarcoma with an unusual presentation.

Antigens, Differentiation↗
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West Nile encephalitis in Israel, 1999: the New York connection.

We describe two cases of West Nile (WN) encephalitis in a married couple in Tel Aviv, Israel, in 1999. Reverse transcription-polymerase chain reaction performed on a brain specimen from the husband detected a WN viral strain nearly identical to avian strains recovered in Israel in 1998 (99.9% genomic sequence homology) and in New York in 1999 (99.8%). This result supports the hypothesis that the 1999 WN virus epidemic in the United States originated from the introduction of a strain that had been circulating in Israel.

Aged↗
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Mitoxantrone in elderly patients with advanced breast cancer: pharmacokinetics, marrow and peripheral hematopoietic progenitor cells.

The aims of this study were to evaluate the pharmacokinetics, tolerability and hematopoietic toxicity of mitoxantrone in elderly women. Thirteen patients with advanced breast cancer, median age of 73 years, received escalating doses of mitoxantrone 8, 10, 12 and 14 mg/m2 on day 1, q 21. There was a linear relationship between the mitoxantrone dose administered and the mitoxantrone exposure (AUC) in plasma (r = 0.856, pc0.001). After 4 courses of treatment, a significant decrease in bone marrow cellularity (p = 0.0067), and HPC content (BFU-E p = 0.0077) was observed. A remarkable, though not statistically significant decrease in circulating HPCs was observed after 4 courses and was still present 8-12 months after the termination of treatment. Therapy with mitoxantrone in elderly women was well tolerated at the dose of 12 mg/m2 for four courses. The significant hematological toxicity observed in marrow cellularity and HPC content warrant further studies.

Aged↗
PubMedDate not supplied

Metastatic breast cancer patients failing first-line, anthracycline-containing chemotherapy: is further therapy of benefit?

During the last 50 years median survival for metastatic breast cancer has not varied and remains 2-3.5 years. To assess the clinical benefit of salvage systemic therapy a retrospective analysis of metastatic breast cancer patients all homogeneously treated with a commonly used first-line anthacycline-containing cytotoxic regimen (FEC) was undertaken. The 140 patients in this report were among 375 entered in two consecutive multicenter randomized trials carried out from Dec. 1983 to Jan. 1990. All patients died during follow-up. Median number of salvage therapies was 3 (range 1-7). Response rate (CR and PR) was 41% with FEC and 7%, 3%, 15%, 0%, 14%, 0%, 0% in patients receiving salvage treatment line 1 to 7, respectively. Time to treatment failure (TTF) was 7.5 months for FEC and 3.5, 2.5, 2.1, 1.6, 2.1, 1.1, 1.6 months at first to seventh salvage treatment, respectively. Only a very small fraction of patients receiving first-line FEC respond to subsequent palliative treatment. The advantages of salvage therapy are unclear and must be weighed against the inconvenience, cost and morbidity of treatment. After first salvage therapy, patients should be considered for randomized trials comparing systemic antineoplastic therapy with best palliative care. Endpoints of all future clinical trials in metastatic breast cancer should include measurement of quality of life and accurate, sequential measurement of symptom control.

Antibiotics, Antineoplastic↗
PubMedDate not supplied

Exogenous glucocorticoids affect in different way the various phases of bone formation in postmenopausal patients.

BACKGROUND: To determine the effect of glucocorticoid excess on the most important circulating markers of bone formation in postmenopausal treated patients. METHODS: The study included 15 postmenopausal women taking glucocorticoids for various medical conditions and two groups of 30 healthy premenopausal and 28 age-matched postmenopausal women as controls. Osteoblastic activity was assessed by measuring both serum levels of osteocalcin (BGP) (N-tact Osteo SP, Incstar Co.) and the bone-specific isoenzyme of alkaline phosphatase (BAP) (Alkphase-B, Metra Biosystems). RESULTS: The mean values of serum BGP found in patients taking steroids were significantly reduced as compared to those found in both fertile and postmenopausal women (p < 0.0001). The mean serum levels of BAP were significantly increased in treated patients as compared to premenopausal women (p < 0.0001), while no significant difference was found between patients and age-matched postmenopausal women. Similar results were also obtained when individual values of both serum BAP and BGP were expressed as standard units in comparison to values obtained in fertile subjects (T-score) or postmenopausal subjects (Z-score). CONCLUSIONS: Steroid therapy in postmenopausal patients differentially affects the various phases of bone formation. Measurement of serum BGP may represent a reliable parameter for monitoring bone formation in postmenopausal treated patients.

Aged↗
PubMedDate not supplied

Sucralfate in the treatment of chemotherapy-induced stomatitis: a double-blind, placebo-controlled pilot study.

BACKGROUND: The study was a double-blind, placebo-controlled, randomised pilot study to assess the efficacy of sucralfate gel in the treatment of chemotherapy-induced mucositis. PATIENTS AND METHODS: At the onset of stomatitis, forty patients received sucralfate gel (1 gr.) or placebo and were instructed to apply the gel over oral mucosas, 3 times daily. RESULTS: Objective response was observed in 14 patients (11 complete response+3 partial response) and in 15 patients (10 CR+5 PR), in the sucralfate and placebo arms, respectively; (p = NS). Analysis of VAS (visual analogue scale) scoring of pain did not detect any statistical difference between the two groups. No important side-effects were observed. Twelve out 21 patients who obtained a complete resolution of stomatitis (5 out of 11 and 7 out of 10 in the sucralfate and in placebo arms, respectively) received further treatment at the subsequent course of chemotherapy; prevention of mucositis was observed in 4 patients in the sucralfate arm and in 6 patients in the placebo arm, respectively. CONCLUSION: In the present pilot study, sucralfate did not demonstrate a significant advantage in comparison to the placebo in the treatment of chemotherapy-induced stomatitis.

Adult↗