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Biomedical subjects

S D Williams

Publications and source records attributed to S D Williams.

159 records · Page 9Linked to original sources

Long term effect of cis-diamminedichloride platinum (CDDP) on renal function and structure in man.

To examine CDDP induced nephrotoxicity in patients with testicular carcinoma, we measured renal function prior to therapy and at six month intervals for twelve months in fifteen patients and twenty-four months in seven patients. CDDP was given iv at 20 mg/M2 per day for five days at three week intervals. Eight patients received three courses, four received four courses and three received more than four courses. The mean creatinine clearance +/- SD prior to treatment was 112 +/- 12 ml/min. By six months, it had decreased to 68.5 +/- ml/min (p less than 0.01) and it remained at that level. Plasma creatinine and blood urea nitrogen increased significantly. Subjects receiving other potential nephrotoxins in addition to CDDP developed a greater decrease in creatinine clearance (p less than 0.05). Proteinuria and functional tubular disturbances were not observed. Microscopic features were characterized by hydropic degeneration of the renal tubular epithelium, thickened tubular basement membranes and mild interstitial fibrosis. Electron microscopy revealed phagolysosomes filled with flocculent material. CDDP resulted in a permanant, nonspecific renal injury in our patients. Although the renal injury has remained subclinical, future courses of CDDP may lead to clinically important chronic renal failure.

Adolescent↗

Combined therapy for small cell undifferentiated carcinoma of the lung.

Fifty-eight patients with small cell lung cancer were treated from September, 1974, to March, 1976, with combined chemotherapy and radiotherapy. Surgical resection of the lung lesion was performed in three patients, and a number of surgical diagnostic methods were carried out in the remaining patients with unresectable of disseminated lesions. Nineteen patients were from the Veterans Administration Hospital and 39 from Indiana University Medical Center. The median Karnofsky performance status was 60. Thirty-nine patients had extensive disease, and 19 had disease limited to the chest and supraclavicular area. All patients received chest radiotherapy and prophylactic whole brain radiation. Adriamycin, cyclophosphamide, and vincristine were given on day 1 and continued every 3 weeks. There were 27 (48 percent) partial remissions of a median duration of 26 weeks. There were 25 patients (43 percent) with complete remission. The median survival for the entire group was 51 weeks. Six of 58 patients (10 percent) are alive and disease free from 24 to 38 months after treatment. Six of 19 patients with limited disease (32 percent) are presently alive and disease free. This includes one patient in whom surgical resection was performed. Combined therapy influences favorably the prognosis of small cell cancer of the ling, expecially in those patients with limited disease and favorable performance status.

Adult↗

Combination chemotherapy with doxorubicin and lomustine. Treatment of refractory Hodgkin's disease.

Ten patients with advanced Hodgkin's disease refractory to combination therapy with nitrogen mustard, vincristine sulfate, procarbazine, and prednisone (MOPP) were treated with a combination of doxorubicin hydrochloride and lomustine. Toxicity was acceptable. Five patients (50%)attained complete remission (median duration, 15 months). Three patients attained a partial remission (median duration, four months). Survival ranged from three to more than 40 months, and five patients are still alive. One patient remains disease-free after a course of radiation therapy to a site of localized nodal relapse. The doxorubicin-lomustine regimen has induced meaningful remissions in a patient population with very refractory disease.

Administration, Oral↗

Nabilone: an effective antiemetic in patients receiving cancer chemotherapy.

Eighty evaluable patients receiving chemotherapy were entered on a random prospective double-blind study to evaluate the effectiveness of nabilone, a synthetic cannabinoid, compared to prochlorperazine. Most of these patients received cisplatin, a drug that universally produces severe nausea and vomiting, as part of a combination chemotherapy regimen. The patients served as their own controls, receiving either nabilone or prochlorperazine during two consecutive treatment courses with the identical chemotherapy. Side effects consisting of hypotension and lethargy were more pronounced with nabilone. Toxicity, in general, did not preclude antiemetic treatment and in no way interfered with chemotherapy. Sixty patients (75 per cent) reported nabilone to be more effective than prochlorperazine for relief of nausea and vomiting. Of these 60 patients, 46 required further chemotherapy and continued taking nabilone as the antiemetic of choice.

Adolescent↗

Testicular cancer.

Although testicular cancer is a relatively rare tumor, it is the most common cancer among men aged 15 to 35 years. In the United States in 1989 approximately 5,500 men will be diagnosed with testicular cancer. Up until 2 decades ago, testicular cancer was the most common cause of a cancer death in this age group. The advances in diagnosis and treatment that will be described in this monograph represent one of the major achievements in the treatment of solid tumors. Testicular cancer is now one of the most curable of all cancers; the 5-year relative survival rate is in excess of 90%. In the U.S. fewer than 500 men will die from this disease in 1989. The primary goals in the treatment of testicular cancer as the 1990s approach will be to further decrease the mortality from this disease and to decrease the morbidity of treatment that has led to this dramatic improvement in survival.

Humans↗

Marketing.

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Humans↗

Designing a market plan.

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Health Services Needs and Demand↗

Promotion.

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Health Promotion↗

Advanced bladder cancer: therapy with cis-dichlorodiammineplatinum(II), adriamycin, and 5-fluorouracil.

Nineteen patients with unresectable or metastatic urothelial cancer were treated with the combination of cis-dichlorodiammineplatinum(II), Adriamycin, and 5-fluorouracil. One patient died within 2 weeks of therapy and one patient had no measurable disease, leaving 18 patients evaluable for survival and toxicity and 17 patients evaluable for response. Eleven patients (65%) achieved a partial remission with attendant clinical improvement, with a median duration of 25 weeks. All nonresponders have died, with a median survival of 17 weeks. The median survival of responding patients was 40 weeks, with two patients alive at 33+ and 63+ weeks. Of particular interest are three patients who had resections of residual pelvic disease after significant regression with chemotherapy. One of these patients remains disease-free at 63+ weeks. Toxicity was significant but generally manageable.

Aged↗

Phase II study of vindesine in patients with metastatic breast cancer.

Twenty-six patients with far-advanced, refractory breast cancer were treated iv with vindesine (DVA) at a dose of 3 mg/m2/week. In 21 evaluable patients there were six partial remissions. Four patients who did not respond after at least four doses of intermittent DVA received continuous-infusion DVA at a dose of 1.5 mg/m2/day X 2 every other week; none responded. Five of the six responders had had disease progression on other vinca alkaloids. Leukopenia and neuromuscular toxicity were dose-limiting.

Breast Neoplasms↗