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Biomedical subjects

S E Order

Publications and source records attributed to S E Order.

At least 91 records · Page 5Linked to original sources
PubMed1983

Concurrent radiochemotherapy in advanced breast cancer.

An initial trial to determine whether the theoretical advantage of concurrent systemic chemotherapeutic protection and local control (by radiation) could be achieved has been applied to 16 patients with breast cancer (Stage 3 and 4). CMFP/CMF combination chemotherapy has been administered with external irradiation (5000 rad breast, 4000-4400 rad nodes). External irradiation was successfully accomplished with tangenital fields to avoid combined modality esophagitis while achieving internal mammary node irradiation. Six patients subsequently received Iridium-192 interstitial implantation. Six patients treated preoperatively (4000 rad, breast) were able to have modified mastectomy within 3-6 weeks of completing radiation therapy without graft requirement or undue morbidity. Acute reactions during therapy included some amplification of epidermitis and myelosuppression. Prolongation of the radiation treatment course occurred in two patients and delay in chemotherapy cycles in four patients. In two patients, the leukocyte count nadir was below 1000 and one was hospitalized with fever. The majority of the patients achieved 75% of the designed chemotherapeutic doses in the ensuing year. Many of the patients with advanced disease were administered an Adriamycin-containing regimen upon completion of the radiation therapy. The current results suggest that it would be feasible to initiate a randomized prospective study using these techniques to compare sequential and concomitant chemo-radiation therapy in primary breast cancer to determine whether there is significant advantage in local control and duration of NED survival in either of the treatment regimens.

Adult↗
PubMed1983

Alternating multiagent chemotherapy for advanced ovarian cancer.

A chemotherapy regimen consisting of hexamethylmelamine (H) 150 mg/m2 orally days 1-14, cyclophosphamide (C) 500 mg/m2 IV day 1 of a 28-day cycle with Adriamycin (A) 40 mg/m2 IV day 1 alternating with cis-diamminechloroplatinum (C-P) 50 mg/m2 IV day 1 every other cycle was administered to 29 patients with advanced epithelial ovarian cancer. Toxicity to this regimen included alopecia, nausea, and vomiting in all patients. Mild paresthesias occurred in four patients. Hematologic toxicity required only minimal dose modification. There was no cardiac, renal, or auditory toxicity. The clinical response rate of 55% and median survival of 14 months compare favorably with that of other reported series. This chemotherapy regimen seems to be well tolerated without jeopardizing the patients' response.

Adenocarcinoma↗
PubMed1983

Selective tumor localization in experimental hepatoma by radiolabeled antiferritin antibody.

The in vivo localization of 131I-radiolabeled antiferritin and normal IgG in the H-4-II-E rat hepatoma model was investigated by serial necropsy. Groups of 14 to 18 animals were injected with 500 microCi (200 micrograms) of normal and antiferritin IgG. The total dose from the nonpenetrating beta radiation was calculated for tumor and normal tissue, and expressed as a targeting ratio of antiferritin to normal IgG for each organ studied. The results demonstrate 2.9 times greater dose deposition in tumors of animals treated with 131I-antiferritin than with 131I-normal IgG. 131I-antiferritin deposited equivalently in primary tumors and metastatic lesions of similar size. The specific binding in tumors could be competitively inhibited by the addition of unlabeled antiferritin but not unlabeled normal IgG. Specific targeting with 131I-antiferritin comparison to 131I-normal IgG did not occur in any normal tissue. There was considerable variation in the dose deposition in different normal tissues.

Animals↗
PubMed1983

Thoracic CT scanning for mediastinal Hodgkin's disease: results and therapeutic implications.

Thoracic CT scans were performed on 42 newly diagnosed patients with Hodgkin's disease. Five of 10 patients with negative chest X ray (CXR) had abnormal thoracic CT scans. Among the remaining 32 patients with mediastinal Hodgkin's disease (MHD) on CXR, pericardial (Ep) and chest wall invasion (Ec) were the two most common sites of involvement which were detectable by CT scan alone. All 14 cases with Ep had M/T greater than or equal to 0.30 and 14 of 21 with M/T greater than or equal to 0.30 had Ep. Six cases had extensive Ec. Ep and Ec accounted for 16 of 19 of the changes in treatment portal or philosophy based on CT scan findings. Because of the high risk of cardiac or pulmonary radiation toxicity in Ep or Ec, radiation treatment alone may be inadequate. Treatment of mediastinal Hodgkin's disease is reviewed here. The use of CT scans for identification of Ep, Ec, and other abnormalities will allow for more precise treatment, further define the use of conventional radiotherapy, combined modality therapy or whole lung irradiation, and allow more accurate analysis of treatment results.

Combined Modality Therapy↗
PubMed1983

Carcinoma of the colon: irradiation by delayed split whole-abdominal technique.

Locally advanced and recurrent colon cancer was treated by irradiating first the pelvis and two hours later the upper abdomen. Curative treatment consisted of 4,000-5,000 rad (40-50 Gy) in 200-rad (2-Gy) fractions to the pelvis and 3,000 rad (30 Gy) in 150-rad (1.5-Gy) fractions to the upper abdomen. Palliative treatment consisted of 2,100 rad (21 Gy) in 300-rad (3-Gy) fractions to the liver, 3,000 rad (30 Gy) in 150-rad (1.5-Gy) fractions to the upper abdomen, and 4,000-5,000 rad (40-50 Gy) in 200-rad (2-Gy) fractions to the pelvis. Treatment was tolerated well, and acute toxicity was limited. Seven of the 11 patients treated curatively remain free of abdominal disease after 10-35 months; median survival among 9 patients treated palliatively was 9 months.

Abdomen↗
PubMed1982

CT scan modification in the treatment of mediastinal Hodgkin's disease.

Seventy-one patients with Hodgkin's disease who were initially treated at Johns Hopkins with radiation or radiation-chemotherapy from 1975--1980 had a five-year cumulative disease-free survival of I-A--100% (12 patients); II-A--85% (33 patients); II-B--83% (seven patients); III-A--75% (ten patients); and III-B--66% (nine patients). Fifty patients with mediastinal masses at the time of treatment demonstrated no marginal misses, two mediastinal recurrences (96% local control), and three lung disseminations. CT scan data yielded stage and treatment modification in 60% (9/15) of recent patients with mediastinal Hodgkin's disease. This demonstrates the need for routine thoracic scans and individual treatment planning in all mediastinal cases. Recommendations for combination treatment in early stage disease are made only for pericardial or extrathoracic chest wall extension based on CT scan findings, our low failure rates, radiation organ tolerances, and available relapse data in the literature, not arbitrary size designations from upright chest radiographs. It can be concluded that patients with mediastinal Hodgkin's disease require CT scan analysis to identify unusual patterns of presentations, sites at risk, and to allow for proper application of radiation portals and/or chemotherapeutic management.

Drug Therapy, Combination↗
PubMed1982

Monoclonal antibodies: potential role in radiation therapy and oncology.

Specificity, which is a hallmark of the immune system, will be used in radiation oncology in both diagnosis and therapy through the application of radiolabelled monoclonal and polyclonal antibodies. Antigenic specificities, antibody preparations, and the tumor as a target for radiolabelled antibody is reviewed. Several clinical situations, i.e. single tumor cell suspensions, intraperitoneal single cells and masses, and solid tumors are reviewed in regard to both immune antibody targeting and specific differences between tumors in these regions. The concentration of tumor associated antigens is introductory to radiolabelled antibodies in diagnosis. In the radiation therapy of solid tumors, data regarding tumor dose, tumor effective half-life, varied antibody preparations, and the use of radiolabelled antibody as a method of tumor implantation is discussed using antiferritin 131I-IgG as a model as a model in hepatoma. The theoretical applications of monoclonal antibody integrated in cancer therapy are then presented as a new goal for future development.

Animals↗
PubMed1982

Multimodality treatment of patients with advanced ovarian carcinoma.

A multimodality treatment program has been applied to ovarian carcinoma at the Johns Hopkins Hospital since August 1975. Forty-nine patients were subdivided into 23 patients with maximally resected Stage III micrometastatic, and 26 patients with significant retained disease, 20 with Stage III macrometastatic and 6 with Stage IV. After initial pilot studies, those patients with minimally retained disease entered a randomized prospective study. Antiovarian antiserum was used in one arm of the study; in both study arms colloidal P-32, delayed split whole abdominal irradiation, and maintenance melphalan were used. For the 23 patients with micrometastatic disease the cumulative survival and survival without evidence of disease at four years is 78 and 34% respectively. Twenty-six patients with macrometastatic disease were treated with or without intraperitoneal antiserum and multiagent chemotherapy; their cumulative one year survival is 50%. The lack of significant toxicity of intraperitoneal antiovarian antiserum and the results of multimodality therapy indicate the feasibility of this therapeutic approach to further improve ovarian cancer therapy.

Adenocarcinoma, Mucinous↗
PubMed1982

Risk factors in interstitial pneumonitis following allogenic bone marrow transplantation.

Total body irradiation is part of the preparatory regimen for allogeneic bone marrow transplantation because of its cytotoxic and immunosuppressive properties. A major toxicity of bone marrow transplantation has been interstitial pneumonitis, which may be, in part, related to the lung irradiation. One hundred and sixty-one consecutive patients receiving allogeneic bone marrow transplantation for leukemia and aplastic anemia at Johns Hopkins Hospital (1968-1979) were retrospectively studied. The present study demonstrated that lung shielding to 600 rad maximum in single dose total body irradiation, fractionation of total body irradiation in comparison to single dose total body irradiation, and absence of graft versus host disease in the leukemia patients, each reduced the risk of interstitial pneumonitis. Total body irradiation significantly reduced the leukemia recurrence rate and/or the failure of remission induction.

Analysis of Variance↗
PubMed1982

Phase I-II study of isotopic immunoglobulin therapy for primary liver cancer.

A phase I-II study of isotopic immunoglobulin therapy was performed in 18 patients with primary liver cancer; 14 were evaluable for toxicity. The patients received a dose of 37-157 millicuries of 131I-labeled antibody. The dose-limiting factor appears to be hematologic toxicity, especially thrombocytopenia. An objective antitumor effect was seen in six of nine patients who were evaluable for response. Present results suggest that further clinical studies with isotopic immunoglobulin are indicated.

Adenoma, Bile Duct↗
PubMed1982

Ip immunotherapy and chemotherapy in advanced epithelial ovarian cancer.

Nine patients with advanced epithelial ovarian cancer, classified as either stage III with macrometastatic residual disease or stage IV, received combination chemotherapy in conjunction with ip rabbit-derived human ovarian antitumor serum (HOATS). The HOATS regimen consisted of the ip instillation of 100 ml of ovarian antitumor serum on Days 1 and 3 of the first chemotherapy cycle. Side effects attributable to HOATS were low-grade fever in three patients and diffuse skin rash in two. The 1-year cumulative survival was 87%, with a clinical response rate of 80%. No significant toxic reactions to HOATS have been observed. Continuation of the present study seems justified.

Adenocarcinoma↗
PubMed1981

The integration of new therapies and radiation in the management of ovarian cancer.

New biologic information has led to a therapeutic program in Stage III ovarian cancer that considers the whole peritoneal cavity the tumor-bearing region and that uses intraperitoneal administration of ovarian cancer antiserum, intraperitoneal P-32, delayed split abdominal irradiation, and chemotherapy. The survival for those patients completing irradiation was 85%. Forty-nine patients with advanced (Stage III, IV, or recurrent) ovarian cancer have been treated with combinations of the present agents. Twenty-two patients have received intraperitoneal ovarian cancer antiserum without significant toxicity. Extensive staging has been a requirement for initial evaluation and includes maximal surgical resection, omentectomy, TAH and BSO, nodal biopsies, and peritoneal cytology. Nineteen patients had 5-mm nodules or less residual disease and were treated with colloidal P-32, abdominal irradiation, and chemotherapy; five of these patients received intraperitoneal antiserum before cytotoxic therapy. The four-year cumulative survival is 84%, and the disease-free survival 43%. A randomized prospective study is now examining the value of antiserum therapy. New experimental data from our laboratory indicate 1) the value of 2/3 biomarkers (alpha globulin and free secretory protein) in following patients for remission of disease and 2) the probability of the development of more effective antiserum with high specific titer. Studies of the radiosensitivity of ovarian cancer indicate the tumor was not different from other solid tumors. Our studies indicate the role of radiation therapy as a cytoreductive agent should be integrated in multimodality therapy and that the immune system offers new possibilities in amplifying therapeutic results.

Alpha-Globulins↗