Search PubMed⌕ Search

Biomedical subjects

S Eckhardt

Publications and source records attributed to S Eckhardt.

At least 55 records · Page 3Linked to original sources

[Follow up of thyroglobulin levels in patients with surgically treated, highly differentiated thyroid cancer].

The highly differentiated thyroid tumours account for 0.80 percent of all human malignancies. The papillary and follicular tumour tissues of this tumour type are relatively benign, hormone dependent and beside their treatment specificity they secrete the tumour specific thyreoglobulin. Thus it becomes possible to follow the development of metastases, the effectiveness of therapy applied as well as the history of the disease. The authors studied the change of thyreoglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients pathologically elevated (70 to 100 ng/ml) thyreoglobulin level was observed. This proves the 91 percent specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false negative cases were found. The authors establish that, irrespective of the site of metastasis, the thyreoglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyreoglobulin level is a suitable marker of the highly differentiated thyroid cancer since it represents the local recurrence of distant metastases with a significant increase while the therapy-resultant tumour diminution with a marked decrease, respectively.

Adenocarcinoma↗

[Combined therapy of malignant testicular tumors].

The 5-year survival of patients with malignant testicular tumors rose during the past 25 years from 10-25% depending on stage to 55-100% after radical castration performed from high inguinal opening, retroperitoneal lymphadenectomy, ultra-tension irradiation and adjuvant chemotherapy. It is stressed that patients diagnosed at stage T1-2, N0-2, M0 may even recover perfectly upon complex therapy. Three to five-year long or even longer survival may be reached with 50% of the patients at the stage T1-3, N1-3, M1. Patients at stage T4, N3-4, M1 die because of the recurrence of the tumor and/or the complication of the adjuvant treatment within 1-3 years and even the interdisciplinary work which is very effective in other stages fails to change this at the present time.

Combined Modality Therapy↗

Postoperative thyroglobulin level determination to follow up patients with highly differentiated thyroid cancer.

The highly differentiated thyroid tumours account for 0.80% of all human malignancies. The papillary and follicular tumour tissues of this tumour type are relatively benign, hormone-dependent and beside their treatment specificity they secrete the tumour-specific thyroglobulin. This it becomes possible to follow the development of metastases, the effectiveness of therapy applied as well as the history of the disease. The authors studied the change of thyroglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients a pathologically elevated (70-100 ng/ml) thyroglobulin level was observed. This proves the 91% specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false-negative and 6 false-positive cases were found. The authors establish that, irrespective of the site of metastasis, the thyroglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyroglobulin level is a suitable marker of the highly differentiated thyroid cancer since it indicates local recurrence or distant metastases by a significant increase while therapy-resultant tumour diminution is accompanied by a marked decrease.

Adult↗

Prednimustine treatment in malignant lymphomas.

Prednimustine (Stereocyt, Leo 1031) is a chlorambucil ester of prednisolone. Results from clinical trials confirm that prednimustine is active in malignant lymphomas. The efficacy of Stereocyt was evaluated in 25 patients, who were divided into three subgroups: 10 patients with refractory Hodgkin's disease and 7 with refractory non-Hodgkin lymphoma (NHL), while 8 patients received prednimustine as primary therapy for low-grade NHL. Totally 17 partial remissions were observed in all three groups of patients. Leukopenia and thrombopenia were induced in 3 patients, but were mild and reversible after withdrawal of the drug.

Adult↗

Activity of epirubicin and dibromodulcitol in advanced breast cancer. Results of the South-East European Oncology Group Study.

The therapeutic efficacy of the combination of epirubicin + dibromodulcitol was evaluated in 108 previously treated or untreated patients with advanced breast cancer. The overall response rate was 39.8%, complete remission 3.7% (mean duration 6.3 months) and partial remission 36.1% (mean duration 3.5 months). The response was rated in function of age, menopausal status, performance status and previous therapy. Toxicity (in case of 115 patients) was evaluated according to the WHO recommendation. The similar therapeutic effectiveness and less toxicity of the above drug combination compared to ADM + DBD regimen are demonstrated.

Adult↗

Ifosfamide chemotherapy of metastatic renal cell cancer.

In view of the divergent reports on the efficacy of ifosfamide in metastatic renal cell cancer, we tested this drug as monotherapy in nine patients on a dosage schedule of intravenous infusion of 40 mg/kg per day on days 1-5, repeated every 4 wk. The drug was administered in 1 liter saline dextrose over 2 hr, with hydration, alkalization of the urine, and mesna. No objective response was registered and subjective response in three patients was of short duration. The number of patients in this series is too small to draw definitive conclusions. However, the results obtained in this study does not prove antitumor activity for ifosfamide in renal cell cancer.

Adult↗

Activity of epirubicin in combination chemotherapy of advanced ovarian cancer. Results of the South-East European Oncology Group (SEEOG) Study.

The therapeutic efficacy of the combination of cyclophosphamide + epirubicin + cisplatin was evaluated in 107 previously treated or untreated patients with advanced ovarian cancer. The overall response rate was 58.8%, complete remission 36.4% (mean duration-7.62 months) and partial remission 22.4% (mean duration-6.74 months). The response was rated in function of age, menopausal status, performance status and previous therapy. Toxicity (in case of 109 patients) was evaluated according to the WHO recommendation. The similar therapeutic effectiveness and less toxicity of the above drug combination compared to CAP regimen is demonstrated.

Adult↗

Pharmacokinetic study in a phase I trial with an alkylating agent, diacetyldianhydrogalactitol (DADAG).

Diacetyldianhydrogalactitol (DADAG), a new alkylating hexitol derivative, was given in 30-min infusions for 5 consecutive days or as a single high-dose administration. The parent drug was eliminated in a biphasic manner, with a terminal half-life of 30-40 h. Dianhydrogalactitol (DAG), the main, pharmacologically active metabolite, appeared after a lag time of about 0.2-0.6 h. Its peak concentration was reached 1-2 h after termination of the infusion. The terminal elimination of DAG followed that of the parent compound. During the 5-day schedule slight accumulation was observed, and the plasma concentrations of both compounds approached the steady state. Over a dose range of 75-1050 mg/m2 the daily mean plasma concentrations of DADAG increased by only about 3-4 times. Dose-dependent expansions of the distribution volumes of the drug (Vc, V lambda, Vss) were observed. The behavior of DADAG and DAG in the body could be adequately described by a three-compartment open model. After equilibration the plasma levels of the parent compound and its metabolite were determined by the rate of return of DADAG from the peripheral compartment and its conversion to DAG.

Adult↗

Problems of staging colorectal cancer.

A total of 2994 cases of previously untreated colorectal carcinomas taken from the database of the International Cancer Patient Data Exchange System of the UICC were analyzed. The objective was to compare pretherapeutic and postsurgical data and to investigate the impact of missing information on the quality of tumor staging under routine conditions. In clinical staging, a higher percentage of items were marked "unknown" in the questionnaires than in histopathological staging. The clinical and postoperative assessment of TNM stages Ib, II, and III frequently diverged, indicating a low precision for clinical staging. Fistulae were rarely observed in either colon or rectum carcinoma.

Aged↗

Dibromodulcitol-based combined postoperative chemotherapy of malignant astrocytomas and glioblastomas.

Continuing our earlier studies with dibromodulcitol (DBD), in a series of 38 evaluable consecutive patients who were operated on for malignant supratentorial gliomas, radiotherapy with smaller daily but higher total doses of DBD has been started 3-5 weeks after surgery. This was followed alternately by a combination chemotherapy of CCNU and DBD or CCNU and Procarbazine. No severe myelotoxicity occurred. Survivals were compared with a group of patients who got irradiation alone. Statistical analysis showed a significantly better survival in the presently treated group: median survival was 55 weeks, p = 0.02. These values were very similar to those groups which were treated by intermittent DBD schedule during irradiation. This study seems to confirm our previous suggestion that the concurrent use of DBD during irradiation might be an important factor in improving survival times.

Adult↗

Pharmacokinetics and metabolism of dianhydrogalactitol DAG in patients: a comparison with the human disposition of dibromodulcitol DBD.

Dianhydrogalactitol (DAG), labelled with 3H, was administered in single intravenous or oral doses to six patients (three in each group) with cancer. Kinetic parameters were calculated for the unchanged DAG and its biotransformation products. Elimination of the drug by metabolism and excretion was described by a catenary model. In order to elucidate the role of DAG as a mediator of the alkylating action of the cytostatic drug dibromodulcitol (DBD), the pharmacokinetic parameters of DAG and DBD were compared. The mean residence time for pharmacologically active molecules in the body was six times shorter for DAG (1.9 hr) than for DBD (11.4 hr). Alkylating action and metabolic degradation proceeded about 8-9 times faster for DAG than for DBD. The process of DBD alkylation implies a slow solvolytic conversion of the parent drug into the more reactive bromoepoxide and DAG. The preformed DAG would be rapidly consumed by intracellular alkylation and degradation, while unchanged DBD could form a depot in the cells and exert its cytostatic activity through the epoxides released in situ by solvolytic activation. Thus DBD entering the cells in unchanged form may have a more important role in its therapeutic effects than had been assumed earlier.

Adult↗

Hormonal changes during a prolonged tamoxifen treatment in patients with advanced breast cancer.

The effect of tamoxifen (TAM) on the serum levels of sexual hormones and on the sex hormone-binding globulin (SHBG) was investigated in 30 postmenopausal patients with advanced breast cancer. To study the 'prolactin reserve capacity' of the pituitary gland, thyrotrophin-releasing hormone (TRH) and sulpiride-induced prolactin release were measured prior to TAM treatment, then in the 2nd and 8th week of the therapy. The TRH (400 micrograms i.v.)-induced prolactin secretion was significantly suppressed by TAM after an 8-week treatment, but only in responding cases. Maximal prolactin stimulation occurred at the 15th min after TRH injection, being equal to 5,600 +/- 800 mlU/l in cancer patients, and decreasing to 2,400 +/- 150 mlU/l after 8 weeks. TAM did not suppress the sulpiride-inducable prolactin release either in responders or in nonresponders.

Bone Neoplasms↗

Pain killing with calcitonin in patients with malignant tumours.

The most essential role of Miacalcic (Calcitonin Sandoz), a 32-amino-acids peptide, is the preservation of osseal integrity. Based on this physiological fact it is assumed that this hormone may have a bone-regenerating effect in bone metastasis formation and sometimes in other malignancies. Though no considerable calcium incorporation could be revealed in our 58 patient treated with Miacalcic, a marked relief of pain was observed in 65.5% of the patients. For objectivation of the subjective pain sensation, the decrease in the quantity of other analgetics used daily, duration of pain and changes of its intensity were studied. These figures were 35.4% on the average, from 12.5-6 h and 23.6%, respectively. The pain-killing character of Miacalcic cannot be explained, but the following assumptions are made: (1) it partially inhibits the synthesis of algogenous peptides; (2) with its possibly cytostatic effect it inhibits the cell proliferation in loco and normalizes the internal pressure of the destroyed region, and (3) by conversion into beta-endorphin it exerts its effect centrally. Compared to the pain-killing effect, the simultaneous improvement of the quality of life seems to be even more essential. It has been proved earlier that a hormone physiologically present, when applied in a high dose, has an analgetic effect, i.e. by utilizing the endogenous substance of the organism, relief of pain can be achieved. We should like to point out that Miacalcic is the only analgetic agent capable of ensuring relief of pain with a simultaneous improvement of the quality of life. Accordingly, the application of Miacalcic in patients suffering from malignant tumours is highly recommended.

Analgesics↗