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Biomedical subjects

S Seeber

Publications and source records attributed to S Seeber.

At least 271 records · Page 15Linked to original sources

[Sequential combination chemotherapy with vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) in non-seminomatous testicular cancer. I. Results of a prospective randomized phase III-study with 71 patients with disseminated disease (stage IV) (author's transl)].

74 patients with disseminated non-seminomatous testicular cancer were randomly entered on a prospective sequential combination chemotherapy regimen with mandatory crossover, consisting of either vinblastine/bleomycin or adriamycin/cis-dichlorodiammineplatinum (II) (DDP) as initial therapy. Independent of the randomization the overall remission rate in 71 evaluable patients was 89% including 54% complete remissions. 35% of the patients remained disease-free at 2+ to 28+ months with a median of 12 months. By additional surgical removal of residual pulmonary metastases in two patients the complete remission rate was increased to 40/71 (56%), and the number of patients with no evidence of disease to 27/71 (38%). According to the life-table method the two-years survival rates were 63% for complete responders and 29% for all other patients, which was significantly lower. 53 patients (75%) were alive at 3 to 28 months with a median of 9 months. Additional advanced abdominal disease, initially elevated beta-HCG and LDH and extension of pulmonary disease were of significant negative influence on the prognosis. The evaluation of single chemotherapy courses revealed equal efficacy of both combinations. However, response to adriamycin/DDP occurred in 46% of the courses, when vinblastine/bleomycin had failed, while response to vinblastine/bleomycin occurred only in 21% of the courses when adriamycin/DDP had failed. Thus different patterns of cross-resistance between these alternative regimens may exist.

Bleomycin↗

[Sequential combination chemotherapy with vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) in non-seminomatous testicular cancer. II. Long-term results of a study with 140 patients with retroperitoneal disease (stage II) (author's transl)].

Following orchiectomy and retroperitoneal lymph node dissection (RND) 140 patients with stage II non-seminomatous testicular cancer were treated by sequential combination chemotherapy consisting of vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum(II) (DDP), plus/minus radiotherapy. 68 stage IIA-patients (complete RND and normal tumor-markers thereafter) received 6 courses of chemotherapy, followed by radiotherapy in 35 patients. 40 stage IIB-patients (minor residual disease after RND or elevated tumor-markers after RND) and 32 stage IIC-patients (advanced residual disease after RND) were treated by at least 12 chemotherapy courses and optional intermittent radiotherapy and/or relaparotomy. In stage IIA and IIB disease the actuarial 4-year survival rates were between 80 and 100%. These favourable results were not significantly influenced by additional radiotherapy and corresponded to the survival rates for 34 stage I-patients. For stage IIC-patients the prognosis was significantly worse with a 12% 4-year survival rate.

Bleomycin↗

[Improved antiemetic treatment with levomepromazine (author's transl)].

The antiemetic effect of levomepromazine (Neurocil) was tested in 76 patients treated for metastasizing malignancies with cis-dichlorodiammineplatinum (II) (Platinex). In all patients conventional antiemetics had been ineffective against gastrointestinal side effects of platinum. Using levomepromazine vomiting and nausea could be successfully prevented in 47 out of 63 patients on conventional cis-platinum doses (20 mg/m2 for 5 consecutive days) and in 5 out of 13 patients on high single day dosages (100 mg/m2). In most other patients clear-cut subjective improvement occurred. The antiemetic effect of levomepromazine against cis-platinum, which ranks among the most widely used cytostatics and causes gastrointestinal symptoms, is of importance in medico-oncological practice as it causes relief for the patients.

Cisplatin↗

[Combined chemo- and radiotherapy in inoperable small-cell anaplastic bronchial carcinoma (author's transl)].

Combined treatment with adriamycin, cyclophosphamide and vincristine (ACO) was used in 50 out-patients with histologically verified small-cell bronchial carcinoma. In 26 patients with locally and regionally limited metastases ("limited disease") radiotherapy (3000 rad focal dose) to mediastinum, hili and tumour opacity as well as prophylactic cranial irradiation (3000 rad focal dose) were performed after 3 cycles of chemotherapy. Complete clinical remission (without endoscopic control) was achieved in 32 out of 50 patients. Remissions in patients with bilateral pulmonary or extrathoracic metastases ("extensive disease", n = 24, 12 complete remissions) only led to limited asymptomatic prolongations of life (median survival time 10 months, median remission period 5 months) despite maintenance therapy. On the other hand patients with "limited disease" had considerable life prolongation (median survival 21 months, historical control value 3--4 months). Seven out of 26 patients in this group survived for 30 months after the onset of the disease, 6 out of 26 are now in their third year after starting therapy without signs of tumour recurrence. The results show that early recognition of patients with local and regional metastases has considerable prognostic value.

Carcinoma, Small Cell↗

Combination chemotherapy with ifosfamide and cis-dichlorodiammineplatinum (II) in advanced malignant melanoma.

Twenty-five patients with measurable lesions of advanced malignant melanoma received a combined chemotherapy containing cis-dichlordiammineplatinum (II) (cisplatin) 30 mg daily at days 1, 3, 5, 7, 9, and ifosfamide 45 mg/kg at days 2, 4, 6, 8, and 10. Most of the patients had been previously treated with DTIC or DTIC-containing combinations. An objective response was observed in 10 patients including three complete and seven partial remissions. Medium survival was 3 months for nonresponders and 6 months for responders. Nausea and vomiting during chemotherapy could be reduced effectively be the use of levomepromacine (Neurocil). Hematologic toxicity was considerable in extensively pretreated patients and made it necessary to postpone subsequent courses in two cases.

Adult↗

Comparative nuclear and cellular incorporation of daunorubicin, doxorubicin, carminomycin, marcellomycin, aclacinomycin A and AD 32 in daunorubicin-sensitive and -resistant Ehrlich ascites in vitro.

The kinetics of cellular and nuclear incorporation of a number of new anthracyclines into daunorubicin-sensitive and -resistant Ehrlich ascites cells were determined in vitro. For comparative quantitative analyses the substances were extracted with a 0.3 N HCl/50% ethanol (v/v) solution from either whole cells or purified citric acid nuclei after various intervals of in vitro incubation. At steady state the intracellular and intranuclear concentrations of daunorubicin and doxorubicin were reduced by about 50% in the resistant cell line. Marcellomycin and carminomycin concentrations were only reduced by 9% and 11%, respectively, and no differences between sensitive and resistant cells were seen in the case of aclacinomycin A and AD 32. When the ratios of nuclear to cellular drug were determined at steady state lowest value was found for AD 32 (0.26). In contrast, aclacinomycin A and carminomycin were mainly (78% and 74%) and marcellomycin almost exclusively (95%) concentrated in the nucleus. When the total amounts of drug incorporated per cell were compared, the highest values were measured for aclacinomycin A and the lowest for AD 32 both in the sensitive and the resistant tumor. Additional determinations of the 50% inhibitory concentrations for thymidine uptake showed similar differences between these anthracyclines which were not related to the potency of the drugs in vivo. It is concluded that apart from nuclear incorporation and inhibition of DNA synthesis other factors may be decisive for anthracycline-induced cytotoxicity.

Aclarubicin↗

[Adriamycin, cyclophosphamide and vincristine (ACO) in small cell bronchial cancer. Course of the disease and long-term follow-up].

This report summarizes our experience in 94 patients with inoperable small cell bronchogenic carcinoma treated with protocols "ACO I" and "ACO II" at the West German Tumor Center Essen. Long-term follow-up is documented for a group of 50 patients who were fully ambulatory. Complete responses were obtained in 20 of 26 patients with "limited disease" and in 12 of 24 patients with "extensive disease". The median survival of all 50 patients was 12 months (10 months in "extensive disease", 21 months in "limited disease"). An analysis of relapse patterns indicated that the local intrathoracal recurrence, especially in patients with "limited disease", remains one of the main problems. The report also includes a detailed analysis of long-term survivors. With the "ACO II" protocol which is designed to study the value of maintenance therapy after aggressive induction treatment in patients with complete response, 44 patients have thus far been evaluated for response (CR 50%). The number of patients randomized for maintenance chemotherapy is still too small to draw further conclusions at this point.

Aged↗

[Results of cytostatic therapy with cyclophosphamide, vincristine, adriamycin and DTIC (CYVADIC) in localized and metastasized osteosarcoma. A retrospective analysis].

From December 1973 to november 1978, 31 patients with osteosarcoma were treated with combination chemotherapy consisting of cyclophosphamide, vincristine, adriamycin and DTIC. 11 out of 19 patients with localized osteosarcoma are alive with no evidence of disease, 14+ to 40+ months after initiation of adjuvant postoperative chemotherapy. The probability of relapse-free survival for this group was calculated as 62% at 2 years and 48% at 3 years. Considering the 15 patients with osteosarcoma of the limbs relapse-free survival will be 79% at 2 years and 62% at 3 years. In 10 of 11 patients with no relapse the primary tumor has been located in the metaphysis of the proximal tibia or the distal femur. All patients with osteosarcoma of the trunk have died from metastases. Most of the 12 patients with metastasizing osteosarcoma died within one year after onset of chemotherapy. In none of these patients a complete remission could be achieved. For patients receiving adjuvant chemotherapy results are comparable with those reported by other investigators. In patients with disseminated osteosarcoma alternative chemotherapy regimens including adriamycin, cis-dichloro-diammine-platinum and ifosfamide may prove superior. In a pilot-study using vincristine-adriamycin-DDP or ifosfamide-DDP response to chemotherapy was noted in 4 out of 7 patients with two continuing complete remissions for 13+ and 5 1/2+ months, respectively.

Adolescent↗

[Combined chemotherapy and radiotherapy of localized and metastasizing Ewing's sarcoma (author's transl)].

Between 1973 and 1978 combined radiotherapy and chemotherapy were given to 22 patients with histologically proven Ewing's sarcoma. The combined chemotherapy consisted of cyclophosphamide, vincristin, adriamycin, as well as dacarbazine in some cases. The neoplasm was a localized one at the beginning of treatment in 14 of the 22. These patients received high-voltage radiotherapy to the primary focus at a focal dose between 42 and 55 Gray (4200-5500 rad), followed by chemotherapy. After 6--8 treatment cycles, adriamycin was replaced by methotrexate. Nine of the 14 patients survived without recurrence for 12 to over 59 months. Eight patients had extensive metastases at the beginning of treatment: they at first received only chemotherapy, followed by radiotherapy or operation, as indicated. Full clinical remission was achieved in five of them: in three this remission has now lasted for more than 18, 40 and 44 months, respectively. These results indicate that (1) additional chemotherapy improves the prognosis of localized Ewing's sarcoma, and (2) even in far-progressed cases the combination of chemotherapy and radiotherapy can achieve lasting remission, which may in fact be a true cure.

Adolescent↗

[Idiopathic thrombocytopenic purpura in Hodgkin's disease--an early sign of a recurrence (author's transl)].

Idiopathic thrombocytopenic purpura (ITP) in the course of Hodgkin's disease is generally judged to be a paraneoplastic immune phenomenon. This concept finds support in the observation of a patient who developed simultaneously a recurrence of ITP and a protein anomaly in the form of an alpha-chain protein. Combined chemotherapy brought about remission of the Hodgkin's disease at the same time as normalisation of the platelet values and disappearance of the alpha-chain protein. There is no necessary correlation between tumour activity and ITP. But if ITP is observed, the most effective means would seem to be rigorous treatment of the Hodgkin's disease.

Adult↗