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Biomedical subjects

U Tirelli

Publications and source records attributed to U Tirelli.

At least 325 records · Page 18Linked to original sources

Combined radiotherapy and chemotherapy with cyclophosphamide, adriamycin, methotrexate, procarbazine (CAMP) in 64 consecutive patients with epidermoid bronchogenic carcinoma, limited disease: a prospective study.

Sixty-four consecutive patients with inoperable epidermoid bronchogenic carcinoma (limited disease) were treated with radiotherapy to the primary and nodal areas and combination chemotherapy with cyclophosphamide, adriamycin, methotrexate and procarbazine. The overall response rate (CR + PR) to combined treatment was 62%. The median survival time was 12.7 months. The toxicity was acceptable and no treatment-related death occurred.

Adult↗

Combined chemotherapy with doxorubicin, bleomycin, vinblastine, decarbazine, and radiotherapy for advanced lymphoepithelioma.

Twelve consecutive patients with advanced lymphoepithelioma and no previous chemotherapy or radiotherapy were observed in our Division between January 1975 and December 1980. Primary treatment of 11 evaluable patients with doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) for at least three cycles resulted in complete remission (CR) in four patients; partial remission with a less than 50% reduction of tumor volume in four; partial remission with a greater than 50% reduction of tumor volume in one; and no response in two. With the addition of radiotherapy in doses of 4500-6000 rad to the primary tumor and the bilateral laterocervical lymph node chains, the combined treatment resulted in CR in eight patients. At 27 months the median duration of CR in these patients has not been achieved, and the median survival has not been achieved at 32 months.

Adolescent↗

Combination chemotherapy for multiple myeloma with melphalan, prednisone, cyclophosphamide, vincristine, and carmustine (BCNU) (M-2 protocol).

From January 1975 to May 1981, 25 consecutive patients with multiple myeloma (MM) were entered in a prospective study and treated with the M-2 protocol (melphalan, prednisone, cyclophosphamide, vincristine, and carmustine [BCNU]). The Karnofsky performance status was less than 70 in 62% of the patients. Nineteen patients were classified as being in stage III, three were in stage II, and three were in stage I. All patients had symptomatic and previously untreated MM. In 17 of 21 (80.9%) evaluable patients, an objective response according to Myeloma Task Force criteria was obtained. There was no difference in response rate among patients in the various stages of the disease or according to types of proteins secreted. The median time to obtain an objective response was 2 months and the median duration of the remission is 18+ months. The actuarial median survival was 42 months. In the first 15 months of follow-up, 20% of the patients died. Toxicity was not negligible and was mainly hematologic. One treatment-related death occurred. Our study confirms the efficacy of the M-2 protocol in MM and supports the data reported by the Memorial Hospital group.

Adult↗

Combination chemotherapy with cyclophosphamide, vincristine, and prednisone (CVP) in TNM-classified stage IV mycosis fungoides.

Nine patients with stage IV mycosis fungoides (MF), according to TNM classification, were treated with cyclophosphamide, vincristine, and prednisone (CVP). CVP induced a 66% overall objective response rate and a 44% complete response rate, which is the highest reported in the literature. CVP is an effective regimen in MF and could be employed in combination with total skin or total lymphoid radiotherapy. TNM classification should be used for all patients with MF, because it makes the evaluation and comparison of treatments more reliable.

Adult↗

Radiotherapy of brain metastases: conventional versus concentrated treatment.

From January 1975 to March 1981, 97 consecutive patients with brain metastases from various tumors were treated with cobalt-radiotherapy. Two successive treatment schedules were employed: the first 52 patients were treated according to a conventional schedule (30 or 40 Gy in 15 or 20 treatments over a 3 or 4 week period), while in the successive 45 patients a concentrated schedule was employed (2 series of 17 Gy in 2 sessions over a 3 day period, separated by an interval of 3 weeks). In the 87 evaluable patients, no significant difference was noted regarding the efficacy of radiotherapeutic treatment (25/47 and 20/40 partial remissions, respectively, with median survival of 4 and 3 months, respectively). Acute toxicity was more relevant with concentrated irradiation (approximately 20% of cases).

Adult↗

Adriamycin, bleomycin, vinblastine and DTIC in advanced diffuse lymphocytic poorly differentiated lymphoma.

From January 1975 to December 1979, 14 consecutive patients with advanced (stage III-IV) diffuse lymphocytic, poorly differentiated lymphoma (DLPD) were treated with adriamycin, bleomycin, vinblastine and DTIC (ABVD). Either maintenance combination chemotherapy with CVP or radiotherapy over bulky disease was added in the cases with complete response (CR). Fifty per cent of the patients achieved CR and 80% achieved objective responses. Among CRs, 100% were alive at 2 years, 70% of them without evidence of disease. Overall, 75% of the patients were alive at 2 years, 30% without evidence of disease. Toxicity was acceptable and no drug-related deaths occurred. ABVD is not the ideal combination for DLPD, but it should be taken into consideration in patients with advanced DLPD in which first line combination chemotherapy regimens are not successful.

Adult↗

VM 26 in advanced mycosis fungoides.

Five consecutive patients with progressive extracutaneous stage IV mycosis fungoides (MF) were treated with VM 25, 100 mg/m2 i.v., for at least 3 cycles. All patients had been extensively pretreated and in particular with vinca alkaloids. Two partial responses of 5 and 9+ months duration and 1 minimal response of 5 months duration were obtained. Transient myelosuppression was encountered in all patients. These preliminary results should encourage further exploration of VM 26, even in less advanced MF.

Adult↗

Hairy cells.

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Aged↗

Sequential combination chemotherapy of advanced head and neck carcinoma: re-evaluation of a highly effective regimen.

Twenty-seven evaluable patients with advanced head and neck squamous carcinoma were treated with a polychemotherapeutic regimen described in 1975 by Price et al. Chemotherapy consisted of vincristine, adriamycin, bleomycin, methotrexate, 5-fluorouracil, hydroxyurea, 6-mercaptopurine and citrovorum factor administered sequentially. One complete remission, 4 partial remissions, 7 minor responses were obtained for a total of 12/77 (44%) objective responses. Toxicity was acceptable. The results obtained were not better than those observed with less complicated regimens administrable on an outpatient basis.

Adult↗

Medical treatment of metastatic renal cell carcinoma.

Thirty five patients with metastatic RCC were observed over a 57 months period in our Division of Radiotherapy and Medical Oncology, and 30 are evaluable for this analysis. MPA was selected as primary treatment agent in 23 patients, VLB singly, in combination with MPA or in combination with CCNU was used in 1.4 and 2 patients. With MPA the TR rate was 3/23 (1 CR and 2 PR). Duration of response for the patient with CR was 6 months whereas for the patients with PR was 21 and 14 months respectively. 4 additional patients showed NC. With VLB-MPA the TR rate was 1/+ (1 PR). Duration of PR was 3 months. The median duration of survival for the 11 patients with CR, PR and NC was 14 months whereas for the 19 patients with NR was 7 months (p < 0.01). TES and TAM showed no or minimal activity as second treatment agents.

Adult↗

Malignant histiocytosis in adults: report of 7 patients from Northeast Italy.

The clinical records and histologic material of seven adult male patients with malignant histiocytosis (MH), observed consecutively at our center during a four-year period, have been reviewed; four of these cases were seen in a year. All patients were born and lived within a radius of 30 miles from Pordenone, a town in northeast Italy. The diagnosis of MH was made in all cases on lymph node biopsy on the basis of the established histologic criteria [1]. At presentation, abnormal histiomonocytic cells were found in the bone marrow and peripheral blood of four patients, two of whom also showed cerebrospinal fluid involvement with atypical histiocytes at a relatively early stage of the disease. Staging procedures documented extensive disease in lymphatic, as well as in extralymphatic, sites in four patients; in three patients, the disease was confined to the lymphatic system. Combination chemotherapy was the first treatment employed in all cases. Four patients, three of whom had limited disease, achieved complete remission with quadruple combination chemotherapy (ABVD, CHOP, or MOPP); three patients with extensive disease achieved only partial remission of short duration with HOP. These results further support the view that adult MH is not obligatorily and rapidly fatal. Good responses to treatment with combination chemotherapy are possible, particularly in patients with disease limited to only lymphatic sites.

Adult↗

[Oncology outpatient clinic in a general hospital].

From January 1975 to June 1979 3,007 new patients have been followed in the Out-patient Clinic of the Division of Radiotherapy and Medical Oncology of the Ospedale Civile, Pordenone. A progressive increase in the number of patients and the validity of follow-up care has been demonstrated. Patients still encounter considerable logistic difficulties, which could be reduced by programming diagnostic procedures the same day of therapy. The organization of a drug service in the Out-patient Clinic, a more active collaboration with the sanitary units working outside the Hospital, and an adequate psychological assistance could solve many of the problems which are superimposed on the direct effects of the disease.

Humans↗