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Biomedical subjects

W D DeWys

Publications and source records attributed to W D DeWys.

At least 37 records · Page 2Linked to original sources
PubMed1982

Pathophysiology of cancer cachexia: current understanding and areas for future research.

Weight loss and failure to gain weight normally in cancer patients are attributable to negative energy balance and altered metabolism. Energy balance is negative because of decreased intake, increased expenditure, or both. Changes in carbohydrate metabolism include glucose uptake and lactate production by tumor, relative hypoinsulinism, and relative insulin resistance. Alterations in protein metabolism include preferential uptake of amino acids by the tumor, decreased synthesis of some host tissue proteins such as muscle tissue, and increased synthesis of other host proteins. Lipid metabolism is seemingly less affected. These metabolic changes result in muscle wasting in adult cancer patients and growth failure in pediatric cancer patients. Host tissues are catabolized to meet the nutritional demands of tumor, and nutritional death may ensue.

Adult↗
PubMed1981

A study of the nutritional status of pediatric cancer patients.

The records of 455 children were reviewed to investigate the relationship of nutritional status at time of first referral to various measurements of disease and survival. Initial symptoms of weight loss, anorexia, fatigue, and early satiety were all directly correlated. Serum albumin level and nutritional status were not directly correlated. Likewise, there was no direct relationship between performance status and nutritional status. However, higher values of serum albumin were associated with better performance status. Nutritional status was directly related to freedom from relapse among children with solid tumors whether they had localized or non-localized disease. In addition, improved survival was related to good nutritional status for children with localized disease, whereas those with advanced disease had a poorer survival regardless of their nutritional status. Nutritional status appears to have prognostic implications among children with cancer.

Body Height↗
PubMed1981

Clinical parameters related to anorexia.

Caloric intake was studied in 89 cancer patients who recorded diet diaries. Twenty-five percent had caloric intake below their calculated basal energy expenditure (BEE). An additional 45% had caloric intakes between 1.0 and 1.5 x BEE. Patients reported symptoms referable to the oronasal area and the gastrointestinal tract as possible factors in decreased eating. Food intake is controlled by several categories of cues and one or more of these may be altered in cancer patients to decrease caloric intake.

Anorexia↗
PubMed1980

Synergistic antileukemic effect of theophylline and 1,3-bis(2-chloroethyl)-1-nitrosourea.

A series of experiments evaluated the antileukemic effect of an agent which elevates cellular cyclic adenosine 3':5'-monophosphate levels by phosphate levels by inhibiting phosphodiesterase. When administered alone, theophylline had only modest antileukemic effects, but it had synergistic effects when administered with 1,3-bis(2-chloroethyl)-1-nitrosourea. This synergism produced an improved therapeutic index in a dose-response study and in a comparison between antileukemic effects and effects on white blood cell nadirs. Uptake of 1,3-bis(2-chloroethyl)-1-nitrosourea and studies of timing of treatment support the hypothesis that elevation of cyclic adenosine 3':5'-monophosphate levels is the mechanism of the observed synergistic effect.

Animals↗
PubMed1980

A proposed model for the prediction of response to endocrine therapy in breast cancer from the estrogen receptor status of one site and the number of metastatic sites.

A mathematical model for prediction of response to endocrine therapy of breast cancer has been developed based on a clonal concept of metastatic spread. The model includes an expression of the likelihood of response of an estrogen receptor-positive site and an expression of the concordance of receptor assays when multiple sites are assayed. Both of these are raised to a power function based on the number of sites of metastases to yield a predicted response rate. An excellent fit of the predictions of this mathematical model and response data from a series of patients receiving endocrine therapy was observed. This model provides a worthwhile insight into the biology of response to endocrine therapy. The model may be extended and refined through additional analyses.

Binding Sites↗
PubMed1979

A randomized comparison of two dosage schedules of methyl CCNU: three-week versus six-week treatments.

Two dose schedules of methyl CCNU were compared for drug effect and toxicity. One hundred thirteen patients were stratified by tumor site, performance status, and prior chemotherapy and randomized to 100 mg/m2 q 3 wk or 200 mg/m2 q 6 wk orally. Response rates were similar (12% vs. 18%, respectively, in the major tumor sub-types studied) and survival was equivalent. Hematologic toxicity, however, was significantly different, with earlier time to the most severe blood count depressions, more frequent occurrence of severe depression, and a larger percentage of patients requiring dosage reduction on the 6-week regimen. We conclude that the 3-week regimen is superior due to its improved tolerance and is recommended especially for combination drug therapy.

Adenocarcinoma↗
PubMed1978

Adjuvant methotrexate and leucovorin in head and neck squamous cancer. Two-year follow-up of a pilot project.

A series of 17 patients with stage III and IV head and neck cancer received three cycles of methotrexate and leucovorin calcium during an interval of two weeks prior to surgery and/or radiotherapy. The dosage of methotrexate was sequentially escalated to produce mucositis (the usual dose-limiting toxicity). All patients have been followed up for a minimum of two years (range, 24 to 44 months). Two recurrences and two second primary tumors occurred in seven patients with stage III cancer, and one recurrence and one postoperative death (pulmonary embolism) occurred in ten patients with stage IV cancer. Seventy-six percent of patients survived, with 71% disease free. Mucositis occurred in 88% but was transient and prevented oral fluid intake in only one patient. Bone marrow suppression was usually mild and did not delay surgery. Escalation of dosage was thought to be important in achieving these encouraging results. A controlled trial is under way to better define the degree of efficacy of this regimen of adjuvant chemotherapy.

Adult↗
PubMed1978

Chemoimmunotherapy of head and neck cancer.

The present review aims at developing a perspective for surgeons of the role of chemoimmunotherapy in the management of head and neck cancer. The biochemical pharmacology of high dose methotrexate with leucovorin "rescue" is also discussed. The need for a combined modality approach in the treatment of patients with this cancer is emphasized.

Antineoplastic Agents↗
PubMed1978

Phase II trial of a combination of cyclosphamide, vincristine, and methotrexate in advanced colorectal carcinoma.

Twenty patients with advanced colon cancer were treated with a combination of low-dose weekly cyclophosphamide, vincristine, and methotrexate (COM) after demonstrated progression of disease with 5-fluorouracil (5-FU). Four patients (20%) had partial responses with a median survival of 15 months, six (30%) had disease stabilization for 3--16 months (median survival, 8 months), and ten progressed with a median survival of 5.5 months. All four partial responses and five of six stabilizations occurred in patients with a performance status of 0 or 1. COM appeared well-tolerated and at least as effective as alternative secondary chemotherapy following 5-FU failure.

Adult↗
PubMed1978

Changes in taste sensation and feeding behaviour in cancer patients: a review.

Recent studies suggest the importance of alterations in taste sensation as a determinant of anorexia in cancer patients. These studies collectively support the conclusions that the likelihood of developing abnormalities in taste increases with increasing body burden of tumour, that taste abnormality is reversible on response of the underlying tumour to therapy, and that the abnormalities in taste can be correlated with decreased intake of energy. It is suggested that these studies, and studies currently in progress, may aid our understanding of food choices in cancer patients and may guide the use of food supplements to assist the cancer patient in maintaining adequate energy intake.

Anorexia↗
PubMed1978

Correction of taste abnormality of malignancy with intravenous hyperalimentation.

A complete remission of widely metastatic bladder carcinoma was obtained with chemotherapy in a 41-year-old man. Severe persistent anorexia led to a 33% weight loss. The anorexia correlated with an elevated sucrose recognition threshold. Following 16 days of intravenous hyperalimentation, taste sensation returned to normal, anorectic symptoms cleared, and weight gain and positive nitrogen balance resulted. There was no stimulation of tumor growth. Restoration of nutritional deficits with intravenous hyperalimentation can improve taste function and appetite so that adequate oral alimentation can be tolerated.

Adult↗