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Biomedical subjects

W F Jungi

Publications and source records attributed to W F Jungi.

At least 19 recordsLinked to original sources
PubMed1992

Swiss adjuvant trials in women with node-negative breast cancer. OSAKO.

Women with node-negative breast cancer have a 30% chance of relapse 5 years after mastectomy. If it is possible to prevent or defer recurrent disease with adjuvant systemic therapy, node-negative patients, with their low tumor burden, should theoretically benefit most from such treatment. In 1974 we started a randomized adjuvant trial in eastern Switzerland, using a subjectively less toxic regimen [chlorambucil, methotrexate, and fluorouracil (LMF)]. Two hundred fifty-four patients were randomly assigned after standardized modified radical mastectomy to observation only or to treatment with oral LMF for 6 months followed by BCG skin scarifications monthly for up to 2 years. While we find no significant statistical difference between the control group and the treated group in terms of relapse-free survival, there is a strong and consistent trend toward prolongation of overall survival within the treated group.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Why do cancer patients use alternative medicine?].

160 patients (53.3%) replied to an anonymous questionnaire distributed to 300 consecutive patients of our Outpatient Oncology Clinic. 83 patients (53%) mentioned some experience of one or more alternative methods of cancer treatment. Most often cited were various herbal teas (35 instances), beetroot juice (16), Vogel plant extracts (15), laying-on of hands (14), homeopathic medicine (13), the mistletoe extract Iscador (13), magnetopathy (12), various diets (10), acupuncture (10) and psychological methods (9). Resort to alternative methods of treatment correlated significantly with lower age (51.5 years vs 59.8 years, p = 0.001). The reasons for using alternative medicine were the desire to do everything possible to regain health (49), to use one's psychological forces as well (35), reports of successful cancer cures (28), desire for a holistic approach (23), hope of "softer" medicine with less severe side effects (18) and, in 7 cases only, disappointment with conventional university medicine. The major source of information was relatives and friends, not the mass media. The physician should be aware of the locally available alternative medicine options and be able to advise his patients accordingly. He should also recognize and give due consideration to the patient's underlying desire for better control of his disease and a more holistic approach to care.

Complementary Therapies↗
PubMed1991

[Peripheral spontaneous remission of hairy cell leukemia following transfusion-associated hepatitis C].

In a 59-year-old patient presenting in October 1981 with pancytopenia, hairy cell leukemia was diagnosed. Splenectomy, followed by treatments with oncovin, lithium, and prednisone were essentially without effect. Up to July 1984 the patient had been regularly transfused with a total of 62 unit. In June 1984 he acquired a transfusion associated hepatitis C which followed a chronic course and resulted in biopsy proven cirrhosis in 1989. The patient became independent of transfusions in July 1984. Repeated blood counts have shown a complete hematologic remission which has now lasted nearly 6 years, whereas focal leukemic infiltrates have persisted in the bone marrow. The patient has tolerated 20 courses of erythropheresis performed because of biopsy proven severe hepatic siderosis without a fall in hemoglobin. It is suggested that the spontaneous long-lasting hematologic remission of hairy cell leukemia is due to endogenous interferon produced in the course of chronic hepatitis C. Low serum levels of interferon-alpha and -gamma were detected.

Combined Modality Therapy↗
PubMed1991

[Frequent errors in the planning and carrying out of tumor therapy].

Errors in planning and executing tumor therapies are not more frequent than in other disciplines of medicine, but lead to more serious consequences because of the narrow therapeutic margin of various tumor therapies and the markedly reduced general condition resulting from various affected organs. Most errors are uncorrectable. Usually errors are of general nature rather than oncology-related. They can be avoided by increased experience exact documentation and information as well as regular controls.

Adolescent↗
PubMed1991

Interferon alfa-2b with VMCP compared to VMCP alone for induction and interferon alfa-2b compared to controls for remission maintenance in multiple myeloma: interim results.

The present trial was designed to evaluate whether interferon (IFN) combined with standard induction chemotherapy and/or interferon remission maintenance treatment improve treatment results in patients with multiple myeloma. Up to now 89 patients have received IFN plus vincristine/melphalan/cyclophosphamide/prednisolone (VMCP) as induction therapy, and 86 conventional VMCP. The proportion of patients with progressive disease was significantly lower (P less than 0.005) under IFN + VMCP as compared to the VMCP treatment group. Survival times were significantly longer (P less than 0.02) after IFN + VMCP induction therapy than after VMCP alone. In the second phase of this investigation, 33 progression-free myeloma patients were assigned to receive IFN as maintenance therapy, and 41 patients served as untreated controls. Patients maintained with IFN showed a tendency towards increased progression-free survival. Haematological side effects were observed significantly more often in patients receiving IFN, with more severe haematological toxicity in patients on the combined IFN + VMCP regimen and an increased number of patients with mild haematological toxicity in the group maintained with IFN. Other side effects, such as fever and fatigue, remained within tolerable limits. In conclusion, the preliminary results of this current clinical trial indicate significant advantages of combined IFN + VMCP induction treatment in terms of reduced disease progression and prolonged survival and possible benefits of IFN maintenance therapy in patients with multiple myeloma.

Adult↗
PubMed1990

[BEP-chemotherapy in patients with testicular tumors--is it worthwhile?].

Since 1985 44 consecutive patients with testicular cancer have been treated with a modified BEP regimen. 70% had metastatic disease and 30% received adjuvant therapy. After mean follow-up of 26 (8-56) months, 91% of patients are alive and all are in remission. Chemotherapy-related side effects were alopecia (100%), myelosuppression (100%), nausea/vomiting (89%) and fever (66%). Patients reported nausea has been rare. It is concluded that BEP chemotherapy is a highly effective treatment which secures complete remission or cure even in patients with advanced metastatic disease. In retrospect the patients considered the treatment worthwhile despite the stress involved.

Adult↗
PubMed1990

Anthracycline-carboplatin combination in metastatic breast cancer.

In a pilot study a carboplatinu, 250 mg/m2 i.v., and 4-epidoxirubicin, 90 mg/m2 i.v. or mitoxantrone, 10 mg/m2 i.v., combination chemotherapy regimen was studied in a group of breast cancer patients with high-risk metastatic disease. All 11 patients had liver and/or lung metastases. Of the 11 patients, 9 had progressive disease and in 2 patients the disease had stabilised. The toxicity of both anthracycline-containing regimes was similar. Subjective toxicity was mild, but hematological toxicity was inacceptable. The tested carboplatinum-anthracycline combination regimes given in the administered doses are not useful in the treatment of metastatic breast cancer, mainly because of toxicity.

Aged↗
PubMed1979

[Diagnostic and therapeutic importance of splenectomy in patients with non-Hodgkin's lymphoma].

Whereas the contribution of exploratory laparotomy in Hodgkin's disease is well characterized, its value in Non-Hodgkin lymphoma (NHL) is not yet defined. This retrospective analysis of 31 cases is a contribution to the ongoing discussion. Laparotomy/splenectomy (LS) was done in 17 patients for diagnostic reasons and in 14 with therapeutic intent. Perioperative morbidity was low. In 17 cases the NHL had infiltrated the spleen. Indications for therapeutic LS were hemolytic anemia, pancytopenia and excessive lymphocytosis with granulocytopenia. The therapeutic benefit from splenectomy was satisfactory, especially in patients with well-differentiated lymphocytic leukemia of type CLL. In contrast, the diagnostic value of LS was minimal, except in patients with first diagnosis of NHL through LS. There was no change in tumor stage in any case. However, 4 false-negative findings contrast with the rapidly adverse course in these patients. Routine LS in patients with NHL does not appear to be justified, but has its value in NHL with primary abdominal localization. Therapeutic splenectomy is of benefit for the majority of patients, particularly those with CLL.

Female↗
PubMed1979

[Experiences with VP-16 in combination with cyclophosphamide or adriamycin in the anaplastic, predominantly small cell bronchogenic carcinoma].

VP 16-213, the new semisynthetic epipodophyllotoxin, was tested for activity and toxicity in two small pilot series of 24 mainly untreated patients with anaplastic, predominantly small-cell lung cancer. It was given in combination with cyclophosphamide or adriamycin. Among 10 evaluable patients receiving VP-16 + cyclophosphamide (5 orally, 5 intravenously) only 1 good partial remission and 4 partial remissions (less than 50%) were achieved. Toxicity was minimal. In 14 patients on VP-16 and adriamycin, remission was complete in 2, good partial in 5 and lesser partial in 2. The hematological toxicity of the second combination was marked. Severe granulocytopenia required reverse isolation of most patients for periods of up to 2 weeks. The response rate for VP-16 + adriamycin was better than for VP-16 + cyclophosphamide, but lower than expected. Possible explanations are given.

Carcinoma, Bronchogenic↗
PubMed1978

[Simultaneous hormonal and drug therapy, compared to hormonal therapy, followed by chemotherapy, in the treatment of metastasizing breast neoplasms. Preliminary results of an ongoing study].

The preliminary results of a still ongoing phase III study in patients with previously untreated metastatic breast cancer are reported. 210 cases are already evaluable. In this study patients are randomized to hormonotherapy either concurrently with combination chemotherapy or alone, chemotherapy being delayed until the occurrence of tumor progression. In both groups patients are further randomly allocated to 3 chemotherapy programs. So far there appear to be differences between remission rates, but not with regard to survival course.

Antineoplastic Agents↗
PubMed1978

[Bone and soft tissue sarcomas].

Great progress has been made both in the treatment of metastatic sarcomas and in adjuvant treatment of Ewing's, rhabdomyo- and osteogenic sarcomas. This is due partly to new and more effective cytostatic drugs and combinations, but to a greater extent to an improved systematic multimodal approach. In patients with metastatic sarcoma, better and longer remissions can be achieved, whereas real cures are possible in Ewing's, rhabdomyo- and osteosarcoma if properly managed using an interdisciplinary approach. Patients with these rare malignancies should be referred to specialized cancer centers, in view of the problems and possible complications of their necessarily intensive therapy.

Aged↗
PubMed1978

[Cooperation between private physician, regional hospital and oncologic center].

Due to numerical, socio-psychological, economic and geographic factors, not all tumor patients can be followed exclusively by specialized oncologic institutions. Institutionalized, well organized cooperation between private physician, community hospital and regional cancer center is mandatory in affording every patient speedy and adequate investigation and treatment. One model of regional oncologic cooperation which has been realized successfully for some years now in Eastern Switzerland is presented. Decentralized oncologic consulting clinics open for in- and out-patients are the cornerstone of this system, which guarantees the same quality of management for the tumor patient in hospital or at home and requires the active participation of family doctors.

Cancer Care Facilities↗
PubMed1978

[Antiestrogens: a new endocrine treatment possibility in metastasizing breast neoplasms. Experiences of the Swiss Cooperative Cancer Study Group with tamoxifen].

The detection of specific hormone receptors in normal and tumor tissue has brought new insight into the mechanisms of action of hormones and anti-hormones. The Swiss Cooperative Cancer Study Group (SAKK) has evaluated the antitumor effect of the new antiestrogenic substance tamoxifen in metastatic breast cancer. 158 postmenopausal patients treated with 20 mg/d tamoxifen by mouth are evaluable at present time. Complete and good partial remissions were achieved in 39 patients (25%) largely with soft tissue but also lung and bone metastases. Tamoxifen was well tolerated and caused few serious complications such as thrombosis/pulmonary embolism and hypercalcemia. These results confirm already published experience with tamoxifen, which may replace the estrogens as the primary endocrine treatment in postmenopausal mammary carcinoma metastasizing to soft tissues, lung and bone.

Bone Neoplasms↗