Biomedical subjects
Publications and source records attributed to W F Taylor.
Extradural hemorrhage caused by otitis media is so rare that only four cases were found in a search of the literature. Certain striking similarities and the singular absence of a major demonstrable bleeding vessel in all cases appear more than coincidental and we have proposed a theory to explain the cause of the hemorrhage.
Ninety patients with advanced breast cancer received a polychemotherapeutic program composed of 5-fluorouracil, cyclophosphamide, and prednisone with or without vincristine as a control group in a series of four consecutive Phase II clinical trials of new drug programs. Objective regression rates were 59% without vincristine and 46% with vincristine. Projected mean length of regressions exceeds 1 year. Site of dominant disease, disease-free interval, or performance scale score (if score was 0, 1, or 2, ECOG scale) failed to influence response rates; decreasing response rates were noted as the length of time increased after menopause. No advantage existed in patients experiencing severe myelosuppression (nadir leukocyte count of less than 1,500/mm), and appreciable response rates occurred without significant myelosuppression. The addition of vincristine to the regimen failed to increase the response rates, and only increased toxicity. The program as outlined is reasonably tolerable and effective for this group of patients with advanced breast cancer.
The Mayo Lung Project (MLP) is a screening program designed to detect bronchogenic carcinoma at a curable stage. Screening tests include chest roentgenograms, three-day "pooled" sputum cytology studies, and lung-health questionnaires. These are being applied every four months to a study population of outpatients who have a high probability of developing lung cancer. Initial patient acceptance of the screening program has been excellent. Small asymptomatic lung cancers have been detected both roentgenographically and cytologically. The two procedures have complemented each other with little overlap. Chest roentgenography has proved most useful in diagnosing peripherally situated cancers, whereas sputum cytology studies have been most effective in identifying early squamous cancer involving major airways. At present, more cancers have been detected roentgenographically than cytologically, but the cytologically detected cases appear to have a better prognosis. Roentgenographically occult cancers have been localized with regularity, although the localization process is complicated. Theoretically, vigorous application of radiologic and cytologic screening, combined with optimum use of localizing procedures and treatment, could increase the five-year survival rate among lung cancer patients to nearly 50 percent. However, the actual survivorship attained will ultimately be determined by currently imponderable factors such as patient acceptance of longterm screening, frequency of multicentric respiratory cancers, and incidence of noncancerous smoking-related diseases, especially chronic obstructive pulmonary disease and ischemic heart disease.
Of 229 patients with primary Ewing's sarcoma of bone, thirty-seven survived five years or longer. When the patients who survived five years or longer were compared with the 192 who did not, two factors associated with longer survival were identified in this retrospective study: location of the primary tumor within an extremity and inclusion of surgery as part of the initial treatment. The probability of five-year survival for all 229 patients with primary Ewing's sarcoma was 16 per cent. For those seen since 1950, this probability was 18 per cent, and for patients without metastasis, it was 22 per cent.
Our data on ovarian epithelial carcinoma show that within a given stage, regardless of the histologic cell type, the increasingly higher grades have an increasingly poorer prognosis. This suggests that more intensive therapy be considered for all patients with ovarian epithelial carcinomas than is currently undertaken. Specifically, this means that, in addition to the standard modalities, chemotherapy should be considered for all tumors beyond grade 1, stage 1a.
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