Biomedical subjects

A Athanassiou

Publications and source records attributed to A Athanassiou.

42 records · Page 3Linked to original sources

PubMedDate not supplied

Chemotherapy with methotrexate, carboplatin, mitoxantrone (Novantrone) and vincristine (Oncovin) in transitional-cell urothelial cancer.

Forty-four patients with either metastatic or locally advanced transitional cell carcinoma of the bladder were treated with the MCNO regimen (methotrexate 300 mg/m2 in 1,000 ml normal saline as a 4-hour infusion on days 1 and 14 with leucovorin rescue 15 mg 6-hourly for 6 doses; carboplatin 300 mg/m2 in 250 ml 5% distilled water as a 1-hour infusion on day 1; mitoxantrone (Novantrone) 10 mg/m2 in 100 ml 5% distilled water as a 30-min infusion on day 1, and vincristine (Oncovin) 1 mg/m2 as an intravenous bolus on days 1 and 14. Patients with metastatic disease were treated with 6 cycles, while patients with locally advanced disease were treated with 4 cycles of induction chemotherapy followed by cystectomy or radiotherapy. The overall response rate was 40%, with 15% complete response (CR). The responses were better for patients with locally advanced disease (CR 25%, partial response, PR, 31.25%, response rate, RR, 56.25%) than for those with metastatic disease (CR 8.3%, PR 20.83%, RR 29.1 %). The differences in these results were probably due to the bad performance status and the presence of visceral metastases in patients with generalized disease. The overall median survival was 14 months, with responders living longer (median survival 28.8 months in patients with locally advanced disease and 22.9 months in patients with metastatic disease) than non-responders (median survival 16 months in patients with locally advanced disease and 8.9 months in patients with metastatic disease). The difference in survival between responders and non-responders was statistically significant in both groups of patients. Toxicity was moderate, but manageable. The MCNO regimen appears to have a lower efficacy than that obtained with cisplatin-based regimens for the treatment of metastatic disease and rather similar efficacy for the treatment of locally advanced urothelial-cell cancer. Therapy with this regimen, though less toxic, may not be a reliable alternative in elderly patients with visceral metastases and a performance status of > or = 2.

Adult↗

PubMedDate not supplied

Paclitaxel in cisplatin or carboplatin-pretreated ovarian cancer. Phase II study.

A phase II trial was conducted in order to assess the efficacy and toxicity of paclitaxel given at a dose of 175 mg/m2 in a 3-hour infusion every 3 weeks in patients with recurrent or cisplatin (CDDP) carboplatin-refractory ovarian cancer. Forty-two patients with a median age of 61 years (range 34-76 years) entered the study. Most patients had bulky disease. Thirty-three patients (78.5 %) presented with stage III and IV diseases. Twenty-two patients (52.3%) had previously been treated with only 1 regimen and 20 patients (47.7%) with > or = 2 regimens. The median treatment interval from the last previous therapy was 4.5 months (range 2-26 months). From 41 patients evaluable for response, 3 (7.3%) achieved a complete and 4 (9.8%) a partial response. All 3 complete and 2 out of the 4 partial responders had previously received > or = 2 chemotherapeutic regimens. Grade 3-4 toxicities included granulocytopenia (35%), which was of short duration, neurotoxicity (9.75%) and alopecia (60.9%). Two patients with grade 4 neutropenia were hospitalized due to pneumonia, which was successfully treated by broad-spectrum antibiotics and administration of G-CSF. A severe hypersensitivity reaction occurred in 1 patient early during the first cycle, resulting in discontinuation of treatment. Median relapse-free survival was 6.9 months, median time to progression 6.2 months and median survival 13.2 months. In conclusion, paclitaxel given at a dose of 175 mg/m2 as a 3-hour infusion every 3 weeks appears to be an efficacious and well-tolerated treatment in patients with recurrent or CDDP/carboplatin-refractory ovarian cancer.

Adult↗

PubMedDate not supplied

Comparison of two different doses of ondansetron plus dexamethasone in the prophylaxis of cisplatin-induced emesis.

This study was conducted to evaluate the efficacy of two different doses of ondansetron (8 mg vs. 24 mg) plus dexamethasone in the prevention of cisplatin (CDDP)-induced emesis and nausea (acute and delayed). The persistence of the anti-emetic efficacy during the second cycle of chemotherapy was also assessed. Eighty patients receiving high-dose CDDP (>80 mg/m2) were randomized to have either ondansetron 8 mg plus dexamethasone 20 mg (8 mg group) or ondansetron 24 mg plus dexamethasone 20 mg (24 mg group), given intravenously as a single dose before the CDDP infusion. From days 2-5, all patients received oral ondansetron 8 mg twice daily. Seventy-five patients (38 in the 8 mg group and 37 in the 24 mg group) were evaluable for analysis. Among these, there were 24 patients who received ifosfamide (IFO) on the 2nd day of treatment; these patients were evaluated separately for delayed emesis. Complete protection from acute emesis was obtained in 26 (68.4%) and 26 (70.3%) patients, in the two groups, respectively. Complete protection against acute nausea was achieved in 23 (60.5%) and 24 (64.9%) patients, respectively. With respect to the delayed emesis, complete protection was achieved in 14 (56%) and 13 (50%) patients not receiving IFO and in 4 (30.8%) and 3 (27.3%) of those receiving IFO. The figures for the delayed nausea were: 12 (48%) and 13 (50%), 2 (15.4%) and 2 (18.2%), respectively. Similar protection against emesis and nausea was recorded during the second cycle of chemotherapy. Both regimens have the same efficacy and thus, taking into account the cost-effectiveness, 8 mg of ondansetron plus dexamethasone in a single intravenous dose should be used for the prevention of high-dose CDDP-induced emesis.

Acute Disease↗

PubMedDate not supplied

Pitfalls of the 'double bubble' sign: a case of congenital duodenal duplication.

The 'double bubble' sign in prenatal diagnosis is most often associated with duodenal atresia. However, other causes of upper intestinal obstruction and cystic abdominal masses need to be considered. One possible diagnosis that can mimic the 'double bubble' sign of duodenal atresia is duodenal duplication, but little information is available to guide sonologists in the prenatal diagnosis of this rare congenital anomaly. In this case report we describe the successful prenatal diagnosis of duodenal duplication, by relying on the early gestational age of presentation, the lack of polyhydramnios, the failure to consistently demonstrate a 'double bubble' on transverse images, and the presence of a normal distal bowel pattern.

Adult↗

PubMedDate not supplied

Squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), and tumour-associated trypsin inhibitor (TATI) for monitoring head and neck cancer.

Eighty-eight patients with head and neck cancer were prospectively monitored, before and after treatment, by means of simultaneous serum SCC, CEA and TATI measurements. Thirty-two (36.6%) patients had early stages (I, II, III) and 56 (63.4%) advanced (stage IV) or recurrent disease. Pre-treatment serum SCC levels were elevated in 20.4% of patients, CEA in 27.2% and TATI in 4.5%. There was no correlation between the incidence of TATI elevation and tumour burden; this marker did not increase with progressing disease stages. CEA and SCC had low sensitivity in the early stages of head and neck cancer and reached 35.7% (20/56 patients) and 25% (14/56 patients) in stage IV or recurrent disease. Despite the low sensitivity of these tumour markers, there was a correlation between tumour marker levels and the course of the disease. This study indicates that the routine assessment of SCC, CEA and TATI serum levels is of no value. However, it can be used as a potential tool for monitoring the efficacy of individual therapy in both early and advanced stages of head and neck cancer.

Adult↗

PubMedDate not supplied

131I-labelled monoclonal antibody H17E2 in the detection of subcutaneous metastasis from gestational choriocarcinoma.

Subcutaneous metastasis is an uncommon finding in gestational choriocarcinoma. We detected such a lesion by external radioimmunoscintigraphy in a patient with gestational choriocarcinoma using 131-I labelled H17E2 monoclonal antibody raised against placental alkaline phosphatase. On the contrary, no positive image of the same metastasis was taken using 131-I labelled non-specific 11.4.1 monoclonal antibody. The successful detection of occult metastatic deposits in choriocarcinoma, which have become resistant to chemotherapy, may be of value for the potential use of curative surgery in these patients.

Adult↗