PubMed Health⌕ Search

Biomedical subjects

A Brandes

Publications and source records attributed to A Brandes.

45 records · Page 3Linked to original sources

Cisplatin, etoposide, and ifosfamide in non-small cell lung carcinoma. A phase II randomized study with cisplatin and etoposide as the control arm.

A Phase II randomized study testing the combination of cisplatin, etoposide, and ifosfamide (PEI) in non-small cell lung cancer (NSCLC) was performed. The standard combination of cisplatin and etoposide (PE) was used as the control arm. Since January 1987, 78 patients were enrolled and then stratified for previous treatments and performance status (PS). The response rate (RR) of PEI was 26% (95% confidence limits [95 CL], 12% to 40%), with one complete response (CR). The RR of PE was 26% (95 CL, 13% to 39%), with no CR. The median response duration was 5 months (range, 2 to 13 months) for PEI and 4 months (range, 2 to 6 months) for PE. The median survival time was 6 months (range, 1 to 22+ months) for PEI and 7 months (range, 1 to 21+ months) for PE. Leukopenia at recycling was similar in both arms (25% for PEI and 29% of PE). The median leukocyte nadir was 2100/microliters (range, 430 to 4870/microliters) for PEI patients and 3150/microliters (range, 500 to 5000/microliters) for PE patients. Three patients had a drug-related death secondary to infections. This Phase II randomized study suggested that the combination of cisplatin plus etoposide and ifosfamide produces results similar to those obtainable with cisplatin and etoposide.

Adenocarcinoma↗

[Monitoring of pacemaker patients by long-term ECG].

Long-term-ECG is an essential method for detecting transitory pacemaker-dysfunctions. Control of antitachycardia-pacemakers is possible as well as VVI-pacemakers and with restrictions DVI-, VDD- and DDD-pacers. Special pacemaker-control-modules increase the sensitivity for the recognition of dysfunctions. Regular check-ups are an important part of guiding the pacemaker-patient.

Arrhythmias, Cardiac↗

Cisplatin plus vindesine versus cisplatin plus VP16 versus doxorubicin plus cytoxan in non-small-cell carcinoma of the lung. A randomized study.

From March 1981 to January 1984, 116 patients with advanced non-small-cell carcinoma of the lung (NSCCL) were randomly assigned to 3 combinations as follows: CDDP + DVA, CDDP + VP16 and DXR + CTX. 94 patients were evaluable for response, 106 for toxicity and survival. Of 31 patients, 15 (48%; 3 CRs and 12 PRs) responded to CDDP + DVA; of 33 patients, 12 (36%, 2 CRs and 10 PRs) responded to CDDP + VP16; of 30 patients, 3 (10%) obtained a PR with DXR + CTX (CDDP + DVA vs DXR + CTX, P less than 0.005; CDDP + VP16 vs DXR + CTX, P less than 0.05; CDDP + DVA vs CDDP + VP16, P = NS). The median duration of response was 22 weeks in the CDDP-DVA group, 17 weeks in the CDDP-VP16 group, and 16 weeks in the DXR + CTX group. No significant difference in survival was observed among the 3 groups (median: 43, 47, 41 weeks, respectively). Hematologic and neurologic toxicities were significantly higher in the DVA-containing regimen. Despite the lack of improvement of overall survival with the CDDP-containing combinations over the DXR + CTX control group, the good response rate makes them suitable to be used in combined therapeutic strategies.

Adult↗

Peptichemio in pretreated patients with ovarian cancer.

From January 1978 to October 1982, 47 patients with histological diagnosis of epithelial cancer of the ovary received peptichemio (PTC) at a dose of 70 mg/m2 (maximum, 120 mg total) every 15 days. Forty-two patients are now evaluable: 27 with stage III and 15 with stage IV disease. All patients but four with stage IV disease had been pretreated and had received at least one drug combination (median, three drugs per patient, including alkylating agents). Before the administration of PTC, the tumor extension in the abdomen was carefully assessed in all patients: ten patients had residual tumor less than 2 cm in diameter, while 32 patients had tumor greater than 2 cm in diameter. Objective responses were obtained in ten patients (23.8%): six complete remissions and one partial remission were observed in stage III patients and one complete remission and two partial remissions were observed in stage IV patients. Of the ten responding patients, eight had tumors less than 2 cm in diameter before receiving PTC. The median duration of response was 16 months. The most frequent side effects were myelosuppression and phlebosclerosis. Bone marrow depression was a common finding after the third course in heavily pretreated patients. Accordingly, in these patients a schedule interval of 3 weeks should be more appropriate. Since most of the responders were in the "small tumor" category, PTC appears to be an active drug in patients with ovarian cancer having small tumors (less than 2 cm). On the other hand, the response rate in a nonselected population of patients remains to be clearly defined with further studies.

Adult↗

Role of second look laparotomy in multidisciplinary treatment and in the follow up of advanced ovarian cancer.

Surgical re-examination after first line surgery followed by chemotherapy is an absolutely necessary step in the course of integrated treatment of advanced ovarian epithelial tumours. Our personal experience of surgical re-staging and reductive surgery in 48 patients affected by ovarian tumours stage III and IV (FIGO), by laparotomic second look is reported. Repeated surgery succeeds in further reducing the neoplastic deposits or radicalizing the first intervention in 33% of the overall series; in 52% of the cases, the second look was negative for neoplasia; in 16% only, despite tumour finding no reductive surgery was possible. If only the cases presenting residual neoplasia after primary surgery are taken into account, tumour debulking was possible in 44% of the patients. The analysis of this series fully confirms the preliminary statement that the smaller the residual neoplasia after surgery, the greater the chances of success for chemotherapy in ovarian cancer. It confirms as well that the laparotomic second look is the only currently available way to usefully assess the full remission of the disease.

Carcinoma↗

Role of computed abdominal tomography (C.A.T. Scan) in the follow up of ovarian tumors.

This study evaluates the possible use of computed tomography not as an alternative diagnostic method but, rather, as a supplement to laparotomy in patients treated for ovarian cancer. The following conclusions can be drawn: in patients presenting no clinical evidence of persistent or relapsing disease C.T. Scan is not a mandatory but, rather, an optional test since it entails 25% false negatives, a 66.6% predictive value and because the involved patients will need, in any case, a further intervention. Conversely, C.T. Scan is clearly indicated in patients presenting clinical evidence of disease. It can prove helpful in detecting metastases in areas that prove difficult to be clinically examined; in assessing whether the retroperitoneal areas conceal neoplastic tissue or in planning the right operation for masses that have been palpated only before chemotherapy, and then in regression. When, despite chemotherapy, tumour progresses, surgery may became useless, and the C.T. Scan may therefore prove helpful in defining the condition and guiding non surgical treatment. Therefore, in the follow up of ovarian cancer the C.T. Scan may be performed on the basis of clinical course, instead than on a rigid aprioristic planning.

Cyclophosphamide↗

Treatment of high-grade gliomas in the elderly.

In recent years the elderly population has grown, and in this category there has been a marked increase in the incidence of cancers with a poor prognosis, brain tumors in particular. However, few authors have focused on treatment for high-grade gliomas in the elderly, which often present problems different from those in younger populations. Several authors have observed that this tumor has a poor response to surgery, radiotherapy and chemotherapy. Elderly patients are therefore frequently undertreated or excluded from cancer therapy trials. Their exclusion from conventional cancer treatment often depends on ad hoc decisions and assumptions by physicians rather than on sound scientific data.

Aged↗

Medical treatment of high grade malignant gliomas in adults: an overview.

Cure of high grade malignant gliomas is seldom possible with surgery and adjuvant radiotherapy as first line treatment, so many trials have been carried out with adjuvant chemotherapy. During the last decade, clinical studies with immunotherapy in recurrent gliomas have been added to the therapeutic regimens. We made an extensive search of the literature on chemotherapy and immunotherapy of high grade malignant gliomas up to 1 January 1990. The median survival time (MST) of surgery and adjuvant radiation is about 35 weeks. Adjuvant single-agent chemotherapy extends the MST by some 15 weeks. Combination-agent chemotherapy did not achieve better results than single agents. Of the cytotoxic agents, the nitrosureas have been most extensively tested. Immunotherapy is in an early stage of clinical testing: however, very recent trials show promising results, especially those which make use of monoclonal antibodies for targeting therapeutics. In the future a combination of chemotherapy and immunotherapy might offer a better outcome in this malignancy.

Adult↗