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Biomedical subjects

A Karavelis

Publications and source records attributed to A Karavelis.

10 recordsLinked to original sources
PubMed1999

Radiation and concomitant weekly administration of paclitaxel in patients with glioblastoma multiforme. A phase II study.

The present study was conducted to evaluate the activity and toxicity profile of radiation (RT) and concomitant chemotherapy in patients with glioblastoma multiforme (GBM). Thirty-nine patients were treated postoperatively with RT and concomitant administration of paclitaxel. Cranial irradiation was initiated 2-3 weeks postoperatively and was administered in 2.0 fractions, one fraction per day, for 5 consecutive days per week, to a total of 60 Gy. Paclitaxel was delivered at a dose of 100 mg/m2 over 3-h once weekly for 6 weeks. Thirty-three patients received all 6 cycles of paclitaxel according to the protocol. Totally, 217 cycles were delivered all of them at full dose. The median relative dose intensity of paclitaxel was 1 (range 0.88-1.1). Three (7.5%) patients achieved complete and 9 (23%) partial response, while 12 (30.5%) patients demonstrated stabilization of the disease. Side effects from combined chemoradiotherapy were mainly mild. Grade III toxicity included infection (7.5%) and alopecia (5%). Median time to progression was 6 (range 0.9-27) months and median survival 10.7 (range 0.9-39.5+) months. The present study has clearly shown that 100 mg/m2 of paclitaxel in 1-h infusion weekly can be safely given concomitantly with RT in patients with GBM with manageable toxicity. However, the efficacy of this combined modality treatment does not appear to be superior to that of RT alone.

Adult↗
PubMed1997

Concurrent radiation and intracarotid cisplatin infusion in malignant gliomas: a feasibility study.

Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiation therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) of 70 (range, 40-90). In all except two cases, histologic studies confirmed malignant glioma. All patients were irradiated with a cobalt 60 equipment. They should have received 45 Gy to the whole brain plus a 15-Gy coned-down boost to the tumor area. Chemotherapy consisted of cisplatin infusion at a dose of 60 mg/m2 on days 2, 22, and 42. Treatment was interrupted in two patients because of progressive disease and voluntary withdrawal in one patient each. In all, 63 courses of cisplatin infusion were administered, all at full dose. Two patients achieved a partial response, and nine had stable disease. Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, confusion, diarrhea, and thrombophlebitis in one patient each. Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks (range, 14-226+). In conclusion, the present study suggests that intracarotid cisplatin administered concurrently with radiation does not improve the therapeutic index in malignant gliomas.

Adult↗
PubMed1996

Spinal cord dysfunction caused by non-traumatic hematomyelia.

Two patients with a non-traumatic hematomyelia at T9 and C3-C7 respectively, are presented. Both patients presented with pain and a Brown-Sequard syndrome. The preoperative diagnosis was made by magnetic resonance imaging, while myelography and computerized tomography were not helpful. Surgical evacuation of the hematomas and in one patient removal of a vascular malformation were performed. The neurological symptoms and signs, after a temporary worsening, progressively improved. The prompt surgical treatment of this entity and the usefulness of magnetic resonance imaging in the preoperative diagnosis and on the planning of the surgical strategy is particularly emphasized.

Adult↗
PubMed1996

Intraventricular administration of morphine for control of intractable cancer pain in 90 patients.

OBJECTIVE: To quantitate the relief of intractable cancer pain by the use of intraventricular morphine administration. METHODS: Intraventricular morphine administration was performed through an Ommaya reservoir. An initial dose of 0.25 mg of morphine sulfate per 24 hours was administered to all of the patients. This dose was progressively increased in 0.25-mg increments until optimal analgesia was attained. RESULTS: Sixty men and 30 women with a median age of 58 years (range, 23-80 yr) entered the study. The median duration of pain was 6 months (range, 0.5-120 mo). A daily morphine dose of up to 1 mg was adequate to achieve an analgesic effect in 77% of the patients. Only nine patients (10%) achieved < 50% pain relief. Using a multiple regression analysis, only the morphine dosage was found to be an independent prognostic factor. The most frequent side effect (22%) was nausea/vomiting. Also, there were two patients with opioid intolerance and two with intracerebral hematomas. Three reservoirs failed. CONCLUSION: Intraventricular morphine administration is a useful method for palliation of intractable cancer pain.

Adult↗
PubMed1995

Primary post-traumatic intraventricular hemorrhage.

A case of primary post-traumatic intraventricular hemorrhage is presented. The patient, a 22 years-old man, after a mild head injury and a lucid interval lost consciousness and progressively developed symptoms of raised intracranial pressure. CT scanning, 24 hours later, revealed blood in the ventricles without concomitant brain contusion. The patient's condition improved dramatically after an external ventricular drainage.

Adult↗
PubMed1992

Foreign body in the sphenoid sinus.

Foreign bodies in the paranasal sinuses, especially in the sphenoid sinus are uncommon. We report a rare case of a foreign body in the sphenoid sinus after an occupational accident.

Accidents, Occupational↗
PubMedDate not supplied

Symptomatic trigeminal neuralgia.

In four cases with trigeminal neuralgia an intracranial neoplasm was detected. In the first two cases a meningioma of the cerebellopontine angle was producing symptomatic trigeminal neuralgia almost identical to the essential one. In the other two cases with a tumor in the gasserian ganglion area the facial pain was of a more atypical nature. In all four cases associated sensory trigeminal deficits were present. The causative factors which may produce symptomatic trigeminal neuralgia are especially discussed in this paper.

Aged↗
PubMedDate not supplied

Correlation of proliferating cell nuclear antigen assessment, histologic parameters and age with survival in patients with glioblastoma multiforme.

A series of 27 glioblastomas multiforme were studied to compare the prognostic value of age and histologic parameters known to influence survival with that of proliferating cell nuclear antigen (PCNA). The labelling index (LI) of PCNA has been found in previous studies to correlate well with flow cytometry, tritiated thymidine, bromodeoxyuridine incorporation and Ki 67. The histologic parameters estimated were endothelial proliferation, number of mitoses per high power field, cellularity and a grading of necroses. The correlation coefficients between survival and each of the histologic parameters as well as with age were found to be negative but statistically insignificant. The values of these correlations in descending order were survival/age (r = -0.22), survival/endothelial proliferation (r = -0.20), survival/mitoses (r = -0.16), survival/cellularity (r = -0.07) and survival/necroses (r = -0.04). The correlation coefficient between survival and PCNA LI was also found to be negative, higher than those between survival and other estimated parameters (r = -0.37) but in a wide variation and still statistically insignificant. Despite this variation, our finding that for PCNA LI > 35% no patient survived more than 6 months may be of clinical importance.

Adult↗