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Biomedical subjects

B Hager

Publications and source records attributed to B Hager.

At least 19 recordsLinked to original sources
PubMed1992

Combined intra-arterial chemotherapy followed by radiation in astrocytomas.

Seventy-five patients harboring astrocytomas received 4 cycles of infra-ophthalmic carotid injections of BCNU, combined with vincristine intravenously and procarbazine orally. All of the patients thereafter, received radiation therapy. The five year survival was 73% for all patients. The age of the patients had no significant impact on survival. The treatment results were compared with the results of 57 patients with astrocytomas who were treated with surgery followed by radiation in the same period. These 57 patients had a 5 year survival of 45% with a five year survival in patients < or = 40 years and patients > 40 years of 70% and 22%, respectively (p < 0.05). In multivariate survival analysis of the BCNU group and radiation group together, treatment group and corticosteroid dependency were the only prognostic factors. No leukoencephalopathy was seen during the treatment or in the follow-up of the patients. We conclude that pre-radiation intra-arterial chemotherapy can be given without significant morbidity and produces an improvement in survival in patients older than 40 years.

Administration, Oral↗
PubMed1992

Pre-radiation chemotherapy in glioma patients with poor prognostic factors.

Nineteen patients in an age group from 56-67 years (mean age 62.5 years) with histologically verified glioblastoma multiforme were treated with chemotherapy consisting of two cycles of oral CCNU, intravenous vincristine and oral procarbazine prior to radiation therapy. Ten of the patients had stable disease, monitored by CT scan and neurological examination, and received whole brain radiation. The median survival was 12 months. Nine patients who had progressive disease during chemotherapy did not receive radiation treatment and were put on palliative treatment with dexamethasone. This group had a median survival of 3 months. The median survival in all of the 19 patients who entered the study was 9 months which was comparable to the survival of 56 patients with glioblastoma multiforme who, in a retrospective study, received post-operative radiotherapy. The most important factor predicting survival was steroid-dependency after surgery.

Aged↗
PubMed1992

Combined intra-arterial and systemic chemotherapy for recurrent malignant brain tumors.

Seventy-nine patients harboring recurrent brain tumors received four cycles of infraophthalmic carotid injections of 160 mg of carmustine. Two milligrams of intravenous vincristine and 50 mg of oral procarbazine was also administered three times daily for 1 week in conjunction with each BCNU treatment. The response rate was 60% with a median survival for patients with astrocytomas, anaplastic astrocytomas, and glioblastomas of 32, 20, and 6.5 months, respectively. The median survival of the responding patients was 20 months, and the survival at 30 months was 45%. The survival in patients not responding to treatment was 5 months, reflecting the natural history of the tumor. There have been no deaths related to the treatment procedure. No incidents of severe or permanent eye complications or leukoencephalopathy were observed. Based on multivariate survival analysis, only patients with a good performance status who are not steroid dependent are candidates for this treatment.

Administration, Oral↗
PubMed1992

Primary malignant lymphoma of the brain. A report of 24 cases from the Norwegian Radium Hospital.

Between 1975 and 1987, 24 patients with primary central nervous system lymphoma were seen and treated at the Norwegian Radium Hospital. The overall median survival was 24 months. Patients with poor performance status (WHO 3-4) had a median survival of 3 months whereas patients with good performance status (WHO 0-2) had a median survival of 40 months (p < 0.0001). Patients who were not steroid-dependent after operation had a better survival than those patients who were steroid-dependent (p = 0.02). Nine patients were still living without evidence of disease at last follow-up, 18-130 months after the initial treatment.

Adolescent↗
PubMed1991

Combined intra-arterial chemotherapy and irradiation of malignant gliomas.

Seventy-nine patients with malignant gliomas (19 anaplastic astrocytomas and 60 glioblastoma multiforme) received 4 cycles of infra-ophthalmic carotid injection of 160 mg carmustine, 2 mg vincristine IV and procarbazine orally 50 mg 3 times daily for 1 week, followed by whole-brain irradiation, with a midpoint dose of 54 Gy/6 weeks. Response, judged by CT-scan, was seen in 31 out of 57 evaluable patients with a median survival of 30 months and 40% survival at 3 years. In all patients who responded to the treatment, a tumour regression was seen on CT-scan after chemotherapy before irradiation. In the 26 patients with progressive disease under chemotherapy, the median survival was 5 months. None of the patients who had progressive disease during chemotherapy had benefit from irradiation. The most important prognostic factors were good pretreatment performance status, glucocorticoid dependency and age. Few serious side-effects of the angiographic procedure were seen. Leukoencephalopathy was not observed in this study.

Adolescent↗
PubMed1990

Intra-arterial BCNU in the treatment of recurrent medulloblastoma.

Two patients with recurrent medulloblastomas were treated with combined oral and intravenous chemotherapy followed by intra-arterial BCNU. The 7 days course of oral and intra-venous chemotherapy consisted of CCNU and Procarbazin orally and Vincristine intravenously (PCV), repeated after 6 weeks. Intra-arterial chemotherapy consisted of 4 cycles of BCNU. Both patients responded well to treatment, evaluated by CT scans. One of the patients died of a new local recurrence 6 months after initiation of chemotherapy, whereas the other patient remains well, without CT evidence of tumour 36 months after the start of the treatment. No serious adverse side-effects related to the treatment were seen.

Adult↗
PubMed1990

Reversible oedema and necrosis after irradiation of the brain. Diagnostic procedures and clinical manifestations.

One hundred and twelve patients with primary brain tumour were followed every 3 months during and after brain irradiation and chemotherapy with brain scanning, EEG and neurological examination. Early delayed radiation reactions were seen in 6 patients. The symptoms developed 2-8 months after irradiation and lasted for 2-3 months. Two types of reactions were observed. One mild form appeared after 2-3 months and was characterized by low-attenuated expansive areas within the irradiated volume, without contrast enhancement on CT scan. Severe reactions appeared in some patients after 6 months, with exacerbation of earlier clinical signs and contrast enhancing lesions on CT. Regression of the CT finding was seen after 3 months. Recognition of this syndrome is important, as a new neurosurgical procedure might cause lasting neurological sequelae in patients who otherwise would recover without treatment.

Adolescent↗
PubMed1989

[Intracranial stereotaxic external radiation using a linear accelerator].

The article describes a method making it possible to give high radiation doses to a localized volume of the brain while sparing normal surrounding brain tissue. The treatment consists of sending multiple narrow radiation beams from different directions to the volume of tissue to be treated by rotating the radiation source and the patient table in relation to each other. Mega-voltage radiation from a linear accelerator is used. A non-invasive stereotactic frame is mounted on the patient and a CT scan of the brain is performed to localize the center and extent of the tissue to be treated. The radiation treatment is then given by using the coordinates on the frame to assure that the center of rotation of the treatment table and the linear accelerator pass through the center of the volume of tissue. The method has been used to give radiation boosts after external radiation to brain tumours, and to treat patients with recurrent tumours. Small localized benign intracranial tumours and AV-malformations have also been treated.

Brain Neoplasms↗
PubMed1989

Early liver metastases in patients with medullary carcinoma of the thyroid gland.

In 13 patients who had been thyroidectomized for medullary carcinoma (MCT), basal and pentagastrin-stimulated immunoreactive calcitonin (iCT) concentrations were measured in a peripheral vein and concomitantly in hepatic veins as well as in the superior and inferior caval veins. The basal concentrations of iCT in serum from the antecubital vein ranged from normal values (less than 0.50 micrograms/1) to grossly elevated (greater than 100 micrograms/1). Intravenous pentagastrin injections (0.5 micrograms/kg) stimulated transiently calcitonin secretion in all patients and peak concentrations occurred in peripheral venous blood and in the inferior caval vein after 3 to 5 minutes. In all patients peak iCT values in the hepatic vein occurred at 1 to 2 minutes and were much higher than in samples taken from other veins. Only three patients showed metastases to liver as judged by conventional clinical and laboratory examinations. Two patients with nonthyroid, malignant disease did not show an increase in serum iCT concentration of hepatic veins. The authors conclude that MCT may spread early to the liver. The presence of liver metastases is an important prognostic factor in patient evaluation and can be demonstrated by measuring iCT in hepatic veins before and during pentagastrin stimulation.

Adult↗
PubMed1989

Ocular complications after intracarotid BCNU for intracranial tumors.

112 patients with intracranial tumors treated with intracarotid BCNU to a cumulative dose of 370 mg/m2 body surface have been examined retrospectively for ocular complications. Average follow-up was 494 days (range 5 months-5 years). The rate of ocular complications was 2.7%. There was 1 case of hemorrhagic glaucoma with amaurosis and an accompanying oculomotor palsy, 1 case of retinal branch artery occlusion combined with third nerve paresis and 1 case of oculomotor palsy.

Adolescent↗
PubMed1987

Treatment of recurrent esthesioneuroblastoma with combined intra-arterial chemotherapy. A case report.

A 65 year old woman presented with a recurrent locally advanced esthesioneuroblastoma. She had earlier been treated with radiation followed by surgery. The recurrence was located in earlier radiated tissues with intracranial infiltration. She underwent treatment with combined intra-arterial chemotherapy (BCNU) i.a., vincristine i.v., procarbazine orally). 6 courses of chemotherapy were given with complete remission. The patient is free of disease and asymptomatic 24 months after treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Cerebral and cerebellar uptake of 99mTc-(d,1)-hexamethyl-propyleneamine oxime (HM-PAO) in patients with brain tumor studied by single photon emission computerized tomography.

The cerebral and cerebellar distribution of 99mTc-(d,1)-hexamethylpropyleneamine oxime (HM-PAO) was investigated by means of a rotating gamma camera in 12 patients with cerebral glioma. Using the corresponding contralateral region as control, reduced uptake of HM-PAO in the tumor region was demonstrated in 10 of the 12 patients. Reduced blood flow in a brain area remote from a circumscribed lesion reflects reduced activation following the interruption of afferent nervous pathways. Reduced HM-PAO uptake indicative of such diaschisis was demonstrated in the visual cortex contralateral to homonymous hemianopia in the two patients with this deficit. In the three patients with the most marked hemiparesis, the cerebellar hemisphere contralateral to the tumor showed significantly reduced HM-PAO uptake indicative of crossed cerebellar diaschisis. SPECT using commonly available gamma cameras and 99mTc-HM-PAO seems capable of depicting reduced flow in functionally inactivated brain areas, and may be clinically interesting as an alternative to more specialized techniques for the investigation of local cerebral blood flow.

Adult↗
PubMed1986

Radiation in combination with intra-arterial infusion therapy with dacarbazine for metastatic malignant melanoma localized to a lower extremity.

Fourteen patients with metastatic malignant melanoma localized to a lower extremity were treated with combined radiotherapy and intra-arterial infusion therapy with dacarbazine. All lesions that were included in radiation fields regressed completely. Two patients relapsed within radiation fields and six relapsed elsewhere. One patient had a serious intimal lesion caused by the catheter.

Aged↗
PubMed1985

Transthoracic fine-needle aspiration. Experience in a cancer center.

The authors summarize 5 years' experience with transthoracic fine-needle aspiration (TFNA) in 180 patients. Aspirated tumors tended to be large and peripheral. A large pneumothorax was seen after 4.3% of aspirations, and various minor complications followed another 23.3%. Emphysema was a significant risk factor for complications. Follow-up confirmed 151 cancers, with a wide variety of origins and histologic types. In the diagnosis of cancer, TFNA cytology had a specificity of 100% and a sensitivity of 82%. Positive TFNA findings usually provided the earliest microscopic diagnosis of cancer or of cancer stage.

Adolescent↗
PubMed1985

Intra-arterial infusion of mitomycin C in treatment of breast cancer: occurrence of skin necrosis in irradiated patients.

Eight previously irradiated breast cancer patients with local recurrences were treated with intra-arterial infusions of 8 mg/m2 mitomycin C given at 3-week intervals. The mean time interval between radiotherapy and intra-arterial chemotherapy was 38 months (range 2-60). In five cases a temporary reduction in tumour size was observed. However, in 3 of the 8 patients severe local pain, starting immediately after the third course of treatment, was followed 4 weeks later by the development of deep necrotic ulcers of the chest wall. These cases are reported here and discussed in relation to the results of previous studies.

Adult↗