National Cancer Data Base. A clinical assessment of patients with cancer.
Explore the source record for details and available documents.
Databases, Factual↗
Biomedical subjects
B J Kennedy
Publications and source records attributed to B J Kennedy.
Survival in Hodgkin's disease by stage and age.
Patterns of care for Hodgkin's disease in the United States were surveyed through voluntary audits of hospitals with cancer programs nonapproved and approved by the Cancer Commission of the American College of Surgeons. Four hundred and seventy-three hospitals reported 6,345 patients diagnosed immediately preceding December 31, 1975. The survival rates varied with age, being better at younger ages and worse in the elderly. By pathologic stage, the younger patients faired better than the elderly in each stage grouping. Histologic type was not a factor in this poor prognosis. Hodgkin's disease in elderly patients has a different biologic behavior than in younger patients.
Adolescent↗
Management of testicular seminoma following organ transplantation.
An increased incidence of malignancies has occurred in recipients of organ transplantation who are immunosuppressed. Although testicular cancers have been uncommon, seminomas are extremely rare. Two patients with long-standing diabetes mellitus and renal transplants developed clinical stage I seminoma of the testis. These patients posed a therapeutic problem with respect to the use of radiation therapy. In one, none was given because of a combination of kidney rejection and antibiotic-induced renal damage. The second patient received radiation therapy with shielding of the transplanted kidney. The surgical distortion of lymph node architecture increases the problems in the use of radiation therapy. Individual factors need to be considered in the use of postorchiectomy radiation therapy for seminoma in transplant patients.
Adult↗
Extragonadal abdominal germ cell cancers.
The charts of eleven patients with abdominal germ cell tumors were reviewed; one had a seminoma. They all had normal testes by physical examination. Therapy consisted of cisplatin-based chemotherapy and, in some cases, surgical debulking. A complete clinical response occurred in seven patients (63%). Two patients relapsed after achieving pathology complete responses and died of progressive disease despite second-line chemotherapy. All patients that failed to achieve a complete clinical response died of progressive disease. Five patients (45%) are long-term disease-free survivors, having no recurrence 4-10 years from the time of the diagnosis (median 6 years). The outcome for this group of patients did not differ significantly from that for patients with mediastinal germ cell tumors in this institution. They do not fare as well as patients with testicular cancer.
Adolescent↗
The evolution of hydroxyurea therapy in chronic myelogenous leukemia.
The evolution of hydroxyurea as a chemotherapeutic agent has been unique. Hydroxyurea inhibits synthesis of DNA, has antitumor activity, and is myelosuppressive. It has attained a significant role in the management of chronic myelogenous leukemia. A nonrandomized comparison of busulfan and hydroxyurea concluded that hydroxyurea was the preferable agent in the treatment of chronic myelogenous leukemia and was associated with less life-threatening toxicity. Because of its systemic effects, hydroxyurea is also used in the treatment of polycythemia and psoriasis.
Humans↗
Excessive test costs in clinical research protocols.
The escalation of health care costs has become an essential part of clinical research. Some clinical research protocols appear to require excessive laboratory testing. A review of an adjuvant breast cancer trial compared the costs of the required laboratory tests to those deemed "essential" to meet the goals of the study. A reduction of 59% in the laboratory tests over 6 1/2 years was accomplished. It is apparent that a significant reduction in cost can be accomplished. With such efforts, greater participation in clinical trials might occur. These observations are relevant in cancer education programs that involve patients on research protocols.
Breast Neoplasms↗
Needed: clinical trials for older patients.
Explore the source record for details and available documents.
Aged↗
Poor prognosis of mediastinal germ cell cancers containing sarcomatous components.
Fifteen patients with biopsy-proven mediastinal germ cell tumors treated with platinum-based chemotherapy were reviewed. They had a period of 4 to 6 weeks between the onset of symptoms and diagnosis. Four patients had sarcomatous elements in their tumor in association with common germ cell histologies. The sarcomatous components consisted of one angiosarcoma, one rhabdomyosarcoma, and two cases with mixed angiosarcoma and rhabdomyosarcoma. All patients with sarcomatous elements died; the median survival for these patients was 9 months. In contrast, six (54%) of the patients who did not have sarcomatous elements in their tumor are long-term disease-free survivors 5 to 8 years after diagnosis. The occurrence of sarcomatous elements in a mediastinal germ cell tumor is a poor prognostic sign, and therapy should be oriented to include drugs and regimens that may be effective against sarcoma.
Adolescent↗
Adjuvant systemic therapy.
Explore the source record for details and available documents.
Antineoplastic Combined Chemotherapy Protocols↗
Tumor marker kinetics in the monitoring of breast cancer.
Controversy exists in using carcinoembryonic antigen (CEA) for monitoring the clinical course of breast cancer. In this study, the kinetics of two plasma tumor markers, CEA and CA15-3, immediately after the initiation of chemotherapy were assessed in 30 patients with advanced breast cancer. Four distinct kinetic patterns were seen. Two patterns fitted the expected relationship where the plasma marker increased during tumor progression (nine patients), and declined in tumor regression (five patients). The third pattern was paradoxical in that objective tumor regression in eight patients was associated with an acute surge of these markers followed by a steady decline. The doubling times for both CEA and CA15-3 were immediately shortened four-fold after therapy suggesting tumor cytolysis in treatment responders. Equally paradoxical was the fourth pattern where tumor progression in eight patients was associated with a rapid and transient decline of markers followed by rebounds. Such a rapid decline may be due to a suppression of marker release, as demonstrated in an in vitro study. Adequate knowledge of these putative paradoxical patterns will permit their effective use in monitoring the disease course and perhaps in the early prediction of the therapeutic response.
Adult↗
Breast cancer staging and the "alert": an educational dilemma.
The reports of adjuvant chemotherapy of node-negative breast cancer have provoked controversy and confusion. Introduced by an "Alert" from the National Cancer Institute, the study was erroneously interpreted by the press, patients, and physicians to include all patients with Stage I breast cancer. In fact, the study excluded small cancers for which the receptor assay could not be done, excluded women over 70 years of age, and combined Stage I and II cancers. The analysis did not utilize the established staging system taught to students and physicians and sponsored in part by the NCI. This, and the willingness of physicians to follow such messages without review of the original data, is of concern to educators.
Antineoplastic Combined Chemotherapy Protocols↗
1987-1988 Medical Oncology training programs.
A continuing survey of Medical Oncology training programs was conducted. In 148 programs, there were 841 trainees. This was an increase in the number of trainees recorded in a 1984 survey (767), with a substantial increase in third-year trainees. Since trainees in combined oncology/hematology programs intend to take the Medical Oncology certifying examination, a continuing output of medical oncologists can be expected.
Certification↗
Up-regulation of estrogen receptors by nonsteroidal antiestrogens in human breast cancer.
Development of resistance to hormonal therapy in breast cancer is frequently associated with a decline or loss of cellular estrogen receptors. Agents which up-regulate the receptor may reduce the incidence of hormonal resistance. Antiestrogens at concentrations ranging from 0.1 to 1 microM produced a 2- to 4-fold increase of estrogen receptors in MCF-7 and T-47D breast cancer cells. This increase, which occurred as early as 3 h and was sustained throughout the 4 days of continuous exposure to tamoxifen, was primarily due to an enhancement in receptor synthesis.
Breast Neoplasms↗
Continuous infusion of recombinant interleukin-2 and lymphokine-activated killer cells in refractory malignancies.
Adoptive immunotherapy with recombinant interleukin-2 (rIL-2) and lymphokine-activated killer (LAK) cells has been reported to effect the regression of tumor in patients with a variety of malignancies. Responses have occurred in patients treated with high-dose bolus rIL2 as well as lower-dose continuous intravenous infusion. Ten patients who had been extensively pretreated with systemic chemotherapy with or without additional radiation therapy were treated with continuous infusion rIL2 and LAK cells. Five patients received rIL2 alone for 96-120 hours prior to leukapheresis in addition to rIL2 at the time of LAK cell infusion. Three patients received LAK cells that had been cultured for 14 days in an automated tissue culture system. No responses were seen in this ten-patient cohort. While the lack of response in these patients may be related to any one or more of several variables, patients who have been heavily pretreated may not respond as well as patients who have received little to no systemic chemotherapy.
Adult↗
Combination chemotherapy with etoposide and 5-fluorouracil in advanced pancreatic adenocarcinoma.
Pancreatic adenocarcinoma is the fifth leading cause of cancer deaths in the United States and the use of currently available combination chemotherapy has not been shown to definitely increase survival. Fourteen patients with histologically confirmed, unresectable or metastatic disease were treated with a combination of etoposide and 5-fluorouracil (5-FU). One patient had a complete response (CR), confirmed by second look laparotomy, that lasted for 30 months. No other responses were observed. While the long-lasting CR was encouraging, the overall response rate was no different from that reported with 5-FU alone.
Adenocarcinoma↗
Nephrotoxicity of continuous intravenous infusion of recombinant interleukin-2.
Adoptive immunotherapy with recombinant interleukin-2 has been complicated by significant nephrotoxicity of uncertain etiology. Creatinine clearance, effective renal plasma flow, plasma renin activity, aldosterone levels, and urinary prostaglandin excretion were evaluated in a 62-year-old man receiving continuous infusion recombinant interleukin-2. There was a marked decrease in the creatinine clearance and renal plasma flow, accompanied by an elevation in plasma renin activity and aldosterone level. Prostaglandin excretion also decreased, implying a direct effect on renal prostaglandin synthesis. The decrease in renal prostaglandin synthesis at a time of increased plasma renin activity may explain the reduction in renal function seen with recombinant interleukin-2 therapy.
Aldosterone↗
Standardized international cancer staging.
Explore the source record for details and available documents.
Humans↗